Diabetes mellitus — a life with overcoming

Diabetes mellitus - a life with overcoming.  Photo from www.romanialibera.ro

Is it possible to live a full life with diabetes? You can, if you are very good for a watch: time to eat properly inject insulin, select adequate dose to control your blood sugar, etc. The fact that this life is more difficult than the average person — by far. This is life with overcoming. So says Valentina Peterkova, chief pediatric endocrinologist RF, director of the Institute of Pediatric Endocrinology of Medical Sciences, Professor, MD, chairman of the public organization "Russian Diabetes Association."

— Valentina, tell us how common diabetes in Russia, and what is the trend growth of morbidity?

Average incidence have the same as in Europe. There is a first type of diabetes — insulin. Such patients, we have a year to about 300 million adults, 16 million children and adolescents 8 thousand. These people can not live without insulin injections, without them, they will die. Type II diabetes is treated easier — diet and oral agents. Such patients have registered about 2 million people.

Diabetes mellitus - a life with overcoming

Valentina Peterkova

— So Much?

Yes, so much — an average of about 3% of the population. And in the older age groups (over 60 years), this figure had already reached 15-18%. Recently, together with Sanofi-Aventis in the framework of the action on the provision of assistance to vulnerable sections of the population, we conducted a survey in a nursing home, where the median was 18.8%, and among those over 80 years old — 28%. And people often do not know they are sick, can not ignore diabetes for a long time until the check blood sugar.

— A youth?

The young second type of diabetes is rare among them is so massive study does not make much sense. But first, a heavy type of diabetes is more common, especially in children. Unfortunately, the medical institution, such patients often come already in a coma, that is, the disease is not detected in the early stages. Baby gets up at night to drink — no one pays attention. And then, when it starts to vomit, he had a sore stomach — call the doctor. Well, if the doctor detects a disease, and the child is admitted to the endocrinology department, but the fact is that diagnose appendicitis or an infection. So we pay special attention to the education of the population.

— What terrible diabetes?

Person who got the disease need for a carefully follow a diet, constantly monitor blood sugar levels in a timely manner to introduce or take prescribed medications. Otherwise, you can quickly die. Already 10-20years formed the complications that are irreversible. Affects the blood vessels, and then the man dies at a fairly young age.

By the way, have diabetes, there is such a feature. Many patients think that they drink pills and they are fine. In fact, when they take on the analysis of glycated hemoglobin or check if there are any complications, it turns out that they are not so well compensated.

— That is the case that a person feels fine, and in fact …

Most often happens that way. Care should be taken behind the eyes, for the kidneys, check out the other organs. When people go blind — it's too late.

— What are the early symptoms of diabetes? What should alert the patient and his family?

Thirst, and weight loss. If a person starts to drink a lot, losing weight often gets up at night to urinate, it will need to check your blood sugar levels. When it's hot, people always drink a lot, but the power of urination is not happening. For example, the water in the hot shops at every turn, and the toilets are not so much — everything comes out through the skin with sweat. A diabetic patient is not only a lot of drinks, but also very often urinates. Therefore, if a child or teenager had never got up at night, and then suddenly started to wake uptwo or three times — have a drink, then the toilet — this should alarm the parents.

— What risks are there? For example, professional?

Occupational risk factors do not. The main risk factor for diabetes — heredity. If someone in the family was already suffering from this disease, Type II diabetes is more likely. And, of course, obesity. With obesity diabetes of the second type is more common.

— What is primary and what is secondary? Obesity causes diabetes mellitus or obesity provokes?

They are somewhat parallel. First develop obesity and diabetes later. It is likely that those who are prone to diabetes, appetite increased by nature, they like sweet, flour. They present metabolic disorders: the so-called metabolic syndrome, increased insulin secretion and other

— What are the traditional ways to treat diabetes?

In diabetes, the first type is required to inject insulin. The second type of diabetes is treated with diet alone before and tablet formulations, now when it is also widely used combination of insulin and oral agents. Older people sometimes enough just to follow a diet.

— Why are people afraid to go to insulin pills?

The causes psychological. Humanly this fear is understandable. Come to any healthy person and say, you may be treated with pills and injections can be daily, what do you choose? Of course, people will choose the pills because regular injections cause fear. It hurts, you should always carry a syringe, you need to do it on a regular basis, regardless of where the atmosphere in which you are now. And sometimes the fear of ignorance, saying that if you really sat down on the needle, then you have no prospects.

— But it is not?

Of course not. Just people, especially, 40-50 years old, who lead an active life, of course, better compensated by the introduction of insulin, rather than receiving oral agents. The doctor never aims to impose a particular patient is a method of treatment. He seeks to find treatment in which blood sugar would be normal. And to achieve this insulin easier than with tablets. But if a good result is obtained only on a diet — no one will assign any pills, if it turns to diet pills — do not appoint insulin. Oh, and if it turns out otherwise, then — insulin. And do not be afraid of it. Besides, now we do not treat those drugs that 15-20years ago.

— Please tell us more about modern methods of treatment of diabetes.

First insulins prepared from animal organs, for example, cows and pigs. They were used when I first started working, and another twenty years I only assign patients these drugs. Meanwhile, the more we learn, was opened genetic engineering technology to obtain human insulin. Its a very long fine-tuned, and then, finally, in 1984-85. these insulins have appeared in the arsenal of medical practitioners. It was a revolution: First, human insulin — this is not pork or bullish, for the person he is "native" and a much better absorbed. Secondly, manufacture of such insulin can be any number, any deficit will not. Third, these insulins, of course, cleaner, because the extract of animal organs is difficult to clean. It was a giant step forward, another century. Human insulin, we used 15 years.

But all these years pharmacology did not stand still, new drugs have been developed, the next generation. Now is the age of the insulin analogs. They're keeping all the advantages of human insulin, have other great qualities: are more evenly can reduce patients' dependency on regular meals, faster and better pick up the individual dose for each patient. And there is a long-acting analogues. These drugs act without the peak and provides a smooth profile of insulin in the blood. There are domestic and insulin, but insulin is the second generation of modern drugs, they lag behind considerably.

— In the West insulin analogues are used more widely than in Russia? If so, why?

They're just more expensive. According to security insulin we do not lag behind other developed countries. New drugs come to us sometimes a little later, but not much later, perhaps in theyear or two.

— How much more? Disease-a ruthless and not mercy, neither children nor adults, regardless of wealth …

Yes, the treatment of diabetes is expensive. State of insulin diabetics provides for free. Always has been, and always will be, I hope. But the means of self — test strips to measure the level of sugar in the blood — the patient has to buy their own, and it is quite noticeable, to spend 2-3 thousand rubles. month. Obviously, in diabetes patients and their families should know clearly what they can and can not be …

"Education" in these patients is time consuming. For them, there are special schools. Such schools, and children and adults are available in all cities. But we would like more: to have special programs on television, "hot phone", in which the patient could at any time to ask a question. Often, the doctor only 15 minutes to receive a patient — of course, he can not tell it all at once.

By the way for the past year working Optiline free hot line for patients with diabetes mellitus, where you can get daily telephone advice of qualified professionals for the effective treatment of diabetes and use a syringe pens. Hotline sponsored by the company Sanofi-aventis, one of the manufacturers of insulin analogues.

— A law on additional drug supply somehow touched the lives of your patients?

After its entry into force, it has become the best I can say it definitely is. The law provides for the free provision of all diabetes insulin, as well as with oral antidiabetic drugs. The only thing in the law, I believe, conceded the situation about the test strips for blood sugar control. But soon, as promised, will be accepted addition to the law, where the gap will be eliminated.

— So what to do? How to help people with diabetes?

I think the way out is that all of us, the people, must unite and help, those who need help. Here's an example: for the blind — people with diabetes have a special sound meter. The device is good, but expensive. As part of the All-Russian public organization of invalids "Russian Diabetes Association," we now collect money from sponsors to purchase them.

— Please tell us more about the work of the Russian Diabetes Association.

All-Russian public organization of disabled people, "Russian Diabetes Association" is now 16 years old. It brings together 56 regional organizations. Each in its own way fights for the provision of all necessary diabetes, is trying to help those hardest. Any person who is diagnosed "diabetes" may apply to the association and to find support there. At the federal level, we are conducting a meaningful dialogue with the Government, other government structures. And not without success. In the end, diabetics were one of the few segments of the population, which even won a few of the notorious Law number 122.

— You refer to the experience of foreign colleagues?

There is the International Diabetes Federation (International Diabetic Federation, IDF), — is a worldwide organization for both health care professionals and people with diabetes. There includes doctors, pharmacists, and the company — manufacturers of products for diabetics, and patients' families, and just good people who help to live with diabetes.

IDF was founded in 1923 in Amsterdam. It currently includes 172 unions in 132 countries. Our Russian Association of IDF is the 16 years of its existence, we enter into the European regional structure. The main objectives are the development of IDF in diabetes research, the use of new methods of treatment and diagnosis of this disease, and as a result — improved quality of life for patients.

How relevant is the issue around the world, says at least the following fact: IDF has recently appealed to the UN with a special letter with a request to draw the attention of governments of all countries to the problem of diabetes.

Our information

Currently in the world there are 175 million registered patients with diabetes. According to the forecasts in 2025 they will have 337 million

Thus, it is necessary to consider that because of hidden until that time, the nature of the disease, lack of access to diagnostics of the total number of patients exceeds the official figures of 1,5-2times.

— And the last question. If it turns out that the child is ill with diabetes. What do you say to his parents?

What am I saying? That this is not the worst disease. There are diseases such as malignant tumor in which doctors give chance, but do not guarantee survival. A diabetes — a disease in which the doctor gives a guarantee that the child will be able to survive, to live and to live a full life. But if the parents first, and then the patient will be in good faith and actively assist the doctor. Among children with diabetes, the majority of higher education degrees. Many people actually become physicians.

— Medics?

And why are you surprised? Sick people often want to help others — this is normal. And then he and his childhood used to make a lot of effort to achieve the. Again, a person suffering from diabetes can and should live a normal, active and fulfilling life. But that's life with overcoming.

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