Psychological and sexual problems in diabetes

Psychological and sexual problems in diabetes.  Photo from http://creative.gettyimages.com

The fact that diabetes— A disease that is characterized by a high content of sugar in the blood, they know almost everything. As that diabetes treatment involved Endocrinologists, and the treatment itself comprises assays for glucose (blood glucose) and the control of this parameter with diets tablets reducing sugar and, finally, injection of insulin.

However, modern doctors believe that substantial aid diabetics can have and others — in particular, psychologists and andrology. As for themselves endokrinogolov-diabetologists, they can significantly improve the results of their work, if they establish with patients more friendly relations.

Psychological problems

If the overall depressive disorders suffer 5-10 % Of the population, among patients with diabetes, the figure is 33%. Thus, the prevalence of depression in diabetes exceeds its prevalence in coronary artery disease as well as cancer and skin diseases.

The studies also found that most people with diabetes suffer from depression nozogennyh (a complex of negative thoughts associated with the disease itself).

  • In the case of Type 2 diabetes is common and dysthymia — a protracted depression, which is characterized by low mood is not so much how much somatic-vegetative like symptoms some other diseases.
  • Diabetics type 1 dysthymia does not happen — but they have a "popular" cyclothymia (regular alternation of states with the decadent state of high spirits and vitality).

The researchers point out that the last two types of depression are similar in origin to the respective types of diabetes. Cyclothymia is more common in adolescence and is associated with a genetic predisposition (as diabetes 1 type). Dysthymia is associated with the negative impact of the environment, and it usually occurs in adulthood (as diabetes 2 type).

It is quite natural that depression does not help to be treated for diabetes. What would have been the correct doctors' recommendations, they will not give the desired effect compensation — as it is also determined by the behavior of patients. Among all chronic diseases diabetes is the most complex in the number of medical procedures to be carried out independently: this diet, and physical activity, and blood glucose control and insulin therapy, and much more. In order to do it all, the patient need not only time and money, but also a large dose of enthusiasm.

At the same time, patients who differ negative view of themselves and their future in three times more likely not to follow the doctor. As a consequence, depressed diabetics are always worse glycemic control, higher incidence of complications, higher mortality rates and other health and social indicators (disability, length of stay, etc.).

What are the reasons for the lack of dealing with depression? Here are guilty and patients (afraid to go to a psychiatrist) and physicians (traditionally diabetologists do not consider psychological problems "their"). Meanwhile, the struggle with mild depression or depression of moderate severity — the competence of endocrinologists. Especially when you consider that they lead their patients for decades, so they have more opportunities to treat patients "as individuals." And to determine the symptoms of depression are not required to carry out complex psychological tests. Enough to ask the patient, not whether he has reduced the mood for a long time, and if he has not lost interest in what was once gave him pleasure?

According to the doctors, I can even make a psychological profile of the person who can successfully achieve compensation for diabetes. These are people who are prone to self-discipline, as well as having good learning disabilities. However, only a quarter of people with diabetes has such features. With the rest of the same need more serious work and personal approach in terms of therapy.

Erection problems in diabetes

Erectile dysfunction — one of the most common complications of diabetes. However, patients are often embarrassed to seek medical help and suffer in silence, torturing themselves and their partners.

Meanwhile, erectile dysfunction (ED) is fraught with problems, not only with sex. In particular, the ED is often the first manifestation of atherosclerosis. 57% of men who underwent aorto-coronary bypass surgery, and 64% of hospitalized myocardial infarction, before suffering erectile dysfunction.

The share of people with diabetes account for 40% of all cases of ED. And if the other men with erection problems usually begin after 40 years, diabetics — already 25. And in this age of erectile dysfunction can lead to serious psychological problems. And without solving them, can hardly be effectively fight diabetes.

Until recently there was no effective means for the treatment of ED. The doctors could offer patients a mechanical device (LOD-aids) and intracavernosal injection. It was only in 1998, with the advent of "Viagra" in a new era of Andrology. In 2002 there was a second drug — "Cialis", and in2003— "Levitra". On the effectiveness of anti-ED, they are about the same, except that the "Cialis" half-life of 17 hours (that is, it is held in the body longer).

However, the use of these agents in patients with diabetes gives a lower efficiency than the other male — 68%. The fact that these drugs modulate the natural erection for their actions, you must have sex drive. And people suffering from obesity or type 2 diabetes, it can be reduced. So for them a "Cialis" is not enough: we need combination therapy of male sex hormones (androgens). In this case, the probability of reduction reaches 80% erection.

Doctor-patient relationship

Patients with diabetes prescribed by a fairly complex set of procedures to control blood sugar, blood fat, blood pressure. Unfortunately, no more than 20% of diabetics can hold all of these parameters are normal. Through 9-10 years in most patients the disease progresses.

A role in these failures play attitude of doctors and patients. Endocrinologists, sufficient knowledge of the theoretical basis, much worse versed in practical matters — when to start insulin therapy to teach patients how to self-control techniques, etc. Patients, in turn, do not consider health a top priority (62%) or simply do not know the target values of the parameters that they need to control (80%). A communication by the organization of patients and physicians in the current health care system only adds to the mutual dislike. Disgruntled doctors intimidate patients insulin therapy, and disgruntled patients fail to fulfill the recommendations of doctors.

Removing these barriers made possible by the establishment of more friendly and partnership relations between doctors and patients. It is known fact that the friendly attitude of the doctor allows almost 20% increase in the number of patients achieving compensation.

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