Glucose (sugar) is essential to life. Diabetes is an abnormal and uncontrolled rise of the blood glucose level, or “sugar diabetes”. This is due to alterations in insulin production or lack of effectiveness in the production of insulin.
Insulin is a hormone produced by the pancreas which allows the absorption of sugar by the blood cells, essential in the supply of energy to the body.
Diabetes may occur at any age but is more common in adults, especially if they are overweight. This type of diabetes is treated through lifestyle changes, medication and/or insulin.
The warning signs are: tiredness, weight-loss, wounds that do not heal, sexual problems, excessive thirst, blurred vision and constant hunger.
This disease affects the entire body. The risk of chronic complications increases when the blood sugar level remains high for a long period of time. This is especially the case as far as the eyes, kidneys, feet and heart are concerned.
Diabetes affects over 382 million people worldwide (8.3% of the world population).
In Portugal in 2013, the disease reached 12.9% of the population between the ages of 20 and 79 (7.8 million people). Of these, 56% have been diagnosed and are receiving treatment. The disease is silently progressing in the remainder undiagnosed individuals. It is estimated that 100,000 diabetics reside in the Algarve alone.
In an effort to adapt the necessary medical care to the needs of this group of individuals, Hospital Particular do Algarve has developed a specialist consultation in Diabetology, involving a multidisciplinary team of professionals whose mission is to control the disease, while minimising complications which may arise both in the long and short term.
Their duties consist of several aspects, including information on the various types of medication available, blood glucose monitoring, correct diet, exercise, individual therapy, and screening for related complications.
Type 1 Diabetes
Also known as Insulin Dependent Diabetes, it is rare and primarily affects children and young people, although it can also appear in adults and even the elderly. The cause of this type of diabetes is a total lack of insulin associated with an almost total destruction of the protective cells of insulin due to an immunological attack. It is not associated with lifestyle or diet. People with this type of diabetes may lead a healthy lifestyle with no major limitations if they comply with the treatment, which must include insulin, appropriate diet, exercise and daily self-monitoring and control.
Type 2 Diabetes
This type of diabetes was previously known as non-insulin dependent diabetes. It appears in adulthood in people who have inherited a predisposition for diabetes. It is also due to environmental factors which include lifestyle and habits (high calorie diet, sedentary lifestyle and stress). People with Type 2 Diabetes often become insulin-resistant (leading to higher insulin requirements). One of the factors that leads to this dysfunction is being overweight, especially having excessive abdominal fat.
Hyperbaric Medicine in the treatment of diabetic ulcers
Diabetic foot is probably one of the chronic complications of diabetes, resistant to prevention and to multidisciplinary treatment. This is as a result of three factors that together lead to lesions/ulcers, neuropathy (decreased sensitivity), peripheral vascular disease (reduced blood flow) and infection. Although infection due to mycoses or fissures is often a consequence of complications resulting from the former two. Fissures occur due to decreased sweating which causes dry skin and due to a substantial decrease in sensitivity. Sores or wounds appear which then get progressively worse. Diabetic Foot is responsible for the majority of lower limb amputations and also for prolonged hospital admissions.
Hyperbaric oxygen therapy is a therapeutic option that has shown very positive results in this specific situation. The number of sessions necessary varies. Normally one to two sessions a day, five to seven times a week are necessary.
By Dr Andreia Cruz
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Dr Andreia Cruz is a specialist in Internal Medicine working at the HPA Health Group.
