Foto: BB.LV / женщина
– Obesity and diabetes are serious diseases, the development of which is determined by a whole complex of interrelated factors. One of the most important risk factors for the development of type 2 diabetes is excess body weight. Controlling body weight, preventing obesity, and timely correction of excess weight can significantly reduce the risk of developing type 2 diabetes. Meanwhile, the number of people with diabetes worldwide continues to grow. The disease not only affects the quality of life but also increases the risk of developing a number of serious complications. To timely identify changes in health status, it is important to regularly monitor key indicators: blood glucose and cholesterol levels, blood pressure, body mass index, and overall body weight. Excess body weight and obesity are among the main risk factors for the development of type 2 diabetes. Losing 5–10% of body weight can help improve blood glucose control, lower blood pressure, and normalize cholesterol levels. ### What is diabetes? Diabetes is a chronic metabolic disease characterized by elevated blood glucose (sugar) levels. Without proper control, this can lead to various health disorders and the development of serious complications. Blood glucose levels depend on the timing of meals and other factors. To assess health status, it is important to consider measurements taken fasting, as well as individual recommendations from a doctor.  _Certified pharmacist at "Mēness aptieka" Yuta Namsone._ (!) The fasting blood glucose level in a healthy adult is typically between 3.5–5.5 mmol/L. In diabetes, blood glucose levels may exceed normal values, so it is important to regularly monitor this indicator. To understand the mechanism of the disease's development, it is necessary to know that the body's cells use glucose as an energy source. The hormone insulin plays an important role in its uptake into cells. If the body produces insufficient insulin or the cells lose sensitivity to its action, blood glucose levels rise. There are three main types of diabetes: 1. **Gestational diabetes** — an increase in blood glucose levels first detected during pregnancy. After the child is born, levels often normalize; however, the woman remains at an increased risk of developing type 2 diabetes later on. Therefore, it is necessary to undergo the recommended postnatal examination. 2. **Type 1 diabetes** develops as a result of an autoimmune reaction, in which the immune system destroys the beta cells of the pancreas that produce insulin. As a result, there is a significant deficiency of this hormone, so patients require constant insulin therapy. The most characteristic symptoms include frequent urination, dry mouth, intense thirst, and unexplained weight loss. 3. **Type 2 diabetes** is characterized by insulin resistance — a decreased sensitivity of the body's cells to insulin, as well as a gradual impairment of insulin production by the pancreatic beta cells. Various factors contribute to the development of the disease, including excess body weight and obesity, insufficient physical activity, and unbalanced nutrition. Genetic predisposition, age, and other individual characteristics also play a role. Symptoms may resemble those of type 1 diabetes; however, they are often less pronounced. Sometimes the disease progresses for a long time with few or no symptoms, which is why it is often detected only when complications develop or during preventive examinations. ### What are the dangers of diabetes? People with diabetes have a significantly higher risk of developing myocardial infarction and stroke compared to those without the disease. Additionally, circulatory disorders in the lower extremities and peripheral neuropathy — damage to peripheral nerves — may occur. These complications increase the likelihood of developing wounds that take a long time to heal, which can progress to ulcers and lead to the development of so-called diabetic foot. Diabetes can also lead to worsening vision and the development of diabetic retinopathy, chronic kidney disease, and kidney failure. In severe cases, circulatory disorders and tissue damage in the lower extremities can necessitate amputation. Moreover, the disease significantly increases the risk of cardiovascular complications, including heart failure. Diabetes complications can gradually lead to decreased work capacity, limitations in daily activities, and a significant deterioration in quality of life. This is why it is so important to control the disease and regularly undergo necessary examinations. ### How to reduce the risk of developing type 2 diabetes? The foundation for the prevention of type 2 diabetes and the reduction of related complications is a healthy lifestyle. First and foremost, it is recommended to limit the consumption of foods and drinks high in added sugars, increase the proportion of vegetables, fruits, and whole grains in the diet. It is also advisable to include fatty sea fish, lean meat, and low-fat dairy products in the menu. Quitting smoking is of particular importance. This habit increases the risk of developing not only type 2 diabetes but also cardiovascular diseases. Regular physical activity is equally important. It is recommended to engage in moderate physical activity for at least 30 minutes a day, choosing a suitable type of activity based on health status. It is also necessary to monitor body weight and strive to maintain it within healthy values. Even moderate weight loss can positively affect metabolic indicators and reduce the risk of disease development. ### How is diabetes treated? Diabetes treatment involves a comprehensive approach. It includes dietary correction, regular physical activity, monitoring blood glucose levels, and addressing risk factors, including excess body weight. Patients with diabetes need to regularly monitor their blood glucose levels and pay special attention to foot care. It is also important to regularly undergo ophthalmological examinations, including retinal examinations. This allows for the timely detection of changes in small blood vessels — signs of diabetic retinopathy — and to initiate treatment if necessary. It is essential to monitor cholesterol levels and regularly check kidney function. Such examinations help to timely detect possible disorders and take necessary measures. If a patient independently monitors their blood glucose levels, it is advisable to have a glucometer and necessary supplies at home — test strips and disposable lancets. If insulin therapy is prescribed, it is also necessary to have the appropriate medications and means for their administration. Medication treatment is tailored individually based on the type of diabetes, the patient's health status, and the recommendations of the attending physician. ### The pharmacist's assistance is important Most patients with diabetes know about the need to change their lifestyle, correctly take prescribed medications, and use medical devices. However, collaboration with a pharmacist also plays an important role in the successful management of the disease. Their task is to support the patient throughout the treatment process, help clarify the specifics of medication use, and provide recommendations for maintaining health. If the diagnosis of diabetes has been made recently, the first consultation with a pharmacist is especially important. The specialist will explain in detail how to properly use prescribed medications and medical devices, as well as what changes need to be made in daily life. The pharmacist will certainly remind that diabetes is not a contraindication to an active lifestyle. On the contrary, regular physical activity helps improve blood glucose control and positively affects overall health. It is equally important to monitor body weight and quit smoking. These measures help reduce the risk of cardiovascular complications and contribute to improving overall health. If necessary, the pharmacist will also discuss with the patient the specifics of daily nutrition. For example, they will remind that it is advisable to eat slowly and that the consumption of fruit juices, including freshly squeezed ones, should be limited, as they can cause a more rapid increase in blood glucose levels compared to whole fruits. Another important task of the pharmacist is to motivate the patient to pay close attention to their health and regularly undergo necessary examinations. The main goal is to prevent the development of complications or detect them at an early stage. To do this, it is necessary to regularly check vision, measure blood pressure, and monitor dental and foot health. Special attention should be paid to foot health and, if necessary, consult a podiatrist — a specialist in foot care and related issues. If the patient is prescribed insulin therapy, the pharmacist will recommend using a new needle for each injection. This helps reduce discomfort and the risk of tissue damage. The specialist will also remind about the correct technique for administering insulin and the need to alternate injection sites to avoid the formation of lumps in the subcutaneous fat. When self-measuring blood glucose levels using a glucometer, it is important to use a new disposable lancet for finger pricking each time. When dispensing medications, the pharmacist pays attention to their quantity, dosages, and the specifics of the prescribed therapy. If the patient is taking five or more medications simultaneously (a condition known as polypharmacy), it is especially important to consider possible drug interactions. Some combinations of medications can increase the risk of hypoglycemia — a condition in which blood glucose levels become too low. Therefore, the pharmacist should warn the patient about possible risks and the specifics of the combined use of medications. I encourage all patients with diabetes not to hesitate to seek help from a pharmacist and ask any questions related to the use of medications for diabetes treatment and other diseases, as well as to prevention and health maintenance.
