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Diabetes is a chronic disease that can’t be cured, but it can be treated. Diabetes develops when the body can’t properly use glucose, a sugar that is an essential fuel for our bodies to function. To enter the cells, glucose needs a hormone produced by the pancreas called insulin. In people with diabetes, their bodies either don't produce enough insulin or the insulin they do produce is used poorly. Glucose then builds up in the blood, which leads to increased blood sugar levels (hyperglycemia).
Over time, high blood glucose causes irreversible complications for the eyes, kidneys, nerves, heart and blood vessels.
Diabetes has become a public health issue and affects a growing number of people. Today, over 830,000 Quebeckers, or more than 10% of the population, live with this chronic disease (Diabetes Québec, 2014). If you don't have diabetes, you likely know someone who does.
Although heredity plays a role, the increase in diabetes is associated with diet and lifestyle, such as too many refined sugars and saturated fats and meat, a lack of dietary fibre, excess weight, and a lack of physical activity. The more a given population has these characteristics, the greater the prevalence of diabetes.
There are three main types of diabetes: type 1, type 2, and gestational diabetes.
Also known as “insulin-dependent diabetes” or “juvenile diabetes,” this type appears during childhood, adolescence or early adulthood and rarely in older adults. About 10% of people with diabetes have this type. It is characterized by a total lack of insulin production. People with type 1 diabetes need daily insulin injections or an insulin pump to survive.
Often called “non-insulin-dependent diabetes” or “adult-onset diabetes,” type 2 diabetes is the most common form (90% of cases). It generally develops in adulthood in people aged 40 and over. Unfortunately, there has been a growing trend in recent years of people getting type 2 diabetes at a younger and younger age. In some at-risk populations, type 2 diabetes can even appear in children.
For some type 2 diabetics, the cells of the pancreas don't produce enough insulin. In For others, the insulin that the body does manage to produce can't carry out its role, a condition called “insulin resistance.” In both cases, the result is increased blood sugar levels because the body doesn't properly use glucose as a source of energy.
Also called “pregnancy diabetes,” this type of diabetes affects about 4% of pregnant women in Canada. Blood glucose levels increase toward the end of the 2nd trimester or during the 3rd trimester of pregnancy. This affects both the baby and the mother. In 90% of cases, gestational diabetes disappears after childbirth, but the mother becomes more at risk of developing type 2 diabetes later in life.
Most pregnant women who suffer from gestational diabetes do not have symptoms. That is why a screening test is recommended between week 24 and week 28 of pregnancy.
Every day, we make choices that affect our health. Adopting a healthy lifestyle is the key to prevention. Making healthy habits part of your daily routine can prevent or delay the onset of type 2 diabetes and its complications:
The causes of diabetes are more complex than simply having too much sugar in your diet. Eating sweets doesn't automatically cause diabetes. However, regularly eating sweets can lead to weight gain, which is a major risk factor of type 2 diabetes.
The symptoms of type 1 and type 2 diabetes are basically the same and include:
In type 2 diabetes, symptoms may go unnoticed for a long time, but the disease will continue to develop and cause damage that can be irreversible.
In people with diabetes, a loss of sensitivity and circulation problems increase the risk of wounds that are slow to heal.
Diabetics also have an increased risk of infection. These different factors slow down their wound healing, and infectious processes can even lead to amputation.
People with diabetes can experience decreased—if not a complete loss of—sensitivity in the feet. Since they don’t feel the pain that usually signals injury to the body, a small cut can easily turn into a chronic wound that is difficult to treat.
A few basic tips:
The goal of treating diabetes is mainly to normalize glycemia (the amount of sugar in the blood, or blood glucose). Diabetes treatment has 4 components:
Research on drug treatment for diabetes is constantly evolving, and advances are made every year.
Checking your blood glucose will help determine how well you are controlling your diabetes. Blood glucose monitoring is also an excellent way to adjust your medication doses and schedule so that you can keep your glycemia within the target values:
|Target values||Optimal values
|Fasting glycemia and glycemia before meals
||Between 4.0 and 7.0 mmol/L
||Between 4.0 and 6.0 mmol/L
|Glycemia 2 hrs after meals
||Between 5.0 and 10.0 mmol/L
||Between 5.0 and 8.0 mmol/L
How to check your blood glucose
Blood glucose is measured with a small portable device called a “blood glucose meter” or “blood glucose monitor.” Your pharmacist can advise you on these different devices and how to use them.
Using a lancing device, you draw a drop of blood from the tip of your finger for analysis with the blood glucose meter. In a few seconds, the reader displays your blood sugar level.
How often you check your blood glucose every day will be established by your doctor and treating team depending on your condition:
Many blood glucose meters are now available, and you'll definitely find one that suits you. Before choosing one, take the time to go over the features, compare each one based on your needs, and talk to your pharmacist. New types of blood glucose meters are constantly being released on the market to meet new technological standards.
Think about ease of handling, display number size, and how easy it will be to carry the device around with you.
Are the strips easy to get out of the packaging and to handle or do they require too much dexterity? Can you easily apply your blood to the strip?
Do you have trouble using it, inserting the lancets (needles), and removing them?
Some blood glucose meters require calibration. Make sure that the calibration step is easy to perform. You can also choose a meter that automatically calibrates with no additional steps, if this is easier for you.
Check how quickly the test is done and the device’s available memory. Also check whether you can upload your results to a computer, if this is something you would like to do. However, note that all devices on the market have good performance. You can simply choose one based on your specific criteria.
What type of batteries does the meter take? Are replacement batteries easy to find?
All blood glucose meters are very accurate, but you need to carefully read the instructions.
Ask about after-sales service in case you have a problem with your device.
Controlling diabetes isn’t a choice but rather essential so that you can enjoy life to the fullest. Don’t forget that a healthy diet and regular exercise are just as important as taking medication when it comes to your treatment. Don’t hesitate to talk to your health care professionals for advice and ask them any questions you may have.
The pharmacy services presented in this section are offered by pharmacist owners who are affiliated with PROXIM. The pharmacists are solely responsible for the professional activities carried out during the practice of pharmacy.
The information contained herein is provided for informational purposes only and is not intended to provide complete information on the subject matter or to replace the advice of a health professional. This information does not constitute medical consultation, diagnosis or opinion and should not be interpreted as such. Please consult your health care provider if you have any questions about your health, medications or treatment.