Currently, diabetes diagnosis delays 5 years on average in Mexico. When drugs used in a first instance are not able to control the disease, it commonly takes another 5 years for patients to be prescribed insulin. However, if the person’s glycated hemoglobin is greater than seven percent, the treatment may be inadequate and it is time to change.
A diabetic person’s treatment should be dynamic and not remain the same for five years. For this reason, it has to be evaluated every six months, checking that glucose goals are achieved. Glycosylated hemoglobin test is the way to know when is necessary to adjust the treatment, said endocrinologist Mariana Mercado García, Medical Manager at Novo Nordisk.
This test main function is to determine whether a patient really is well controlled and the current treatment is effective. When the result is less than seven percent, it means that there is an optimal level of blood glucose, both at fasting and after eating.
However, in the absence of medical continuity there is no evaluation, so that treatment is not adapted. For example, oral medications are used for a while, but the beta cells of the body continue to be destroyed as the disease progresses, independently of what the patient does.
In this regard, she said that to avoid complications implicating several organs as a result of high blood sugar levels, it is necessary to add insulin to patients’ medication. After 5 years, antidiabetic drugs gradually lose effectiveness and are not enough to control patient’s glucose levels, and it is advisable to add insulin.
The problem is that medical checkups are spaced, approximately every six months. If there is a rise in glycated hemoglobin and insulin use is delayed, this will be reflected in years of life lost and development of complications — such as visual or chronic renal failure — as a result of not acting on time.
Moreover patients commonly have a distorted perception of the meaning of adding insulin, as they think that it means a severe progression of diabetes. If a person needs this hormone, it does not mean there is a severe advancement of the disease. It means that the disease has more years of evolution and is more difficult to achieve goals without the help of insulin, said the specialist.
International treatment guidelines indicate that people diagnosed with diabetes must change lifestyle, diet, exercise levels and use metformin. After that, it will depend on whether the patient is controlled, otherwise, it is imperative add another drug or insulin.
This is because the disease is chronic and degenerative, the pancreas produces less insulin gradually and the body needs more help from medication. It is not possible to stop the deterioration of beta cell function, so it is required modifying treatment depending on glycosylated hemoglobin.
Source: Agencia ID
