TREATMENT OF TYPE I DIABETES

Little can be added to what is already of public domain: diabetes mellitus is a problem of public health, which affects an enormous number of persons, and whose complications have a devastating effect on the health of the affected persons.

The same way, it is very well-known that there exist basically 2 types of diabetes, known as type I and type II.

In the diabetes type I, the beta cells of the pancreas, the only place where it is possible to produce insulin, have been damaged in a serious and irreversible form. As today, the only effective remedy is the replacement therapy with insulin. The future, no yet written so we cannot forecast which the solution will be able to come, but transplantation of pancreatic beta cells or the production of mother cells (stem cells) able of synthesizing insulin are two possibilities at which the medical science is employed with intensity.

It is not known with accuracy the cause of the damage of the beta cells of the pancreas, although there are several hypotheses: autoimmune damage, damage from virus, damage for environmental toxins, etc. Due that there is not a clear causes, it is a situation difficult to prevent.

The handling of the type I diabetes is not easy at all. It should be directed by a Medical Doctor Specialist in this disorder, in general an Endocrinologist. So much the under-dosificación (risk of cetoacidotic comma), as the over-dosificación of the insulin (hipoglucemic coma) both they can put in risk the life of the patient.

On the other hand, and it is easy to understand, is not the same the control that the organism does of the production and secretion of insulin, fitting and adjusting continuously to the needs in different situations (fasting, ingestion, exercise, etc), which to put the insulin to a “fixed dose”.

The wide diffusion and facility of use of the devices used to measure the capillary glycemia have allowed to emulate more the physiological situations. These persons they can measure the glycemia 4-6 – and up to 8 times a day and fit its needs for insulin, simulating better the way of working of our organism.

MEDIDOR DE GLUCOSA

The diagnosis of type I diabetes, in general in a young person, often in the pediatric age, is a shock for the families. From this very moment, the child or the girl will not be as normal persons. They will not be able to eat what they want. They will have to be dependent on its levels of glucose (sugar), on the doses and moments to injet the insulin themselves. Of being very attentive to their symptoms. They will be very different from the rest of the children of their age. In the adolescence there are frequent the rises of rebelliousness and the abandonment of the discipline, in the diet or in the medication and the visits to Emergencies of the Hospitals for cetoacidotic coma. It is not easy, neither for the patient nor for the family, to live through these situations.

Presently, the treatment with insulin is absolutely necessary. If the organism does not produce insulin it does not stay any more remedies that the substitute therapy with insulin. Since it is known that the risk of vascular damage, the most important damage that takes place in this type of diabetes, correlates with the high levels of the glycemia, all the efforts of the treatment are directed to control the glycemia. The different presentations of this hormone, of rapid, intermediate, retarded, prolonged action, etc, the bombs of insulin, the meters of the capillary glycemia, the availability of teams of education and of specialized units, all have facilitated very much this target, which even, nowadays is far from be reached.

The adequacy of the diet and the programs of exercise is another important part of the treatment, of paramount importance, in addition to the insulin.

Other remedies, like the medicines, the mineral and vitamin supplements, the omega supplements 3, the fythoterapics, the homeopathy, the energy therapies, the manual therapies, etc, etc, can only play a secondary role in the handling of this devastating illness.

Joaquín Muñiz Girón, MD.