Diabetes mellitus
Overview
Diabetes mellitus (DM) is a group of disorders that affect how your body uses blood sugar (glucose). As a result of diabetes, your blood glucose levels rise and are uncontrolled, which can lead to serious health problems.
According to the World Health Organization, by 2022, there will be more than 422 million people with diabetes globally. It is estimated that in Greece, 9.1% of the population suffers from diabetes. Diabetes is directly linked to the so-called Western lifestyle, which includes residing in large urban areas, eating an unhealthy diet, and living a sedentary lifestyle. It is one of the leading causes of death worldwide.
The main cause of diabetes varies by type. These are classified as:
- Type 1 DM
5-10% of people with DM have DM1. It is attributed to the autoimmune destruction of the pancreatic beta cells, and usually leads to a near complete lack of insulin. DM1 has a prevalence that varies widely between countries. In Greece roughly 9.7 per 100,000 people are diagnosed each year. It can appear at any age, but mostly in childhood and adolescence.
- Type 2 DM
It is due to an impairment in the way the body secretes insulin via the pancreatic beta cells, which are required to meet metabolic needs. DM2 affects more than 90% of people with DM.
- OTHER SPECIFIC TYPES OF DIABETES
- GESTATIONAL DIABETES
Diagnosis
DM is diagnosed through different blood cells (following specific requirements), including:
- Fasting plasma glucose ≥126mg/dL
- 2-hour plasma glucose (at 75g glucose loading test) ≥200mg/dL
- Random plasma glucose measurement ≥200mg/dL in a person with typical symptoms of hyperglycemia or a hyperglycemic crisis
- HbA1c ≥6,5%
We recommend regular screenings for people who are at a higher risk of developing DM. The people who have higher risk factors include:
- People who are overweight or obese (BMI ≥25 kg/m2) and have at least one of the following factors:
- A 1st degree family history of DM (parents, siblings, children)
- History of hypertension or cardiovascular disease
- History of dyslipidemia (triglycerides >250mg/dL, HDL <35mg/dL)
- Women with polycystic ovary syndrome
- Conditions associated with insulin resistance
- History of prediabetes
- History of gestational DM
- HIV infection
Additionally, we recommend screenings for the whole population over the age of 35.
If the results of screening are normal, they should be repeated at least every 3 years, with more frequent screening depending on initial findings and risk factors.
Treatment
Treatment for DM involves regulating and maintaining glycemic targets. Lifestyle modification (diet and exercise) is an essential component of any hyperglycemia management program.
Management of hyperglycemia generally involves medication and specifically the oral administration of metformin. Other orally given antidiabetic drugs include glitazones, sulfonylureas, DPP-4 inhibitors, GLP-1 agonists and SGLT2 inhibitors. Insulin is added to oral treatment regimens when the therapeutic goal is not achieved with the oral medications, and it is not possible to initiate GLP-1. Each insulin management program is personalized for each person with DM, and depends on how dysregulated their system is, and on their general condition.
Why GMI
The GMI Diabetes Clinic specializes in diagnosing and treating various forms of diabetes and its complications. Patients with type 1, type 2 diabetes mellitus, gestational diabetes, patients with insulin pumps and patients with diabetic foot problems are treated following the latest international and European guidelines.
At the GMI, we see our patients holistically. At our Diabetes Clinic, we also treat patients with common comorbid disorders such with arterial hypertension, dyslipidemia, obesity, hyperuricemia. We offer both the best possible treatment and regular monitoring to patients with these disorders.
