The specialist notes that the goal should always be to prevent comorbidities from endangering the patient’s life.
Dr. Leticia Hernandez, president of the Puerto Rican Society of Endocrinology and Diabetes. Photo: Journal of Medicine and Public Health. Fabiola Plaza.
Because of the high incidence of infection diabetic in Puerto Rico Dr. Leticia Hernandez DavilaAnd the President of the Puerto Rican Society of Endocrinology And Diabetes Science (SPED) exclusively to the Journal of Medicine and Public Health, the goals a patient should always have in order to control their blood glucose levels.
Primarily, the specialist noted that all diabetics should understand that the basis of treatment is always lifestyle changes, and that “this should be something that should start from our childhood and be a habit. Those people who have not started it or have a prior diagnosis diabeticThey should make some lifestyle changes, starting with maintaining a healthy diet and getting physical exercise, “whether it’s 30 minutes a day.”
Once this important step is recognized, as indicated by the head of SPED, the attending physician will select the appropriate medications, not only for the disease, but also for other potential comorbidities that the patient may have.
“If you have cardiovascular disease, kidney disease, obesity, risk of hypoglycemia, and also according to what is in the best interest of that patient to control it and this patient must be compliant, that is, he should consume these drugs according to the doctor’s instructions. I recommend with it “.
Dr. Leticia Hernandez identified stress as having an effect, but temporarily, “For this reason, clinicians and patients should put in place some methods to control that stress,” she said.
She added that during sleep, patients can experience changes in glucose levels while they sleep, but in this case, the specialist notes that it is important to maintain constant controls to avoid spikes through individual strategies.
“If you see that the fasting glucose is high, it is because it was taken the night before, at what time, what was my level of physical activity the previous day, the level of stress, in the case of women, it can also be related to the menstrual period, so there are different factors that can affect these glucose levels.
Another essential aspect, in the expert’s opinion, is that the patient, along with their doctor and nutritionist, manage their sugar levels with medications and food. “There should be a coordination, perhaps a snack, containing protein and carbohydrates for a certain period, during which the patient has a higher risk of developing hypoglycemia.”
Dr. Hernandez specified that glucose metering mechanics are part of the solution, “Here knowledge is power, the more I know about the insulin I’m using, the effects it has on me, and this physical activity affecting me well, I can make adjustments to avoid this kind of event, and we have today as well. technology, which are continuous glucose sensors that can determine how those glucose levels will be, he said.
He stressed that supplements are useful, but that it should always be under medical supervision, and patients who have to spend a lot of time can use them.
“Food is a very important thing, as there has to be a mixture of interaction between what the doctor and the patient and the nutritionist are and be based on what the tastes of that patient are, what nutritional requirements they need, so that it is determined what is the specific plan for that person, that plan has to Be individual,” he explained.
The specialist referred to the moment when the patient suffers from diabetic Controlled, “We typically measure glycated hemoglobin or A1C which gives us this average glucose level for the past three months, however, blood glucose tests that the patient does at home can also help determine how to control those changes and those fluctuations. which this patient may suffer and which should be taken care of.”
He pointed out that “the patient should know himself and help the doctor and the nutritionist to understand that patient.”
He explained that specialists should be concerned with other aspects related to drug costs, in particular, “management guidelines diabeticboth of which are from the American Association of diabetic In addition to the American Society of Clinical Endocrinology, it has specific recommendations.”
But he made it clear that the patient will always see fluctuations in glucose levels, so control of care is the most important thing to avoid so-called medical inertia.
“If our patient leaves the goal of control we had, we have to make a timely change in that treatment and step up to get back to that goal we set,” he concluded.
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