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Diabetes: Longer life expectancy and better quality of life through optimal therapy


Diabetes affects all organs of the human body

According to estimates, around seven million people in Germany alone suffer from diabetes. Around 350 million people are said to be affected worldwide. The metabolic disorder affects all organs of the body, especially the heart and kidneys. It is therefore essential to take these organs into account when treating diabetes.

It has long been known that diabetes increases the risk of heart disease such as sudden cardiac death and heart attack. The metabolic disorder also goes to the kidneys. Optimal diabetes therapy has been put through its paces from day one and can thus contribute to a longer life expectancy and better quality of life. This is pointed out by the Austrian Diabetes Society (ÖDG).

Massively reduced quality of life

"People with diabetes are considered to be a high-risk collective for cardiovascular diseases, especially the creeping and chronic heart failure (called heart failure in medicine) is particularly treacherous because it remains undetected for a long time and massively limits performance and thus quality of life," explains ÖDG President Alexandra Kautzky-Willer.

"Out of two type 2 diabetes mellitus patients one will suffer from heart failure in the course of their life and heart failure is far too often responsible for early death," said the Univ. Prof. Dr. from the University Clinic for Internal Medicine III, Department of Endocrinology and Metabolism, at the Med Uni Vienna.

But according to a study published a few months ago in the journal "Diabetic Medicine", heart failure in diabetes often remains undetected and untreated. "A simple blood test with the determination of a biomarker can provide clues early on," says Kautzky-Willer.

Prevent heart health

According to the ÖDG, people who have already had a heart attack are at particularly high risk of developing other cardiovascular diseases. However, the risk of people with diabetes is just as high.

"We are seeing that the boundaries between primary and secondary prevention of cardiovascular diseases in patients with diabetes are disappearing," said Assoz. Prof.in Priv. Lecturer Dr.in Yvonne Winhofer-Stöckl, PhD, from the University Clinic for Internal Medicine III, Department of Endocrinology and Metabolism, at the Med Uni Vienna and First Secretary of the ÖDG.

"It is necessary to deal with the heart health of people with diabetes as carefully as people who have already had a heart attack," explains the expert.

Most common cause of kidney replacement therapy

As the press release continues, diabetes is still the leading cause of kidney replacement therapy. The so-called dialysis costs quality of life and life time because it has to be carried out several times a week and there is no vacation from this therapy, because even vacation destinations have to be selected on site if dialysis is possible.

Another form of kidney replacement therapy is kidney transplantation; But here, too, you are not considered cured afterwards, you have to take anti-defense drugs for life and you have an increased risk of infectious diseases.

A first indication of deterioration in kidney function is when protein is found in the urine. This shows that the kidney vessels are no longer working as well.

Protein in the urine

According to the ÖDG, an increase in the risk of cardiovascular diseases is also observed from the point in time when protein is found in the urine, because the vascular damage takes place in both organs.

This vascular damage arises directly from blood sugar but also from increased blood pressure and harmful blood lipids, both of which are typical concomitant diseases of type 2 diabetes mellitus.

“There is a close cycle between the heart and kidneys. The hormonal and metabolic interplay affects both organs. The first signs of kidney weakness often appear with the first signs of cardiovascular disease, ”explains Winhofer -Stöckl.

"And unfortunately, the underlying diabetes is often only discovered when there are complications," adds Kautzky-Willer.

Adequate exercise and a balanced diet

Kautzky-Willer explains what patients can do themselves to keep their health as long as possible despite the chronic illness of diabetes:

“Daily exercise, a balanced diet, for example the switch to Mediterranean food, weight loss if you are overweight, a good biorhythm with enough sleep and good resilience, as well as an immediate smoking cessation are the most important measures that everyone can take for themselves. Every step counts here! Every lifestyle change contributes to reducing the risk of complications. ”

The first years of the illness are crucial

Early and consistent diabetes therapy pays off. "Especially in the first years of the disease, we can lay the foundation for a long and healthy life despite diabetes through consistent therapy. At the beginning of the disease, we have to intensify the treatment so that we can give our patients life and quality of life decades later, ”says Winhofer-Stöckl.

All risk factors for cardiovascular diseases must be observed from the start and optimally adjusted. For blood sugar, blood lipids and blood pressure, it is important to reach and then keep the respective target values ​​as quickly as possible. In the case of blood sugar, the HbA1c value is at the center here because it is particularly meaningful as a long-term value.

Optimal diabetes therapy also protects the heart and kidneys

"Our dogma in therapy has changed over time, which can also be clearly seen from our new guidelines: In the past, the glucocentric view was in the foreground, then the importance of multifactorial therapy with consideration of all the risk factors already mentioned (cholesterol, blood pressure, blood sugar , ...) also thanks to new drugs such as RAS inhibitors, anticoagulants, statins and most recently PCSK9 inhibitors, and now we are actually at the beginning of personalized, individualized therapy with new antidiabetic drugs with additional benefits, ”emphasizes Kautzky-Willer.

“Today we have diabetes medication that not only lowers blood sugar, but also has a positive effect on the heart, vascular calcification or heart failure, and kidneys. This has been proven to lead to a higher life expectancy and a better quality of life. But this only applies if diabetes is identified in good time and treated consistently, ”says the doctor. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Austrian Diabetes Association (ÖDG): INSPECT DIABETIC TREATMENT FOR HEART AND KIDNEYS, (accessed: December 9, 2019), Austrian Diabetes Association (ÖDG)
  • Diabetic Medicine: Heart failure among people with Type 2 diabetes mellitus: real ‐ world data of 289 954 people from a diabetes database, (accessed: 09.12.2019), Diabetic Medicine


Video: Living long with Diabetes (January 2022).