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Published on: 10/22/2020 13:12
There are over 3.7 million people with diabetes in Italy, plus another million who do not know they are. Over 80% have type 2, non-insulin-dependent diabetes and 8 out of 10 diabetics do not achieve good glycemic control with a glycated hemoglobin value of less than 7, thus maintaining a high risk of developing complications. Living with a chronic and ‘life-long’ disease, such as diabetes, has a strong impact on everyday life, but living with this ‘travel companion’ can be facilitated and sometimes the solution is within reach. The campaign, promoted by Novo Nordisk, starts from this premise, “Don’t complicate your diabetes!“, which aims to put diabetes management and new treatments that are changing the paradigm of care and patients’ lives back at the center of attention.
The Web site www.noncomplicartiildiabete.it is online with tips and tricks on proper nutrition, physical activity, psychological well-being, adherence to therapy, and a web miniseries will be launched shortly. The acceptance of this ‘companion’ for life – a note reads – is not at all obvious and this is true both for people who develop type 2 diabetes in adulthood, but also for the young people they meet. type 1 diabetes.
“The acceptance phase is an extremely important moment because if this does not happen, you risk living in opposition to diabetes itself – he declares Paolo Di Bartolo, Director of the Clinical Network of Diabetology, Ausl Romagna and president of the Diabetic Doctors Association (Amd) – and therefore having a life characterized by profound discomfort and an attitude of constant rejection of the ‘diabetes condition’ as, of course, an element of social stigma but also as an obstacle to a fully normal life. Diet, physical activity, therapy, glycemic monitoring, medical visits, attention to other diseases and the risk of complications – he argues – represent a tiring and stressful routine that can often lead to depressive symptoms, anxiety and eating disorders, which however can be overcome “.
The management of type 2 diabetes has changed dramatically over the years. The value of glycated hemoglobin (HbA1), excess weight and the micro- and macro-vascular risk are the key factors to keep under control. A different organization of the diabetes services, the integration between general practitioner and diabetologist and the arrival of innovative drugs allow an evolution in the management and overall treatment of patients.
“Unfortunately, the use of innovative drugs in Italy is still lower than what we see in neighboring countries, such as Spain and Germany”, underlines Agostino Consoli, full professor of Endocrinology at the University of Chieti and territorial Uoc director of Endocrinology and metabolic diseases at the Pescara Local Health Authority. “The causes – he explains – are various: bureaucratic fetters, limitations on their prescription imposed at the regional level, but, above all, ‘inertia’ on the part of the therapist who struggles to abandon his old therapeutic habits to turn instead to offers of modern pharmacology certainly more useful “.
“The most recent guidelines strongly recommend that a patient with type 2 diabetes, with a high or very high cardiovascular risk profile or who has already had a vascular event (as happens for 25-30% of people with diabetes), should be also treated with a diabetes drug that has been shown to have cardiovascular protection characteristics, for example a Glp-1 receptor agonist. From the data it appears instead that today in Italy no more than 15% of diabetics are treated with the new drugs “.
Therapeutic innovation helps patients with type 2 diabetes better manage their disease and their care pathway through drugs that, together with greater effectiveness in bringing patients to target, thanks to a reduced frequency of administration help to keep diabetes under control without the daily thought of therapy. Semaglutide, which belongs to the class of Glp-1 analogs or GLP-1 receptor agonists, is one of these innovative therapies that are paradigm-changing in diabetes therapy. “” First of all, because it is a drug that is injected under the skin but it is not insulin and therefore does not cause hypoglycemia, in addition to the fact that there is no problem of changing the dose as is done with insulin, because the dose is predetermined “, explains Francesco Giorgino, director of Uoc of Endocrinology, Aou Consortium Polyclinic of Bari and president of the Italian Society of Endocrinology (You).
“GLP-1 analogues, such as semaglutide, are ‘smart’ drugs because they reduce blood glucose only when it is high, while if it is normal they do not work. In addition, this therapy makes you lose weight because it acts at various levels on the appetite and appetite centers. sense of satiety. Also there is the possibility of use these drugs not only to reduce blood sugar and weight but to reduce cardiovascular and kidney complications. Numerous studies in recent years have revealed that these agonists have an important protective action against heart attack, stroke and cardiovascular death. Very useful drugs which, for all these reasons and for their greater hypoglycemic efficacy, are to be preferred over basal insulin when oral drugs are no longer able to ensure adequate glycemic control in the person with diabetes “.
It is necessary for the diabetic to find a new balance, a new lifestyle through proper nutrition, regular physical activity, adherence to prescribed drugs. The patient may find it difficult to adhere to the prescriptions of the diabetologist but there is a way not to complicate the diabetic disease and achieve these goals. “It is necessary to have a very close relationship with disease and knowledge of it, above all to learn that it is not about living a life as an ascetic, but simply trying to live a normal, healthier life, and with a valid reason for doing it: health “, he comments Andrea Giaccari, head of the Endocrine and Metabolic Diseases Center, University Hospital Foundation ‘A. Gemelli ‘Irccs of Rome.
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