It is very important that children recently diagnosed with diabetes have access to as many resources and tools as possible, so that they can become familiar with the disease and help them assimilate their new situation.

As this is a child audience, it is necessary to describe the process in a simple way and in language that they can understand. It is important to treat diabetes in a natural way without causing them any alarm or approaching it from a negative point of view.

The attitude of the parents is fundamental; the way in which the parents understand and approach the new situation will determine the degree of acceptance of the child in the face of the disease and their collaboration in the treatment.

The International Society for Pediatric and Adolescent Diabetes (ISPAD) has established guidelines for diabetes treatment that cover the knowledge, skills and attitudes that people with type 1 diabetes should know and manage in order to integrate treatment into their daily lives.

ISPAD establishes two levels of education: the first involves acquiring basic knowledge of the treatment of DM1 and is taught at the beginning of diagnosis, and the second level is taught on an ongoing basis.

On the other hand, the American Diabetes Association (ADA), which is one of the most important scientific societies related to diabetes, recommends that in the age group of 1 to 12 years, education be directed at parents and caregivers, while from 12 years of age, considering the emotional and cognitive development of the child, education should be directed primarily towards the patient, with parents included.

Child's responsibility in diabetes control according to their age

 

• 2-4 years: Children collaborate and participate in activities directed by their parents. The objective is for them to learn to live with diabetes as just another activity in their lives. Education is directed towards all those activities aimed at the participation of self-control in the child, ensuring good development with a healthy and balanced nutritional intake.

 

• 4-6 years: They ask why, recognizing that they are different from others. The goal is to make them understand why they inject insulin differently from other children, in order to get them to participate in self-control. Education is aimed at assimilating basic concepts of diabetes, through the metaphor of the story. The goal is to integrate all food groups into the diet.

 

• 6-8 years: Children learn to read and write and to know the time, so the goal is for them to be able to self-monitor, learn to differentiate between high and low blood sugar levels and participate in insulin injections. They must learn to differentiate between food groups, ensure that they eat in a healthy way, and recognize the symptoms of hypoglycemia and take urgent action. Education is focused on differentiating between normal, high and low blood sugar levels and must be motivational and provide knowledge through play.

 

• 8-12 years: At this age, children's sense of responsibility increases and they know how to interpret and differentiate between good and bad behaviour, as well as understanding the consequences of their actions. The aim of education is to gradually increase their autonomy in controlling diabetes (getting them to inject insulin, achieving good results in treating hypoglycaemia, etc.). Basic knowledge of sports performance is provided, menus are prepared using the different food groups and the participation of their friends is encouraged.

 

• 12-16 years: Their sense of responsibility increases and independence and autonomy are progressing, so that they understand the consequences of their actions. They must acquire responsibility in the treatment and control of diabetes without supervision, identify with their group of friends with their diabetes, have autonomy in decision-making in modifying their treatment and know how to act in special situations. Education provides knowledge of action and risks in special situations (alcohol, tobacco, sexuality, etc.).

 

• 16-18 years: Increasing independence and autonomy, coinciding with the transition to adulthood. They gain autonomy in diabetes control and their responsibilities increase, and their acquired knowledge is assessed for transfer to an adult hospital. Good integration should be achieved with good control of their diabetes in adulthood, reinforcing their knowledge and skills, promoting the need for good control to avoid long-term complications.

 

From the age of 12, we could say that they are already fully immersed in new technologies, so the use of a health application, specifically for diabetes such as the CONTOUR^® DIABETES app, can help them better interpret their blood glucose values ​​and, therefore, make better decisions in diabetes self-management.

Source: How should a child with diabetes take responsibility for their treatment? By Ana M. Gómez Rodríguez, Nurse at the Hospital Sant Joan de Déu, Barcelona

View Post

 Measuring blood glucose correctly is one of the key points for self-managing diabetes. Having a precise and accurate meter is the first step to achieve this, although not the only one, since there are variables that can influence the success of the measurement.

At Ascensia we promote the education of people with diabetes, so in today's article we review the main variables that can negatively affect the glucose meter and thus minimize possible interferences:

• Endogenous variables: are those that are specific to the patient and his physical characteristics. This is the case of the patient's oxygenation, changes in body temperature (for example, it has been proven that there is an increase in blood sugar levels due to hyperthermia after a sauna), or changes in other body substances such as blood itself, uric acid, sodium or bilirubin, among others.
  
  
• Exogenous variables: are those substances that may be present in the body both through the intake of various foods and through the use of some drugs.
  
  
• Operational errors: according to a study carried out by the Spanish Society of Clinical Biochemistry and Molecular Pathology, these types of errors are the most frequent and account for up to 97% of all errors. Some of these errors are:
  
  
• Error due to a batch change of test strips
  
  
• Incorrect calibration of the test strip batch may cause deviation in results
  
  
• Poor storage of test strips. Poor storage conditions can lead to a decrease in the stability of the strips due to having the containers open, at an inappropriate temperature or near a light source.
  
  
• Poor cleaning of the glucose meter. Cleaning these devices with chemical agents can interfere with the correct reactive process.
  
  
• Errors related to the blood collection site: changing the sample collection site (pulp bud, forearm, thigh, etc.) causes clinically significant differences in the result because glucose equilibrium is reached at different times. Poor cleaning of the collection site can also be a cause of measurement errors.
  
  
• Environmental factors: Altitude and temperature influence correct meter readings.
  
  
• Post-analytical factors: are those that arise from the recording of data by the patient and that can lead to a bad clinical decision. The most common error is not recording or recording incorrectly the measurement values.
  
  

To minimize these possible errors, Ascensia would like to offer a series of recommendations on how to correctly measure blood glucose.

First of all, it is essential to have the necessary material at hand:

• blood glucose meter
  
  
• capillary puncture device
  
  
• lancets
  
  
• Test strips suitable for the meter
  
  
• cotton or tissues
  
  
• results monitoring system. At this point, the use of intelligent systems, such as mobile applications, which directly transmit information to a patient's medical record available on the network, is recommended.
  
  

Once all the materials are available, always in a good state of conservation and following the manufacturers' instructions, to perform capillary blood glucose we will take into account:

• Always read the meter instructions
  
  
• Wash your hands properly with soap and water and rinse them well.
  
  
• We recommend using the lateral part of the fingertip to always perform the puncture, since the pulp of the finger is more painful.
  
  
• respect the puncture times
  
  
• Use automatic puncturers that allow you to adjust the force and depth of the puncture and are less painful.
  
  
• deposit the blood sample correctly to ensure the necessary amount collected by the strip
  
  
• transfer the results to your control system, either through a technological device (highly recommended for reducing human error) or a notebook
  
  

In any case, always discuss any questions with your medical professional. You can also share your concerns with our specialists through the Ascensia Diabetes Program.

Author: Communication Department Ascensia Diabetes Care Spain SL formed by Martina Comillas and Verónica Gragera

View Post

 If you have diabetes, your cholesterol levels will be high when your total cholesterol is above 200 mg/dl, your LDL (bad) cholesterol is above 100 mg/dl and your HDL (good) cholesterol is below 40 mg/dl. A sedentary lifestyle and being overweight are factors that promote the appearance of bad cholesterol.

Watch Food Complications of Diabetes

Cholesterol is a type of fat that is necessary for the body to function properly. When cholesterol levels are higher than recommended, the risk of cardiovascular diseases increases.

To prevent your cholesterol levels from rising, it is very important to avoid being overweight. For this reason, it is recommended that you:

• Follow a healthy eating plan that includes: milk, flour, fruit, vegetables and salads, protein foods and fats.
• Limit the consumption of animal fat, as it is a saturated fat and rich in cholesterol.
• You do physical activity regularly.

REMEMBER: TO EAT A DIET WITH LOW FAT CONTENT OF ORIGIN ANIMAL (rich in cholesterol and saturated fats) YOU SHOULD: REGULARLY CHOOSE FOODS WITH LOW ANIMAL FAT CONTENT.

1. Skimmed or semi-skimmed milk and yogurt.
2. Fresh cheeses (cottage cheese, Burgos, Villalón) and skimmed cheeses.
3. Low-fat sausages.
4. Lean meats (skinless chicken, rabbit, veal, beef, horse).
5. Occasionally, small pieces of lean parts of fatty meats (pork loin, steak, leg of lamb).
6. 2-4 eggs per week.
7. All types of white and blue fish.
8. Olive, sunflower or corn oil.

Cook the recommended foods in a simple way with olive oil: grill, oven, steam, “papillote”, sauté or microwave.

RESTRICT REGULAR CONSUMPTION OF FOODS WITH HIGH ANIMAL FAT CONTENT (cholesterol and saturated fat)

1. Whole and fortified milk and yogurt
2. Creamy and fatty cheeses (Roquefort, Manchego, Brie, Camembert)
3. Patés, fatty sausages (chorizo, butifarra, sobrasada)
4. Fatty meats (large pieces with visible fat from lamb, pork, game)
5. Brains, giblets and offal
6. Egg consumption greater than 4 units per week
7. Pastries, cakes
8. Precooked foods
9. Butter, lard, cream, heavy cream, margarine, coconut and palm oils

Avoid cooking methods such as batters and sauces with lard, butter, cream, etc. These recommendations, which apply to the whole family, must be followed very strictly when your cholesterol levels are high. Some people may be restricted from eating certain foods altogether, and may be prescribed pills to control their cholesterol levels. If this is the case for you, never forget to take your medication.

View Post

 Being part of a family is a unique and enriching experience that gives us the opportunity to grow, learn and love unconditionally. However, it also involves assuming responsibilities and working together to achieve common goals. In this sense, the family can be seen as a team where each member contributes their talents and skills for the benefit of all.

Teamwork in the family

As with any sports or professional team, families function best when there is open communication, collaboration, and mutual respect. Each member should feel valued and heard, and have the opportunity to contribute in a meaningful way.

Benefits of family teamwork

The benefits of working as a team in the family are numerous. Among them we can highlight: 

Greater happiness and satisfaction: Families who work together tend to be happier and more satisfied with their lives. This is because they feel supported and loved by their loved ones.

Better communication: Teamwork encourages open and honest communication between family members. This can help prevent conflicts and resolve problems effectively.

Greater resilience: Families that work together are stronger and more resilient to life's challenges. This is because they have the support and help of their loved ones.

Developing social skills: Children who grow up in families that work together learn to collaborate, communicate, and solve problems effectively. These skills are essential for success in life.

Here are some tips for working together as a family:

Set common goals: Get together as a family to discuss your goals and objectives. This will help everyone feel motivated and committed to working together.

Communicate openly and honestly: talk to each other respectfully and listen carefully to what others have to say.

Take responsibility: Each family member should take on responsibilities appropriate to their age and abilities.

Celebrate your accomplishments: Take time to celebrate your accomplishments as a family. This will help strengthen family bonds and increase motivation.

Seek help when you need it: If you're having trouble working together, don't hesitate to seek professional help. A family therapist can help you develop better communication and conflict resolution skills.

Analyze a family health plan: It is important to consider a comprehensive health plan that has important coverage for everyone. At Humana, we apply greater benefits to families who join a plan up to the fourth degree of consanguinity, where everyone wins.

Having a family is a precious gift that we should value and care for. By working as a team, we can create a harmonious and enriching family environment where everyone wins. Remember that the family is a team where each member plays an important role in achieving success.

View Post

 Discover the fascinating history of diabetes, from its earliest records to current advances in its treatment and prevention.

Origins of diabetes: a look at its discovery

Diabetes is a disease that has affected humanity since ancient times. The first records of this disease date back to the ancient Egyptian civilization, where the characteristic symptoms of diabetes were described, such as excessive thirst and abundant urination.

However, it was not until the 19th century that diabetes began to be better understood. In 1889, German physician Oskar Minkowski conducted an experiment in which he removed a dog's pancreas, resulting in the appearance of diabetes-like symptoms. This led to the conclusion that the pancreas plays an important role in regulating blood sugar.

Later, in 1921, Canadian scientist Frederick Banting and his colleague Charles Best discovered the hormone insulin, which turned out to be crucial in the treatment of diabetes. This discovery revolutionized the management of the disease and allowed people with diabetes to live a more normal and healthy life.

The first treatments for diabetes: from diet to insulin

Before the discovery of insulin, diabetes treatments focused primarily on diet and controlling blood sugar levels. Doctors recommended that people with diabetes follow a diet low in carbohydrates and sugars, and limit alcohol consumption.

However, these dietary treatments were not enough to adequately control the disease, especially in more severe cases. It was the arrival of insulin that allowed for a significant advance in the treatment of diabetes. Synthetic insulin came into use in the 1920s, allowing people with diabetes to regulate their blood sugar levels and lead healthier lives.

Over time, different types of insulin and delivery methods, such as insulin pumps and continuous glucose monitoring devices, have been developed, which have further improved diabetes management and facilitated self-treatment of the disease.

Scientific and technological advances in diabetes management

Over the years, there have been numerous scientific and technological advances in diabetes management. For example, more effective medications have been developed to control blood sugar levels, such as dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. These medications help regulate blood glucose levels and reduce the risk of diabetes-related complications.

Furthermore, technology has played a major role in diabetes management. Continuous glucose monitoring devices allow people with diabetes to measure their blood sugar levels continuously and get real-time information about their glucose levels. This helps them make more informed decisions about their diet and medication.

Insulin pumps have also made insulin administration easier, as they allow for continuous and precise delivery of the hormone. These scientific and technological advances have significantly improved the quality of life of people with diabetes and reduced the risk of serious complications.

Is it possible to reverse diabetes? Featured cases and studies

Diabetes is a chronic disease that has no cure, but there are cases in which it has been effectively reversed or controlled. These cases mainly concern type 2 diabetes, which is closely related to lifestyle and risk factors such as obesity and lack of physical activity.

Studies have shown that through lifestyle changes, such as eating a healthy diet, exercising regularly, and losing weight, it is possible to control type 2 diabetes and even reverse symptoms in some cases. In addition, bariatric surgery has been shown to be effective in treating type 2 diabetes in people with severe obesity.

However, it is important to note that each case is unique and not all patients with type 2 diabetes can reverse the disease. Furthermore, type 1 diabetes, which is an autoimmune disease, cannot be reversed or prevented through lifestyle changes.

Future prospects: research and hopes for diabetes treatment

As scientific research advances, new avenues for diabetes treatment and prevention are being explored. For example, studies are underway into stem cell therapy, which could offer a long-term solution for people with type 1 diabetes by replacing damaged or destroyed insulin-producing cells.

In addition, new medications and therapies are being developed that could further improve diabetes control and reduce the risk of complications. For example, therapies with protein kinase C (PKC) inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors are being investigated, which could help regulate blood sugar levels more effectively.

In summary, the history of diabetes has been marked by important discoveries and advances in its treatment and management. Although there is still no definitive cure, research continues in search of new therapies and hope for people with diabetes.

View Post

This is probably one of the biggest fears of diabetics: the hypoglycemia crisis during sleep. What will happen to me if I do not notice it? If my body does not react? If I do not wake up at all? If I lose consciousness without anyone noticing, or worse? I spoke at length with my doctor, so as not to imagine the most frightful scenarios. He assured me that the risk of hypoglycemia that would go unnoticed is, under normal conditions, extremely low.

Indeed, a very high amount of adrenaline is released into the body during hypoglycemia, which eventually wakes anyone up. Or has someone already fallen asleep on a roller coaster, his heart pounding at an hour? It's unlikely. This is exactly what happens in the body during hypoglycemia. The body, as long as there are no drugs, potent drugs or alcohol in the blood, also reacts to hypoglycemia during the night, at a time when one is still able to face it and control it yourself.

Fooling pulse and heart palpitations

The words of my doctor reassured me somewhat and, over time, I learned to trust my body. Naturally, I still have nocturnal hypoglycaemia, but these have so far always woken me up. These experiences, however, are very unpleasant and leave traces. That's what happened a few weeks ago: I had a terrible nightmare in which I was pursued by a horde of wild animals and my heart was pounding. Drenched in sweat and totally panicked, my worries made me leave my dream and come back to reality. Completely disoriented and heart pounding, I needed a few moments to realize that it was only a dream. Tremors ran through my body and I alternated between hot and cold.

I tried to calm down, I wanted to go back to sleep. But my pulse just refused to slow down and it was after a few minutes that I understood: it was hypoglycemia! I measured my blood glucose and indeed, the instrument indicated a low value: 2.8 mmol / L. Still keeping a bottle beside my bed, I rushed to drink a large glass of cold tea. Unfortunately, cravings are also symptoms of hypoglycemia: I stuffed myself with biscuits, bread and chocolate, bringing down the whole thing with the sweet drink. It was only after awhile that I noticed that my body and heart palpitations had calmed down. Since I already knew that I had eaten too much, I used a little insulin as a precaution through my pump,

Happily rare

However, I am glad that nocturnal hypoglycaemia remains rare for me! The night is so much more calm, pleasant and relaxing. I have noticed many times that I often have nightmares shortly before hypoglycemia wakes me up. I have also been awakened by hypoglycemia, then go eat something that was in the fridge without my noticing it and without being able to remember it in the morning.

All this gives me the guarantee that my body also reacts on the level of the subconscious and that I just have to trust it. I can also trust my doctor because he is really right and, with confidence, we sleep really better!

View Post

For the first question of the week of this year, we asked you what topic you would like to read a blog post. One of the answers was: diabetes and puberty.

In this respect, we can fulfill your wish. Our blogger Martin Ruegge has agreed to share his personal experience about adolescence.

During puberty, our hormones play tricks on us. From a hormonal point of view, the physical transition phase from child to adult is an emergency for the body. For people with diabetes, it is reinforced by the effects of the disease.

Martin Ruegge, how did you live this period? 

In a surprisingly serene way! I did not experience a rebellious phase as we hear from others, who no longer measured their blood glucose or even gave up insulin injections. Of course, it was harder to control my blood glucose level at the time, because other hormones took over ... And I also admit that I tried to get hold of many sweets and other treats, which were then almost all forbidden to me.

What were the practical difficulties - in everyday life and interaction with friends - in terms of independence and detachment? What did you experience more difficult during puberty? 

On the one hand, all the existential changes that took place parallel to puberty. Either the professional choice, the search for a place of learning, the same learning and all aspects related to training. I was busy with restlessness, nervousness and sometimes even stress. The risk of forgetting diabetes was even greater. Fortunately, I had caring masters of learning who always asked me if I had measured my blood sugar.

On the other hand, there was this new freedom, like the exits. My apprentice salary opened up new possibilities. Including eating outside. During my schooling, I always dined at home, which was no longer possible during the apprenticeship. So I was faced with a lot of upheaval. It was also at this time that I learned to give structure and regularity to my daily life, to better control my diabetes. That's exactly what I admire about Jan Neuenschwander, whose daily life seems pretty exciting!

Were there phases where you had more trouble accepting your diabetes? How did you overcome these "downs"? 

I have always had the ability to focus on certain goals and to motivate myself in that direction. At the time, I was told that a cook's apprenticeship (my first training before becoming a nutritionist) would be hardly compatible with my diabetes. There was still no insulin pump or continuous MGC glucose measurement. I was warned against stress in the kitchen, against the temptation to snack between meals. Added to that were the concerns of physical exertion. But these objections and concerns motivated me even more to give the best of myself and to prove that I was able to assume and achieve my goals as a diabetic.

Do you have any tips for teenagers with diabetes who are in puberty? 

Pursue your goals and try to realize your dreams. To achieve one's goal, one must be efficient. It is therefore worthwhile to control one's diabetes as best as possible. And if your blood sugar level rolls over, keep a cool head!

What are the positive things? Meetings or events that have remained etched in your memory and still make you smile today? 

Say, all the nonsense that can be done during the puberty phase (which, according to Wikipedia, lasts from 12 to 21 years). I have more than one memory. I particularly enjoyed Mondays. My mother always went to gymnastics those nights. At the same time, there was a short time when my dad was taking a shower. My brother and I used the interval to rob the sweet drawer in the living room. With a little training, I could even make a bolus after. ;-)

View Post