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Estimates indicate that the number of people with diabetes will reach 1.3 billion by 2050

Estimates published last month in the scientific journal The Lancet point out that the global number of people with diabetes should reach 1.3 billion by 2050. In 2021, about 529 million people suffered from the disease, i.e. the number of cases of the condition should more than double in less than 30 years. “The projection is very worrying, since the kidneys and the heart are among the main affected by diabetes. Kidney disease is 10 times more common in diabetics because of an event known as hyperfiltration of blood in the kidneys. Therefore, diabetic patients should count on the help of a nephrologist to control the disease and avoid kidney damage.

In addition, diabetic patients have a three to four times greater risk of suffering a cardiovascular event”, explains Dr. Caroline Reigada, nephrologist, specialist in Internal Medicine by the Irmandade da Santa Casa de Misericórdia de São Paulo and in Nephrology by the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo. “Diabetes is an umbrella term for a number of conditions involving high blood sugar levels. It can occur due to defects in the secretion or action of the hormone insulin, which is produced in the pancreas by the so-called beta cells. The main function of insulin is to promote the entry of glucose into the body’s cells so that it can be used for various cellular activities. The lack of insulin or a defect in its action results, therefore, in the accumulation of glucose in the blood, which we call hyperglycemia”, explains nutritionist Dr. Marcella Garcez, director and professor at the Brazilian Association of Nutrology (ABRAN).

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By 2050

The publication points to the rapid increase in obesity rates and inequality in access to health as the main causes for the growth in the number of cases of diabetes in the future. And, according to the authors, most of these cases are constituted by type 2 diabetes, which is characterized by impaired insulin secretion and increased insulin resistance. “The disease is responsible for more than 2 million deaths annually and is the seventh leading cause of disability worldwide”, explains the nutritionist.

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The condition, when not controlled, can have negative consequences for the entire organism, including vision, nerves and lower limbs, in addition to causing dehydration, difficulty in healing and respiratory complications. And the kidneys and the heart are among the main ones affected. “Diabetes is an extremely inflammatory disease, in which the exaggerated amount of glucose in the blood is capable of causing blood hyperfiltration in the kidneys (the so-called glomerular hyperfiltration). In addition, it increases the concentration of advanced glycosylation products (the process in which sugars are added to proteins and lipids, transforming them into glycoproteins and glycolipids), which are most responsible for the complications of diabetes. When these products are activated by the immune system, diseases of blood vessels and nerves appear, as well as kidney damage. These are the so-called micro and macrovascular complications of diabetes. That is, changes in smaller vessels, such as the kidneys and retinas (microvascular, and large vessels and the heart (macrovascular)”, explains nephrologist Dr. Caroline Reigada. Worldwide, 44% of people with the disease develop chronic kidney disease.

Control

Therefore, it is essential that patients already diagnosed with diabetes keep the disease under control. “The control of diabetes, which presents easy diagnosis (a simple blood test), should aim, in most cases, a glycated hemoglobin lower than 7%”, says Dr. Caroline Reigada. And those who still don’t suffer from the disease should perform tests regularly to detect any possible changes early. “Remember that diabetes can be an insidious disease. The diagnosis of pre-diabetes and its treatment is the best way to avoid complications”, adds the nephrologist.

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But the best way is to spare no efforts to prevent diabetes. “Intensive lifestyle modification remains the best way to reduce the risk of developing type 2 diabetes. It is necessary to improve eating habits, include physical exercise, improve sleeping habits, avoid alcoholism and smoking. And, in the prevention and treatment of metabolic syndrome, physical exercise is considered of great importance. Such an intervention has been shown to improve glucose tolerance and reduce insulin resistance. The moderate practice of aerobic and strength exercises is indicated for everyone, even more so for pre-diabetics and people with metabolic syndromes, as long as it is frequent and obeys a periodicity. Flexibility and relaxation activities, associated with strength and aerobic activities, also bring positive impacts. The most important thing is to get out of the sedentary lifestyle”, adds Dr. Marcella Garcia.

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Estimates indicate that the number of people with diabetes will reach 1.3 billion by 2050

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