Contribution Of Insulin In Puerto Rican Patients Diagnosed With Diabetes

The objective of the scientific community in Puerto Rico is to expand education and prevention spaces.

One in six adults in Puerto Rico suffers from diabetes, a condition characterized by high blood sugar levels. A disease that if not treated in time can lead to serious complications such as amputations and diabetic kidney disease. These were precisely some of the topics discussed by a medical panel from the Auxilio Mutuo Hospital in collaboration with the Medicine and Public Health Journal in the Diabetes: Beyond Insulin discussion.

According to the endocrinologist Yanerys Agosto, Puerto Rico not only has a high incidence of diabetes, with approximately 17%, but it is also the territory of the entire United States with the highest prevalence. “Puerto Ricans are among one of the ethnicities or races that are very susceptible to developing diabetes. So basically every Puerto Rican over the age of 21 should undergo an evaluation for diabetes at least once a year. Patients who have obesity, who are gaining weight, patients whose mother and father have been diabetic, women who have had gestational diabetes or developed during pregnancy are at risk. If we have a sedentary lifestyle, we do not do physical activity, we do not watch what we eat, because we are also more at risk of developing type 2 diabetes (the most common among adults) ”, indicated the endocrinologist.

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Pediatric patients

For his part, pediatric endocrinologist Luis Font pointed out that type 1 diabetes is the most common among patients under 18 years of age and although the prevalence cases are less than one percent, increases are reported annually. “When we talk about pediatric patients, one in every 400 pediatric patients has type 1 diabetes. That’s less than one percent of the pediatric population, but it has been noted that there is an annual increase in that percent. The symptoms that we rather see in patients with type 1 diabetes is weight loss or increased thirst, increased frequency of urination and an increase in appetite at the same time ”, said Font.

Diabetic kidney disease

Meanwhile, the nephrologist Verónica Meza spoke of those diabetic patients who could develop complications such as diabetic kidney disease. “When we talk about diabetic kidney disease, we statistically know that patients have a 30 to 40% risk of developing this disease. About 10% of these patients require dialysis or some renal replacement therapy. We know that a person is more likely to develop diabetic kidney disease if they have a first-degree relative who is diabetic and has kidney disease as a result of diabetes. Obesity, sedentary lifestyle or how active your lifestyle is are also associated. Smoking and people who were born prematurely or developed low birth weight have a greater predisposition to develop kidney disease in the future ”, explained the doctor, who added that in 2020 about 6,200 patients developed terminal disease and needed renal replacement therapy or dialysis.

Likewise, Meza emphasized that cardiovascular health must be taken care of to reduce the mortality of diabetic patients. “Many of these patients die before having kidney disease and the primary cause of death is cardiovascular disease and infections. So as part of the treatment we have to take care not only of the prevention and treatment of kidney disease, but also of cardiovascular disease ”, he stressed.

Wound and ulcer care

Regarding the physical manifestations such as wounds, ulcers or the so-called diabetic foot, Dr. Lourdes Marrero from the Ulcer Clinic of the Auxilio Mutuo Hospital, urged patients to seek care in time and not when the condition is developed or at risk of amputation. “The patient does not make the ulcers alone. It usually has a triad, which is what we most commonly see, these patients are going to have neuropathy, deformity, and repetitive trauma. The ulcer clinic is not when the ulcer is serious, it is to prevent me from becoming serious. There are many times that the patient stays receiving service and they told me to put cassava powder or pickpocket oil on me. The important thing is that the patient goes to the one he knows, to the podiatrist or to a clinic where there is a doctor specializing in wound management in order to avoid having his leg amputated ”, he emphasized.

Marrero also recommended diabetes patients to constantly check their feet to avoid any major complications. “It is very important that diabetic patients check their feet every day. That he visit his podiatrist, that they do not cut their nails, that if they feel like doing it too much, that they file them a little. That they wear closed shoes at all times in the house. No walking barefoot. The diabetic patient does not feel, that is, they have already lost the protective sensation that you are walking, you feel a nail and you are going to take your foot out. The diabetic patient does not (have sensation). I have found wounds of diabetic patients that it occurred to them to take the keys to a neighbor’s house in New York in stockings in the snow and obviously he does not feel the cold, his whole foot was burned and he lost half of his foot, “he warned .

Balanced nutrition of the diabetic patient

Regarding the nutrition of the diabetic patient, the lawyer Suheily Villanueva mentioned that each patient should follow their treatment in the hands of a nutritionist who helps them keep their sugar levels under control with a balanced diet. “A healthy diet has many benefits in addition to physical activity. It is very important that this patient is hand in hand with the nutritionist. We are going to try to improve those labs. We are also going to work on food, which is very individual. And education is the most that infers with which the patient can follow that healthy diet. That he learns to read that nutritional label, how much water he needs, that he learns how his plate is going to look every day, “said the nutritionist.

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