What are the different types of diabetes and what age groups do they affect?
Generally speaking, there are two primary types of diabetes based on the mechanism that lead to its formation. The first is type 1 diabetes which is caused by autoimmune destruction of the primary cells responsible for the production of insulin (beta cells of the pancreas). Sooner or later, the result is the eventual lack of insulin requiring life-long maintenance and application of insulin. Therefore, this is also referred to as insulin-dependent diabetes. The second type is type 2 diabetes where the primarily problem is caused by an insufficient affect of insulin on the body. Initially, excessive amounts of insulin are produced. Often, this type of diabetes is referred to as non insulin dependent diabetes.
The age distribution associated with each type of diabetes has changed somewhat within the last few decades. Type 1 diabetes was associated with children although the actual destruction of pancreatic cells generally occurred in adulthood. On the other hand, type 2 diabetes which was associated with obese adults has been shifting to children as more and more of them face weight issues.
In addition to the two types of diabetes we discussed, there are other, more rare types of disorders that concern overall insulin secretion (genetic dysfunctions of beta cells or damage to pancreatic issue not caused by the immune system).
How do symptoms associated with type 1 and type 2 diabetes differ?
In its advanced stage after the disease been detected late, elevated blood sugar levels are evident and symptoms include thirst, frequent and high-volume urination and general dehydration. Patients often complain of vision impairment disorders.
In the case of type 1 diabetes, significant weight loss and diabetic ketoacidosis occurs. This is often associated with abdominal pain, vomiting, nausea, rapid breathing and gradual loss of consciousness.
When suffering from diabetes, especially type 2 which can go undetected for years, some long-term complications may be the first detectable symptoms. These include damage to the retina, kidneys and more.
What is the most important factor in treating type 1 and type 2 diabetes?
As mentioned earlier, the basic and only option of treating type 1 diabetes is the administration of insulin through a needle. Treatment aims to get as close as possible to the natural secretion levels. It is absolutely necessary for insulin therapy to be combined with dietary measures that limit the intake of white sugar and starches (polysaccharides).
When treating type 2 diabetes, the treatment itself depends on the stage the disease is in. The focus is primarily on the improvement of the insulin impact on the body. An essential and most effective means of treating it rests in weigh reduction and increase of physical activity. The drug of choice is usually metformin. If these methods fail, we have to resort to drugs that increase insulin secretion. In advanced cases, insulin itself may need to be applied.
The number of patients with diabetes is on the increase. What do you see as the primary cause?
The overall increase in diabetes can be blamed primarily on the increase of type 2 diabetes cases which are closely related to obesity. Obesity, through various mechanisms affects the impact of insulin on the body as well as the overall secretion of insulin itself. At a certain point, the capacity of the organism is surpassed and this leads to the development of type 2 diabetes. There are many other factors that are associated with obesity or simply directly have an impact on the development of type 2 diabetes. These include a lack of physical activity, psychosocial stress as well as the diet composition. We should also not forget that there is a certain congenital propensity associated with the development of the disease.
Is it possible to prevent this disease? Is diabetes a hereditary disease?
Type 1 diabetes cannot be prevented. People who have relatives suffering from type 1 diabetes are more prone to suffer from autoimmune destruction of beta cells of the pancreas. This risk factor (not the autoimmune disease itself) is linked to genetics. We have yet to discover a method of decreasing the likelihood of this disease developing in a specific individual.
There are also genetic traits associated with type 2 diabetes. Unlike with type 1 diabetes however, it can be actively prevented by implementing a healthy lifestyle. In this respect, there is virtually no distinction between children and adults.
Is the patient limited in the same way with type 1 and type 2 diabetes? Is it possible to fully cure the disease?
If we consider an uncomplicated case of diabetes, the biggest limitation is posed by the required application of insulin rather than dietary limitations or swallowing tablets. Insulin treatment involves injecting insulin under the skin or continuous administration of insulin via an insulin pump. Treatment also requires frequent blood glucose measurements using a glucometer. In advanced stages of the disease, regardless of the type, chronic complications including vision impairment and lower sensitivity of the limbs are among some of the complications patients face.
Theoretically, it is only possible to cure type 2 diabetes unless all the capacity of beta cells to secrete insulin has been depleted. This treatment involves aggressive and sustained reduction in the overall body weight.
How do you approach Canadian Medical Care clients? Could you please elaborate on the individual care offered for diabetes patients and what lies behind your success?
Diabetes is a multi-factor disease often accompanied by other diseases and complications resulting from diabetes itself. The success of the treatment depends highly on the level of cooperation from the patient, his/her abilities, the age and other dispositions. Tolerance to various drugs also differs from patient to patient. These are all reasons that require a “tailor made” solution for each patient suffering from diabetes. We pay great attention to the reduction in body weight as well as ensuring more physical activity. In this respect, we cooperate with nutritional specialists of Canadian Medical Care.
Can you please describe organ complications follow-up care? For example, how do you treat diabetic foot? Do you cooperate with other specialists from Canadian Medical Care while treating diabetes?
Based on the recommendation of the Czech Diabetes Society we perform screenings of potential complications with all patients suffering from diabetes. After we discover any complications, we cooperate with other specialists from Canadian Medical Care. We have excellent relationships with ophthalmologists, sonographers, neurologists and vascular specialists. Patients with advanced cases of diabetes can suffer from diabetic retinopathy, diabetic foot syndrome and when required, we then send them to specialized practices.
The occurrence of simultaneous endocrine disorders (thyroid diseases) can be addressed through our diabetes-endocrinology practice. In cooperation with gynecologists from Canadian Medical Care, we just began treating pregnant women who have been diagnosed with gestational diabetes.
We devote sufficient time to patients of Canadian Medical Care. Patients book their visits for a specific time and do not need to wait for hours in the waiting rooms. We monitor the entire treatment process (including long-term treatment plans) as well book appointment and checkups. All of this is done through timely reminders on the mobile with the help of the CMC Client Zone app.
CMC has two branches in Prague. Our central branch is situated in a beautiful small chateau in Prague 6 – Veleslavín and the second one can be found in Prague 4 – Chodov. The practice is open up to three times a week. Patients can book their appointments by emailing email@example.com or can call our call center on +420 235 360 133.