Maria José Jiménez, endocrinologist at Vithas Almería: “Advances in the treatment of type 1 diabetes are aimed at providing patient autonomy”

Every year on November 14, World Diabetes Day is celebrated, an event designed to raise awareness of the disease, which typically affects 14% of Almeria’s population and, in particular, “among patients with diabetes, it affects 6% of those with type 1 diabetes.” and in recent years there has been an increase,” says Maria José Jiménez, endocrinologist at Vithas Almería.

– Spain is the second country in Europe with the highest prevalence of diabetes: 14.8% of the population is aged between 20 and 79 years… Is there anything to worry about?

– Yes, we should worry, because diabetes is far from a trivial pathology, but is associated with multiple complications. In fact, it is the number one leading cause of blindness in the developed world, followed by chronic kidney disease, hemodialysis use, kidney transplantation, and non-traumatic lower limb amputation. In addition, people with diabetes have a two to four times higher risk of developing cardiovascular complications, that is, coronary heart disease, stroke or heart failure, which is the leading cause of death for these patients.

–What causes can cause type 1 diabetes?

– Type 1 diabetes mellitus is a complex, heterogeneous disease, it is multifactorial and is characterized mainly by the autoimmune destruction of beta cells that secrete insulin. Thus, these types of patients require treatment with insulin therapy. Susceptibility and resistance to this disease will be determined by the interplay between multiple genetic factors, which are more influential in children, and environmental factors, which become more important in adults. The list of environmental factors that contribute to the development of type 1 diabetes includes viral infections, air pollution, or early exposure to cow’s milk protein or gluten.

– What about type 2?

– It is a multifactorial or metabolic disease in which patients have a combination of varying degrees of insulin resistance and deficiency of insulin secretion. And among the most important biopathogenic factors, we have obesity, family history of diabetes, and ethnic group, since it is more common in Hispanics or African Americans. Focusing on gender, it is slightly more common in men with similar levels of obesity than in women and may be explained, among other things, by different patterns of fat distribution in men with greater dietary accumulation of visceral adipose tissue. character, smoking and even birth weight.

– Does an unhealthy lifestyle contribute to the development of type 2 diabetes?

-Certainly. This is one of the factors. Poor nutrition, foods rich in refined or processed sugars, and a sedentary lifestyle all contribute to the development of obesity, and if the distribution of this fat is predominantly visceral, then a state of low-grade inflammation occurs, which contributes to the development of obesity. diabetes.

– What benefits does sports bring to diabetics?

– The benefits of exercise for diabetes go beyond improving blood glucose levels. This affects such important parameters as reducing mortality in general, as well as improving the quality of life. Exercise has been observed to increase the sensitivity of peripheral tissues to insulin and improve the transport of glucose into cells. In contrast to what occurs in type 2 diabetes, the evidence for the beneficial effects of exercise on glycemic control in type 1 diabetes is less clear. Even so, increased physical activity is associated with a lower risk of complications and increased life expectancy in patients with type 1 diabetes. In addition, there are clear benefits in relation to cardiovascular risk factors or, of course, psychological well-being. existence and quality of life. Professionals recommend performing moderate-intensity aerobic exercise every week, preferably every day, and if not possible, then from 3 to 5 days and combining them with strength exercises at least 3 times a week.

– How advanced are the methods of treating type 1 diabetes?

– In type 1, where the greatest progress is observed in technology. For example, in insulin pump systems or with reconnected smart pens and insulin caps, which also allow you to monitor the administered dose. This reduces involuntary forgetfulness, missed doses and better demonstrates adherence to treatment.

– Where will research develop in the future?

– Everything is aimed at making the patient more autonomous, say, than insulin, each time with the help of artificial intelligence we try to create a closed system so that insulin can be administered depending on this algorithm and so that the patient practically does not have to do this. anything.

– Recently, the case of a young teenager from China became known who had not suffered from insulin dependence for a year while undergoing stem cell treatment in China. Will we ever see this in Spain?

– Of course, it can reach Spain. This is part of pioneering research into using stem cells to treat diabetes. There is still a long way to go before definitive treatment. This patient needs to be monitored over a long period of time because the words “cured” mean that she does not require insulin. In our country it is difficult to predict when and how this might be implemented. Clinical trials always start in adults for safety reasons, but if they work, they can of course be expanded to the pediatric population.