Monitor your glucose levels to keep it under control.
Simulate the pancreas. There are many systems that seek to control the concentration of glucose in a patient’s blood. Because? Make life easier for diabetics. The disease affects 537 million people worldwide, and this figure is expected to increase to 643 million in 2030. According to the Spanish Diabetes Society, in Spain an estimated one in seven people suffer from the disease, as our country has the second highest number of cases in Europe.
Type 1 diabetes accounts for 1 in 10 cases of diabetes in Spain., affecting almost 90,000 people. The main reason is that it is autoimmune, that is, the immune system of a person with this pathology confuses the cells of his pancreas, which are responsible for the production of insulin, with foreign cells and tries to destroy them. Thus, these patients have a complete lack of insulin, a hormone that is necessary to introduce glucose into cells so that they can function. Because of this, to survive, diabetics need to inject insulin several times a day to regulate blood sugar levels and avoid short- and long-term complications.
Traditionally, finger pricking, or in other words, puncturing a capillary in the fingers, is used to measure blood glucose levels in people with diabetes. This measure, in addition to being inconvenient for patients, only provided an isolated view of the sugar level they had at that particular moment. Recent government funding for continuous glucose monitoring systems has changed this. These systems consist of a small sensor that is placed on the arm or stomach for 10 to 14 days and sends minute-by-minute blood glucose data to a receiver, which could be a reader, a cell phone, or even a computer. Smart watch. Thus, people with diabetes have continuous information about their glucose levels and their fluctuations, which allows them to act and even anticipate a drop (hypoglycemia) or a rise (hyperglycemia) in glucose levels.
This approach has shown important improvements in the control of this condition in various studies. Without a doubt, this was a real step forward for the professionals treating these patients, as they gained more information: monitoring glucose levels 24 hours a day and accumulating data over weeks and months to better develop. treatment strategies and lifestyle of patients.
However, the large amount of information provided by these systems makes their analysis very complex, requiring a lot of time and prior experience from specialists, which is a challenge in clinical practice. For this reason, various indices have been developed that summarize all this information. Until now, these parameters had some limitations, and up to seven of them had to be taken into account in order to know what the problem is with a diabetic’s glucose level and be able to offer a suitable solution.
In 2022, an alternative proposed is the theoretical use of a glycemic risk index, which attempts to summarize in one figure all the information provided by continuous glucose monitoring systems in humans. This new parameter emerged from scores assigned by 330 international experts to data from 225 diabetic patients treated with insulin. The analysis showed that the experts’ ratings depended on two components: one related to time spent at low glucose levels (known as hypoglycemia), and the other related to time spent at high glucose levels (hyperglycemia).
Despite much international support, its recent emergence has meant that its usefulness in routine clinical practice has not yet been demonstrated or validated in the pediatric population. For this reason, a team composed of endocrinologists and pediatricians from the University of Valladolid (UVa) and the University Teaching Hospital of Valladolid confirms the effectiveness of the glycemic risk index thanks to a real-life evaluation involving 202 adult and pediatric patients.
Specifically, explains Dr. Gonzalo Diaz Soto, they calculated this index in these patients and studied how it performed in these populations, depending on age and type of treatment, comparing it with other indicators used so far. “This study, which was the first in the world in adults and children in routine clinical practice, demonstrates that this index is effective and allows us to accurately assess diabetes control in our patients,” said Dr. Paloma Perez Lopez. .
His calculation, in his opinion, is simple. And its benefit, he adds, is great because it allows for a higher risk assessment for hypoglycemia, which is an emergency, and a lower risk assessment for hyperglycemia. “This weighting allows for risk stratification and patient prioritization in a simple way.” Added to this, he explains, is making better use of the various appointments they schedule with their patients. Without neglecting, the doctor notes, making the most of all the information they receive as a result of constant glucose monitoring. In this way, he emphasizes, they can have a clearer understanding of the strategies to follow and address the most important aspects, such as screening for chronic complications or the psychosocial area.
In fact, says Gonzalo Díaz Soto, they will continue to study the glycemic risk index along with other promising indicators, for example, derived from the psychosocial sphere of diabetics, such as quality of life or disease-related stress, to see whether this tool is a good indicator in this sense . Other projects they have in mind are analyzes of other patient groups, such as pregnant women with gestational diabetes or older adults.
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