Los diabéticos llegan tarde al tratamiento

Woman Performing Blood Test on Herself

Cuando empiezan a recibir insulina, el 84% ya sufre complicaciones de este trastorno, como enfermedad renal o cardiovascular.

Cuando a la enorme mayoría de las personas con diabetes el médico les indica que deben comenzar a inyectarse insulina, ya es tarde.

Eso es lo que revela el estudio más grande realizado sobre diabetes tipo II, que mostró que, en el momento de comenzar a usar insulina, el 84% de los pacientes ya había desarrollado alguna de las complicaciones que se asocian con esta enfermedad, que se caracteriza por diferentes trastornos metabólicos que resultan en niveles elevados de azúcar en sangre (hiperglucemia).

Enfermedad cardiovascular, enfermedad renal, problemas en la vista, úlceras en los pies y neuropatías… Todas las complicaciones de la diabetes, que pueden prevenirse con un control adecuado de los niveles de glucemia, estaban presentes a la hora de comenzar con la insulina, según reveló el estudio apodado A 1 chieve, que evaluó a 66.726 pacientes con diabetes tipo II de 28 países -incluida la Argentina-, y cuyos resultados iniciales fueron presentados recientemente en el congreso de la Sociedad Norteamericana de Diabetes, que se realizó en San Diego, Estados Unidos.

“Este trabajo muestra algo que ocurre en distintas partes del mundo: que el paciente llega a la insulina cuando ya tiene avanzada su enfermedad”, dijo a LA NACION el doctor León E. Litvak, presidente de la Sociedad Argentina de Diabetes (SAD) y uno de los autores de la mencionada investigación.

Distintos tratamientos

Las inyecciones de insulina constituyen una de las formas de tratamiento de la diabetes tipo II, enfermedad en la que las células del organismo del paciente se vuelven resistentes a los efectos de la insulina propia.

Inicialmente, el tratamiento de la diabetes implica medidas relacionadas con un régimen adecuado de alimentación y la práctica de actividad física, así como también el uso de medicamentos orales (hipoglucemiantes).

“Existen estudios que sugieren que a los cinco años del diagnóstico, el 50% de los pacientes con diabetes requiere insulina -comentó Litvak, jefe de la Sección Diabetes y Metabolismo del Hospital Italiano de Buenos Aires-. No es que a los cinco años, sí o sí, la mitad de los pacientes requieran insulina, pero los médicos debemos estar atentos a que muchos de nuestros pacientes sí la necesitarán.”

En los países de América latina, según mostró el estudio A 1 chieve , el tratamiento con insulina se inicia, en promedio, a los 10,4 años de diagnosticada la enfermedad.

¿Por qué se demora?

“En primer lugar, la gente tiene cierto prejuicio ante el uso de la insulina, ya que la asocia con grandes complicaciones, cuando en realidad las complicaciones resultan del avance de la enfermedad cuando no es tratada en forma adecuada -respondió el médico endocrinólogo-. Pero esa asociación no sólo es ficticia, sino que cuando la enfermedad está avanzada no queda otro camino más que utilizar insulina [hormona que controla el nivel de azúcar en sangre].”

El otro freno para el uso de la insulina proviene del ámbito médico.

“El médico sabe que para que el paciente pueda usar insulina es necesario darle un mínimo de entrenamiento, de educación diabetológica, y eso hace que demore el inicio -agregó Litvak-. Además, en la Argentina muchos pacientes no son atendidos por especialistas en diabetes, sino por médicos clínicos, cardiólogos y nutricionistas, y en especial los clínicos tienen miedo a comenzar con insulina, por temor a los episodios de hipoglucemia [niveles anormalmente bajos de glucemia, que pueden causar cefalea, desorientación, convulsiones, pérdida de la conciencia y otros cuadros].”

Y si el clínico deriva al paciente a un especialista, agregó Litvak, ahí hay una demora.

“Si el paciente no tiene acceso a un especialista, es probable que quede en manos de un médico que, al no conocer cómo se utiliza la insulina, no la usa”, concluyó el especialista.

Se estima que en la Argentina el 7% de la población adulta presenta diabetes. En su tipo II, la enfermedad es causada por una resistencia de las células a la insulina, lo que repercute en el metabolismo de los carbohidratos, lípidos y proteínas.

Entre otros síntomas, la diabetes puede manifestarse por una emisión excesiva de orina (poliuria), aumento anormal de la necesidad de comer (polifagia) e incremento de la sed (polidipsia).

  • 9,5%

Son las muertes por diabetes. Se encuentra involucrada en decesos por cualquier enfermedad en individuos de entre 20 y 79 años.

  • 8,1 Miles de millones de dólares

Es el costo anual de la diabetes y sus complicaciones en América latina.


Fuente: lanacion[dot]com[dot]ar

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