Abstracts by keywords: diabetes
In Germany, around 7.5 million people live with diabetes (IDF2017) [1]. A total of 95% of them have type 2 diabetes (T2D) and 5% have diabetes type 1 (T1D) or another type according to the diabetes classification [2]. In many cases, oral antidiabetic drugs for T2D or insulin for T1D and T2D can be used very successfully [3-4]. The goal of diabetes management is always to achieve and maintain good blood sugar control. As recommended by the American Diabetes Association, a glucose level of 70-180 mg/dl (3.8-10 mmol/l) should be achieved. This value can of course be adjusted individually as required. The second goal is to avoid hypoglycemia (<70 mg/dl or <3.8 mmol/l) and hyperglycemia (>180 mg/dl or 10 mmol/l) as much as possible. The long-term goal of diabetes treatment is the prevention of diabetes complications such as retinopathy, nephropathy and neuropathy [5-10]. The biggest burden in the daily life of a patient with diabetes is monitoring blood sugar. Many fingertip blood samples are necessary every day in order to be able to adjust the individual insulin regimen and achieve good blood sugar control. In order to achieve optimal blood sugar control with intensive therapy, frequent blood sugar measurements are necessary (self-monitoring of blood sugar levels (SMBG)). Unfortunately, capillary blood sampling is not able to adequately prevent hypoglycemia and hyperglycemia. Hypoglycemia and hyperglycemia affect quality of life, and hypoglycemia in particular is a major burden in living with diabetes [11]. Blood glucose testing is very time-consuming and painful and many factors must be taken into account. In addition, capillary blood glucose measurements only represent a snapshot of the current glucose level. Flash Glucose Monitoring (FGM) has been available in Germany since 2014 and is reimbursed by health insurance companies for adults and children aged 4 and over with T1D and T2D.
28.07.2020
Hypertension is responsible for more than seven million deaths worldwide each year, accounting for approximately 13% of all deaths [1]. In Germany, hypertension is diagnosed in more than 60% of people aged 65 and over [2]. Diabetes mellitus (DM) is one of the most common chronic metabolic diseases, affecting around 7% of people in Germany [3]. DM is one of the main risk factors for hypertension [4]. Most hypertension and DM patients require drug therapy, often polypharmacotherapy, to achieve optimal blood pressure and blood glucose control [4,5]. Several classes of drugs are recommended for the treatment of hypertension [4] and DM [5]. However, adherence to these therapies is still a common problem [6, 7]. The current coronavirus pandemic is having a major impact on healthcare systems around the world. Maintaining adherence in patients with chronic diseases during a pandemic can become a major challenge for physicians and pharmacies [8]. There is a risk that good care for Covid-19 patients could negatively impact the care of around 19 million patients with hypertension [9] and over 7 million patients with type 2 diabetes mellitus [10]. To date, no studies have been published on prescriptions of antihypertensive and antidiabetic medications or patient adherence to these therapies during the pandemic. It is to be expected that people are less likely to be adherent to therapy during this time. The aim of this study was to examine the development of the number of patients who received cardiovascular or diabetic medications from pharmacies in the first quarter of 2020.
28.07.2020
40 years ago, the WHO declared that at least 50 percent of diabetes cases worldwide could be prevented and - as can be read in the Diabetes Health Report 2013 (1, p. 23) - called for actions to prevent this disease. However, the call received little attention back then - much like it does today. Over these many years, the German healthcare system has invested billions to care for people with this disease. According to the CODE-2 study (2), the costs caused by patients with type 2 diabetes in Germany amounted to around 15.7 million euros in 1998 - which has since extrapolated to many hundreds of billions of euros. But: Despite this immense investment, why are there still deficits in diabetic care as one of the most cost-intensive chronic diseases? It is reasonable to assume that the fundamental problem of almost all “non-communicable diseases” - enabling the people affected to self-manage and motivating lifestyle changes - cannot be overcome with the current acute care approach alone.
24.01.2013
Diabetic foot syndrome is a secondary disease of diabetes mellitus and often leads to non-traumatic amputations. These are associated with high medical costs, loss of quality of life and high mortality (Heller et al. 2004). Diabetic foot syndrome occurs with a prevalence of 6.5% among type 2 diabetes patients (Lauterbach et al. 2010). Endogenous risk factors such as B. diabetic polyneuropathy or peripheral arterial disease (PAD) have a prevalence of 30% and 25%, respectively (Lauterbach et al. 2010). Prevention of diabetic foot syndrome is therefore very important. In addition to the endogenous risk factors mentioned, exogenous factors such as: For example, inadequate footwear or poor foot care play a crucial role (Uccioli et al. 1995; Chantelau/Haage 1994; Brent et al. 2006). According to the International Consensus on the Diabetic Foot (1999), the prevalence of diabetic foot syndrome could be reduced through, among other things, regular inspections of the feet and footwear, training of patients and family members and the wearing of suitable footwear. An important and effective intervention measure is to train and instruct patients to self-inspect their feet.
24.02.2012
The complexity of the metabolic disease diabetes mellitus type 2 affects many organs in the body. Accordingly, a positive correlation is often found between the severity of diabetes and the occurrence of other diseases such as neuropathy, peripheral arterial disease (PAOD) and coronary artery disease (CHD) (Bauer T, 2011). CHD means that the coronary arteries that supply the heart muscle with oxygen are narrowed. This constriction is caused by arteriosclerosis, which in turn can arise from hypertension, hyperlipidemia and increased blood sugar levels in diabetes mellitus. In particular, the increased blood sugar damages the vessels and leads to micro- and macroangiopathies. As a result, diabetics are much more likely to develop CHD than non-diabetics (Kannel W, 1979). The risk of coronary heart disease is already increased before the diabetes diagnosis, as the pre-diabetes phase with elevated blood sugar levels exists for a long time before the confirmed diabetes diagnosis (Hu FB, 2002)