ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume: 16 Issue: 1 Year: 2024
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Turkish Society for Pediatric Endocrinology and Diabetes
Diabetes from the Clinician Perspective [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2015; 7(2): 24-24

Diabetes from the Clinician Perspective

Şevki Çetinkalp1
Ege University Faculty Of Medicine, Department Of Endocrinology And Metabolism, Izmir, Turkey

What are the features of diabetes which makes it difficult for the clinician: - although diabetes is the oldest known disease, its definitive treatment has not been found, - diabetes shows an unhindered increase all over the world and as in our country, - adverse environmental factors lead to development of diabetes, - there is still discussion about the diagnosis and the diagnostic criteria of diabetes, - is a lifelong disease, - requires continuous treatment, - has acute and chronic complications, - deteriorates the quality of life of the patients considerably, - is a major cause of cardiovascular morbidity and mortality, - is a disease with high cost for the community, - changing treatment guidelines for each year. Who can say “no, this is not a problem” for those common matters? As you go into the details of diabetes, you realize that as new pathogenetic mechanisms are discovered, questions and problems will be increasing. Do new definitions and the new pathogenetic mechanisms lead to new treatment modalities? - Yes, they do. - If so, do new treatments provide exact solutions? - No, they do not. - Since abnormal blood glucose levels cause acute or chronic complications, is it expected that normalization of blood glucose ameliorates everything - Very logical, it is expected. However, each logical information may not be medically accurate. Especially, when the issue is diabetes, one way of thinking leads to many mistakes and disappointments. Unfortunately, our knowledge of glycemic control (ACCORD, ADVANCE, VADT, UKPDA) does not comprise everything, but it only points to part of it. In addition to that, if metabolic memory hypothesis is correct, it is emphasized that regulation of blood sugar during the first few years of the disease is quite important. - What makes diabetes so difficult? - It does not matter which parameter you take, it is very uncommon to see terminologies beginning with MONO, because the current definitions of diabetes start with MULTIPLE. If you start with MONO, the result will be either disappointment or unknown mechanisms which are not established yet. What makes diabetes difficult is the fact that diabetes is MULTI factorial. If you are talking about diabetes as you have many definitions, several mechanisms, many thoughts, you should be open to all those things, too. Diabetes treatment cannot be simple. Diabetes treatment requires a professional approach and treatment. There is no single doctor treating diabetes, there are many of them: endocrinologist, diabetologists, internal medicine specialists, family physicians, ophthalmologists, cardiologists, orthopedists specialized in diabetic foot, vascular surgeon, dermatologist, infectious disease specialists, nephrologists, neurologists, anesthetists, obstetricians, general surgeons, plastic surgeons and urologists. We may come across a diabetic patient on each floor of the hospital. Therefore, collaboration of experts is essential. The prevalence of diabetes is increasing all over the world and in our country. According to the International Diabetes Federation data, the prevalence of diabetes is 8.3% in the world in 2013. In Turkey, the prevalence of diabetes is 18.3% according to the CREDIT 2 study. We need to increase our knowledge and share it to stop the diabetes epidemic. Difficulties will always be present, because this is inherent in diabetes. The important thing is to try to overcome these difficulties and not to give up. We will never know the end of the road.

Keywords: Diabetes, clinical approach, problems, solutions, expectations

Şevki Çetinkalp. Diabetes from the Clinician Perspective. J Clin Res Pediatr Endocrinol. 2015; 7(2): 24-24
Manuscript Language: English
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