Hey guys! All good? Let's talk about diabetes today, folks.
Why do I like to talk about diabetes? We know that diabetes is one of the deadliest diseases for the heart, folks! So, if you are diabetic and still don't have a good cardiologist to accompany you, look for a cardiologist as soon as possible.
We know that diabetes facilitates numerous heart diseases, increases the risk of having a heart attack, increases the risk of having a stroke, greatly increases the risk of having heart failure. So, if you are diabetic or pre-diabetic, stay with me until the end of the video, I will give you several tips and talk about some mistakes that diabetics make; you can be diabetic and not know you are making these mistakes! So, come with me until the end of the video and run the vignette!
Doctor Roberto Yano, Cardiologist. Hello heart friends! All good?
I am Doctor Roberto Yano, Cardiologist, Pacemaker Specialist. So why do I always like to talk about diabetes? Diabetes is a pathology that I always like to warn you, friends of the heart.
We know that diabetes is one of the deadliest heart diseases; It is one of the main causes of heart failure. Diabetes makes the heart weak. And, why does he make the heart weak?
The diabetic lives in a pro-inflammatory state, the body, the cells are all inflamed. This excess glucose corrodes the muscles of your heart and what is muscle, over the years, becomes fibrosis, a scar. It ceases to function and upon ceasing to function it will lose its pumping capacity.
Then, over the years, that heart that every time it beat, ejected 70% of blood from the ventricle to the aorta, you will reassess, it is ejecting 15%, 20%! That's because the diabetic left diabetes poorly controlled for many years. So, if you have diabetes, it is very important that you follow up with a good Endocrinologist.
. . But I always say that every Cardiologist, at least, should know how to treat diabetes better than the Endocrinologist!
Why? Because diabetes is a disease that will lead to numerous heart pathologies. So, as I said earlier, diabetes, this excess glucose, it also corrodes the vessel walls, corrodes our endothelium, increasing the atherosclerosis process, facilitating the entry of fat into our arteries, clogging all our arteries, our arteries of the heart.
Many people with diabetes begin to complain of pain in their legs, why does this happen? Because our leg innervations have what we call vasa nervosa, which are the vessels that irrigate our nerves. So, you end up having microinfarctions due to poorly controlled diabetes, and this enervation dies down!
Then, you start to have those chronic pains, diabetic neuropathy. So, there is the process of atherosclerosis, there is the process of heart failure, this clogging of microcirculation as well, which diabetes causes. Another thing that diabetes can lead to, countless types of cancer, because imagine, you all inflamed, with all your cells developing badly, facilitating mutations even in your cellular DNA, increasing the risk of having, then, also countless types of cancer , guys.
You didn't know that, that diabetes also increases the chance of you having cancer one day! And what are the main mistakes that diabetics make, that the diabetic who comes to my office makes and, many times, he doesn't know? The first thing, folks: the diabetic has to know the value of his glycated hemoglobin.
I get tired of seeing in my office, the patient arrives for the first evaluation, because in the second he will already know, because I will talk so much about glycated hemoglobin, that in the second consultation he will already know by heart what his glycated hemoglobin is. But what is glycated hemoglobin? It estimates how your glucose has been over the past 90 days.
So, the fasting blood glucose on the day the test was taken is also important, it gives us an idea if the diabetes is well or poorly controlled, but through the glycated hemoglobin we will know how was the patient's glucose in the last 90 days. And sometimes he comes to the office and doesn't know. But, do you know the value of your glycated hemoglobin?
Surprisingly, more than 90% of patients do not know the value of glycated hemoglobin! We know that a glycated hemoglobin above 7 already shows that diabetes is poorly controlled. For elderly, bedridden or debilitated people , in some cases we can even accept a glycated hemoglobin of 7.
5 or even 8 in some cases. But most of the time, a glycated hemoglobin above 7 already shows that your diabetes is poorly controlled. So, you who are diabetic, you will take your last exam, see the value of your glycated hemoglobin, and if it is above 7, you will go back to your Cardiologist, you will go back to your Endocrinologist, and they will work out a strategy to see what you are going to do to control this diabetes, either by optimizing medications, or by changing your eating habits, or by intensifying physical exercise!
We know that the diabetic who doesn't exercise, the diabetic who is a smoker, for example, is a total disaster! But that diabetic who eats poorly, for sure, the chance of having a heart attack, stroke, heart failure, kidney failure is much greater! Another thing I was forgetting is the issue of diabetes related to kidney problems.
So, that glucose, it also consumes all your kidney cells, so the chance of the diabetic progressing to kidney failure is also very high! Another thing that the patient often does not know, today there are numerous medications, which are increasingly safer. .
. To give you an idea, today to make a medication for diabetes, first you have to prove that it will not cause harm the heart. But, there is a high range of medicines that are for diabetes, which also help to protect the heart.
So, talk to your doctor, talk to your cardiologist to choose the class of drugs that will also help protect the heart. There are drugs for patients who have heart failure, who use drugs for diabetes. So, these are newer things, from three to four years ago, we used diabetes drugs to treat heart failure.
There are diabetes medications that promote weight loss as well. So, if you're obese, type 2 diabetic, insulin resistant, with a lot of abdominal fat, talk to your doctor, maybe it's good to take a medication that will make your diabetes well controlled, and that will promote your slimming. There are diabetes medications that don't cause hypoglycemia, they have a smart action, so to speak; he sees that your glucose is fine, he decreases the functioning.
Because, until then, the older drugs caused a lot of hypoglycemia, they didn't have that intelligence. Not infrequently, patients with blood glucose levels of 50 or 45 would appear at the office, with the effects of dizziness, fainting, even mental confusion due to hypoglycemia. So, there are numerous classes of drugs, which are specific for those who are obese, which are specific for those who have heart failure, which are specific for those who have kidney failure, which are specific for those who have high blood pressure.
And sometimes, if you don't follow up with a person who deeply understands diabetes, he won't know how to treat it correctly. Once again I repeat: Every Cardiologist has to know how to treat diabetes better even than the Endocrinologist! That, at least, is the idea we cardiologists have!
But, let's go to the third mistake that diabetics make, I get tired of seeing it in the office. . .
, but first, you're already subscribed to the channel, have you clicked the bell to receive all notifications? At the end of the video, don't forget, guys! If you like the video, don't forget to like it.
When you like it, you help spread more information! And, as I always say here, my idea is to save the world, folks! And I want to know if you're coming with me or not!
Why do I say save the world? Now I'm putting subtitles in Japanese, English, Spanish. So you from all over the world; If you're married to an American, an Englishman, a Spaniard, you'll be able to see all my tips in the subtitles!
Then I want you to follow me on Instagram too! My Instagram is @dr. yano But, come on!
Third mistake: being afraid of insulin. I also get tired of seeing people in the office afraid to take insulin. "Ah, doctor, but I'm going to be dependent!
I'm going to have to take insulin for the rest of my life! " Indeed, from the moment we start insulin, it is unlikely that we will regress to oral medications afterwards. Sometimes, we even use oral medications together with insulin.
But today there are excellent insulins, people! Insulins using 4 mm needles. In the old days, I know that most people still use it, the one at the health center, with a rather large injection, in which it is not possible to obtain glycemic control in the most adequate way.
But, today, there are very good insulins, those with ultra slow release, with prolonged effect, those that last 24 hours. There are also those ultra-fast-acting insulins that you apply immediately before meals, which manage to maintain your blood glucose, and finally, your glycated hemoglobin always well controlled. These applications with these injections, with 4 mm needles, are practically painless, folks!
So, sometimes, you talk, you who take insulin and are not able to control your diabetes, talk to your doctor, your cardiologist, consider the possibility of switching to a better quality insulin. Today, there are even nasal-acting insulins, with ultra-fast action! So, nowadays, you manage to control diabetes through all this arsenal.
Remembering that exercise will be fundamental! The more exercise you do, the more your glucose will be controlled, the less medication you will need! And, of course, you'll have to improve your diet, a diet that may be rich in carbohydrates, empty calories; you who drink soda, beer, a lot of caloric and low-nutrient things, you have to change your mindset and look for a good Nutritionist, a good Physical Educator, a good Cardiologist and a good Endocrinologist.
This is in a perfect world, I know we often can't afford to pay all these professionals, but there's a lot you can do on your own! A lot that depends only on you! All right, guys!
For those who don't know, Clínica Yano is now here in Indaiatuba. So, you from Indaiatuba, Campinas, Salto, Itu, Sorocaba, many people from São Paulo. I'm serving more people from São Paulo than here from Indaiatuba!
And, the Clinic is on the side of Viracopos! You can come from Manaus, take a plane here, and consult in person. And, we also serve all of Brazil via telemedicine!
It's ok, guys! Look how much information! Then don't forget to share the video!
I know this video can help a lot of people, if you have a relative or friend who is diabetic, send it to them! And, even for you who are pre-diabetic, or you who don't have any disease! Look how much information there is, which will help you to take care of your health more and more!
OK people! I'm staying here! Today's message is this!
A big hug and until next time!
