The possibility of carrying out diagnostic tests in the pharmacy office is a useful and necessary tool to develop an interesting aspect of Pharmaceutical Care. The monitoring of the main risk indicators of the most common chronic diseases in our society and the detection of health problems through these tests in just 5 minutes allow to bring a very important added value to the service provided from the counter.

There are many risk indicators that can be controlled in the pharmacy office and chronic patients need this service,

 Why do they need it?

Once the disease has been diagnosed and treatment has been introduced, it is true that they must visit their general practitioner on a regular basis. But these visits can take a long time, (even more so in these times, where making an appointment with a specialist doctor can take months…)

If medical check-ups with the doctor take place every 3 or 6 months, or even once a year; in this time period several things can happen:

– the patient voluntarily wants to control the risk parameters to ensure that his treatment is adequate. 

– The doctor himself advises these tests of self-control warning that in case of abnormal results advance your appointment with him.

– A chronically ill person detects a small change in his health and wants to confirm the cause before requesting an urgent medical consultation.

To offer this service and be able to carry out these rapid analyses of detection and follow-up of different pathologies from the pharmacy office it is enough to have a quiet space –it is not necessary to be too wide-and the appropriate material. It is also of great importance to trust the professional who attends you in the pharmacy, and see in it a person who listens to you and cares about you. In this way the patient will feel active listening and how the pharmacist gets involved with the patients.

          GLUCOSE

Food is transformed by the body, through metabolism, into glucose mainly. It travels through the bloodstream to reach cells of different types of tissue providing the energy they need to function.

Blood glucose levels are clinically called glycemia. These levels vary throughout the day, ranging from concentrations of 70 to 145 milligrams per deciliter of blood.

In the morning, fasting is lower and they rise after each meal (postprandial glycemia) and fall again two hours later.

It is recommended that blood sugar is measured when you wake up in the morning and before breakfast and is considered normal if your glucose levels are between 70 and 100 mg/dl fasting and at less than 140 mg/dl two hours after each meal.

Glucose is the risk indicator used to control diabetes.

The alarm should go off when blood glucose levels while fasting are between 100 and 125 mg/dl and after eating between 140 and 199 mg/dl.

Diabetes is spoken of when the blood glucose is above 126 mg/dl fasting and 200 mg/dl two hours after meals.

   DIABETES

 Diabetes is a chronic metabolic disease characterized by elevated blood glucose (or blood sugar), which over time leads to serious damage to the heart, blood vessels, eyes, kidneys, and nerves.

It may be due to insufficient insulin production by the pancreas, or resistance to insulin action by the body. That’s why we talk about type 1 diabetes or type 2 diabetes.

  • Type 1 diabetes. Also called juvenile diabetes or insulin-dependent diabetes. A chronic condition of the pancreas, which produces little or no insulin by itself.
  • Type 2 diabetes. It is most common, usually in adults, when the body becomes resistant to insulin.

It is estimated that approximately 90% of diabetes patients suffer from type 2 diabetes.

In the last three decades, since the late 1990s, the prevalence of type 2 diabetes has increased dramatically in “developed” countries. This makes us think that the prevalence and development of this disease has a lot to do with the lifestyle we currently follow in the Western world. Two of the particularly noteworthy factors in the “boom” of this disease (demonstrated) are the decrease in levels of physical activity and the increase in levels of overweight and obesity.

Currently, this disease is suffered by some 537 million people worldwide, 5.1 of them in our country. The number of people with diabetes in Spain has increased by 42% since 2019. Fact that puts the focus on the treatment and prevention of this disease.

Almost a third (30.3%) of people living with diabetes in Spain are undiagnosed. When diabetes is not detected or treated properly, it can cause serious and life-threatening complications, e.g. diabetes. a heart attack, stroke, kidney failure, blindness or amputation of lower limbs. These complications reduce quality of life and increase health costs.

In 2020, 20.46 people per 100,000 inhabitants died from diabetes in Spain, a figure higher than the previous four years, coinciding with the pandemic. In recent decades mortality has decreased compared to the 1990s, when this rate stood at 35.66.

Much can be done to reduce the impact of diabetes. Evidence suggests that type 2 diabetes can often be prevented: early diagnosis and access to proper follow-up for all types of diabetes can prevent or delay complications for people with the disease.

How to measure blood sugar

In healthy people, blood glucose measurement is usually included in any blood or urine test, especially for people who are obese, over the age of 50, or have been diagnosed with high blood pressure or hypercholesterolemia. In both cases, blood and urine samples should be obtained on an empty stomach.

Measurement of blood sugar in the pharmacy office

Therefore, in the pharmacy office can carry out important work, which contributes directly and actively, in the prevention and early detection of this disease.

The role of the pharmacist in all this is fundamental, both in the control and follow-up of patients with this pathology and in the detection of the disease in patients who do not know how to have it.

From the pharmacy office we can carry out an early detection of people at risk of diabetes. It can be done by screening by completing the Findrisk test. This test consists of a series of questions whose answer determines the patient’s risk of developing diabetes.

In those people in which the test result of a risk score, we will perform a capillary glycemia test. If an out-of-range result is obtained, it will be referred to the doctor. We can also make recommendations to promote a healthy lifestyle. Allowing to reduce the risk and, therefore, avoid or delay the appearance of this disease.

                Pharmacy tests for diabetes:

  • Sugar level. On the one hand, we can determine the sugar level that we present in blood at the time of the analysis. Blood glucose levels are minimal after 8 hours of fasting, so this test is usually done first thing in the morning. In this way, if fasting blood sugar is not at correct levels, we must make hygienic-sanitary recommendations and periodically monitor blood sugar in case of small variations and refer to the doctor if necessary.
  • A glycosylated hemoglobin test. On the other hand, there is another test that allows us to know the average level of glucose in the blood during the last three months, it is called the glycated hemoglobin test (HbA1c). This test is very useful for the detection of type 2 diabetes and prediabetes, as well as for the control of diabetic patients already diagnosed. The test result is delivered in percentages, the higher the percentage, the higher the blood sugar level.

With this battery of options we can contribute to the detection of diabetes and also increase the knowledge of the patient: risk of suffering it, information to seek a healthy lifestyle and thus collaborate in this serious health problem.