Diabetes is a heterogeneous condition that can present in different forms and with different underlying mechanisms. From autoimmune type 1 diabetes, to type 2 diabetes linked to lifestyle, through to gestational diabetes, MODY diabetes, and other types, each form requires a personalized approach. In all cases, controlling blood glucose levels is essential to prevent complications and preserve quality of life.

Diabetes mellitus is a chronic disease that results from an excess of glucose in the blood (hyperglycemia) due to a disruption in the production or action of insulin.

There are several recognized types of diabetes:

• Type 1 diabetes: an autoimmune disease that requires insulin treatment from the time of diagnosis.

• Type 2 diabetes: the most common form, associated with genetic factors and lifestyle factors such as obesity and physical inactivity.

• Gestational diabetes: appears during pregnancy.

• MODY diabetes: rare forms of genetic origin.

• Other types of diabetes: such as those secondary to pancreatic diseases or associated with certain medications.

The diagnosis of diabetes is established through blood tests that assess glucose levels and other metabolic parameters. The tests most commonly used are:

Main diagnostic tests

· Fasting glucose
(Diabetes is diagnosed when ≥ 126 mg/dl on two separate occasions).

· Glycated haemoglobin (HbA1c)
(Diabetes is diagnosed when ≥ 6.5%).

· Oral glucose tolerance test (OGTT or “curve”)
(Diabetes if glucose is ≥ 200 mg/dl at 2 hours).

In cases where type 1 diabetes is suspected, especially in young individuals, rapid onset or marked symptoms, it may be necessary to evaluate specific autoantibodies (GAD65, IA-2, ZnT8, insulin), which help distinguish between different types of diabetes.

Normal glucose values

· Fasting: 70–99 mg/dl

· Postprandial (2 hours after OGTT): < 140 mg/dl

Persistently elevated values (especially above 160–180 mg/dl for several days) can cause the three classic symptoms known as the 3 Ps:

Classic symptoms of diabetes

· Polyuria: increased urine output.

· Polydipsia: excessive thirst.

· Unintentional weight loss.

Other frequent symptoms that should alert us

· Constant hunger

· Blurred vision

· Fatigue or tiredness

· Frequent infections (urinary, skin…)

· Slow wound healing

· Irritability or mood changes

· Nausea or general discomfort

Important in type 1 diabetes

We now know that before symptoms appear, type 1 diabetes can be detected through autoantibody screening tests, which identify the disease at very early stages.
→ This enables early diagnosis, prevents onset in ketosis and allows for appropriate follow-up planning.

The treatment of diabetes depends on the type of diabetes and the specific needs of each patient. At barnaclínic+, we combine the most advanced treatment options with individualized, multidisciplinary follow-up.

Treatment of type 1 diabetes

· Intensive insulin therapy using multiple daily injections (MDI) with insulin pens.

· Continuous subcutaneous insulin infusion (CSII) via insulin pumps or hybrid closed-loop systems.

· Either of the two previous modalities are accompanied by the use of continuous glucose monitoring systems (sensors or CGM).

· Immunotherapy in early stages of the disease.

· Diabetes education focuses on providing the knowledge, skills, and attitudes needed to adapt and improve metabolic control throughout the different stages of diabetes (onset, treatment change, onset of complications, etc.).

· Psychological and nutrition support tailored to the patient's profile.

Treatment of type 2 diabetes

· Medical nutrition therapy and regular physical activity.

· Oral or injectable medications (GLP-1, SGLT2, etc.).

· Insulin therapy with or without continuous glucose monitoring.

· In selected patients, diabetes remission may be achieved through intensive lifestyle changes and sustained weight loss.

Treatment of gestational diabetes

· Strict nutritional and glycemic control.

· Physical activity adapted to pregnancy.

· Insulin in cases that are not controlled by diet alone.

· Coordinated follow-up by a multidisciplinary team including gynecologists and endocrinologists

At barnaclínic+, we offer a comprehensive, precise and personalized approach to the diagnosis and treatment of diabetes, regardless of the type. Our team from the Endocrinology and Nutrition Department of Hospital Clínic de Barcelona provides:

Human and close approach

We support every step of your diabetes treatment process with personalized care, therapeutic education, and tools to improve your quality of life.

Cutting-edge technology

Closed-loop systems (insulin pumps), glucose sensors, connected platforms that allow remote data access Closed-loop systems with remote data access.

Innovation and advanced treatment

We are a leader in research and new therapies for type 1 diabetes, type 2 diabetes, gestational diabetes, MODY diabetes, and other types of diabetes.

Expert multidisciplinary team

Endocrinologists, nutritionists, diabetes educators, clinical psychologists, and exercise specialists work together to address each patient's needs.

In-person, online or mixed monitoring modality

Wherever you live, our team can offer diabetes monitoring options tailored to your needs.

Diagnosis and monitoring in one place

Analysis, consultation, therapeutic planning and progress monitoring without travel.