{"id":721,"date":"2026-07-01T07:11:00","date_gmt":"2026-07-01T13:11:00","guid":{"rendered":"https:\/\/revistaece.dataware.cloud\/?p=721"},"modified":"2026-06-03T09:56:29","modified_gmt":"2026-06-03T15:56:29","slug":"hablemos-de-la-diabetes-y-del-monitoreo-constante-de-glucosa","status":"publish","type":"post","link":"https:\/\/revistaece.dataware.cloud\/?p=721","title":{"rendered":"Hablemos de la diabetes y del monitoreo constante de glucosa"},"content":{"rendered":"\n

Ch\u00e1vez Vera Sara1<\/sup>, P\u00e9rez Nava Alejandra2<\/sup>,Frontana Uribe Bernardo A.3<\/sup><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Fechas de recepci\u00f3n: <\/strong>15-3-2026<\/p>\n\n\n\n

Fechas de aceptaci\u00f3n: <\/strong>14-4-2026<\/p>\n\n\n\n

Qu\u00edmica\/Epistemolog\u00eda social<\/strong><\/p>\n\n\n\n

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DOI: https:\/\/doi.org\/10.64121\/rece.2026V5.cpf45<\/div><\/a><\/div><\/div>\n\n\n\n
PDF<\/div><\/a><\/div><\/div>\n<\/div><\/div>\n\n\n\n

Resumen<\/strong><\/h2>\n\n\n\n

La diabetes es un padecimiento de alta incidencia a nivel global; su prevalencia en adultos ha aumentado del 7% al 14% entre los a\u00f1os 1990 y 2022. El control y la prevenci\u00f3n de esta enfermedad est\u00e1n estrechamente ligados al monitoreo constante de la glucosa en sangre. Dado que conocer nuestros niveles de glucosa nos permite adecuar la dieta, el ejercicio y la ingesta de medicamentos que contribuyen al control de la diabetes, los gluc\u00f3metros y los sensores continuos se convierten en nuestros mejores aliados. En este art\u00edculo abordaremos desde los antecedentes hist\u00f3ricos de los dispositivos de cuantificaci\u00f3n de glucosa hasta las herramientas m\u00e1s modernas disponibles comercialmente, as\u00ed como sus ventajas y desventajas a considerar para integrarlas en nuestro estilo de vida.<\/p>\n\n\n\n

Como es bien sabido, la diabetes es una enfermedad muy com\u00fan en M\u00e9xico y el mundo. De acuerdo con la Federaci\u00f3n Internacional de Diabetes, 589 millones de personas padecen actualmente esta condici\u00f3n a nivel global y, de estos, al menos 35 millones de adultos de 20 a 79 a\u00f1os la padecen en Am\u00e9rica Latina. Pero \u00bfsabes, en realidad, qu\u00e9 implica este padecimiento?<\/p>\n\n\n\n

La diabetes, tambi\u00e9n conocida como diabetes mellitus, es un trastorno que afecta nuestra capacidad de producir energ\u00eda a partir de los alimentos y tambi\u00e9n se denomina enfermedad metab\u00f3lica. Este padecimiento se caracteriza por un nivel de glucosa (es decir, az\u00facar) en sangre demasiado elevado, como resultado de una producci\u00f3n deficiente de la hormona insulina por el p\u00e1ncreas. Desgraciadamente, una vez que se presenta, es un padecimiento cr\u00f3nico e incurable, por lo que el enfermo de diabetes vivir\u00e1 con \u00e9l el resto de su vida.<\/p>\n\n\n\n

La insulina permite que la glucosa se transporte en el torrente sangu\u00edneo hasta las c\u00e9lulas, donde se convierte en energ\u00eda que necesitamos para mantenernos con vida y realizar todas nuestras actividades diarias (v\u00e9ase la Figura 1). Cuando nuestro cuerpo deja de producir insulina, o bien cuando la que produce es muy poca o defectuosa, el organismo no es capaz de producir energ\u00eda a partir del az\u00facar obtenida de los alimentos, provocando su acumulaci\u00f3n en sangre. \u00a1Esto puede causar da\u00f1os muy graves si no se controla!<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Ilustraci\u00f3n 1: Ciclo de la glucosa. Imagen propia.<\/p>\n\n\n\n

Para empezar, si los \u00f3rganos esenciales para la vida no reciben energ\u00eda, la persona puede caer en coma y, en el peor de los casos, morir. Pero aun evitando este escenario tan catastr\u00f3fico, tener niveles de glucosa en sangre elevados durante largos periodos afecta a muchos \u00f3rganos, por ejemplo, el coraz\u00f3n, los ri\u00f1ones, los nervios, las terminales venosas en las extremidades y los ojos. Si estos niveles no se controlan y permanecen elevados, con el tiempo estos da\u00f1os pueden ser irreversibles, causando alguna discapacidad en el paciente como: ceguera, insuficiencia renal, infartos, accidentes cerebrovasculares o la amputaci\u00f3n de extremidades.<\/p>\n\n\n\n

Actualmente, se catalogan distintos tipos de diabetes, siendo tres los m\u00e1s importantes: i) la diabetes tipo 1 (DT1), que no se puede prevenir, dado que es una enfermedad autoinmune en la que el propio cuerpo ataca al p\u00e1ncreas hasta el punto de que ya no le es posible producir la insulina necesaria. Este tipo de diabetes es m\u00e1s com\u00fan en ni\u00f1os, por lo que durante mucho tiempo se le conoci\u00f3 como diabetes infantil. Sin embargo, nadie est\u00e1 a salvo, por lo que es muy importante realizar chequeos rutinarios. Las personas con DT1 necesitan inyectarse insulina para vivir (insulinodependientes), y la dosis debe ajustarse constantemente seg\u00fan la edad, la alimentaci\u00f3n y la actividad del paciente d\u00eda a d\u00eda. ii) La diabetes tipo 2 (DT2) es el tipo m\u00e1s com\u00fan en todo el mundo; ocurre generalmente en adultos; sin embargo, cada vez se reportan m\u00e1s casos en ni\u00f1os. Esto ocurre cuando el cuerpo no produce suficiente insulina o se vuelve resistente a ella. Este tipo de diabetes est\u00e1 estrechamente ligado a los h\u00e1bitos alimenticios y al nivel de actividad f\u00edsica, por lo que s\u00ed es prevenible comiendo sanamente y evitando el sedentarismo, pero, una vez que se desarrolla, tambi\u00e9n es incurable y requiere cuidados similares a los de las personas con DT1. iii) La diabetes gestacional: este tipo de diabetes se presenta solo en el 10% de las mujeres embarazadas y suele resolverse por s\u00ed misma tras el parto; sin embargo, el hecho de haber desarrollado diabetes gestacional es un factor que aumenta la probabilidad (hasta en un 19%) de desarrollar DT2. En el estudio \u201cDiabetes & Woman\u2019s Health Study\u201d se consider\u00f3 un total de 2,434 mujeres diagnosticadas con diabetes gestacional; 601 de ellas desarrollaron DT2.<\/p>\n\n\n\n

Seg\u00fan la Organizaci\u00f3n Mundial de la Salud (OMS), en el 2021 se reportaron 537 millones de personas con diabetes (considerando todos los tipos) y, tan solo en ese a\u00f1o, la diabetes y la nefropat\u00eda diab\u00e9tica causaron m\u00e1s de dos millones de defunciones en el mundo. Las proyecciones de la OMS indican que para el a\u00f1o 2030 ser\u00e1n 643 millones de personas las que padezcan esta condici\u00f3n y, para el 2045, hasta 783 millones de personas en el mundo. En esta enfermedad, la prevenci\u00f3n, el monitoreo y el control, mediante dieta y medicamentos, ayudan a disminuir los cuadros graves y las muertes asociados a las discapacidades provocadas por la diabetes. Para ello, existe una amplia gama de herramientas que permiten a pacientes y profesionales de la salud medir la concentraci\u00f3n de glucosa en sangre. <\/p>\n\n\n\n

Las primeras pruebas que permitieron medir el nivel de glucemia de los pacientes fueron pruebas de orina en laboratorios de an\u00e1lisis cl\u00ednico en 1776. A partir de este descubrimiento se desarrollaron pruebas caseras; por ejemplo, en la \u00e9poca de los 50 se empezaron a comercializar productos como \u201cClinitest\u201d, un reactivo que indicaba, por cambio de color, un rango de concentraci\u00f3n de glucosa; los pacientes deb\u00edan recolectar y hervir muestras de su orina para despu\u00e9s agregarles el reactivo. Estas pruebas evolucionaron hacia las pruebas de embarazo en tiras, similares a las actuales. Por otro lado, las pruebas en sangre tambi\u00e9n empezaron a desarrollarse en esta \u00e9poca y r\u00e1pidamente demostraron su utilidad; sin embargo, eran muy diferentes de los tests de punci\u00f3n dactilar que conocemos actualmente. Aun en la d\u00e9cada de los 60, estas pruebas estaban limitadas \u00fanicamente a instituciones m\u00e9dicas profesionales, donde la muestra de sangre se tomaba con jeringas reutilizables con agujas mucho m\u00e1s gruesas que las peque\u00f1as lancetas populares hoy en d\u00eda. Este procedimiento, adem\u00e1s de resultar doloroso, caro y tardado, con mayor invasi\u00f3n y estr\u00e9s para el paciente, conlleva un riesgo mucho mayor de infecci\u00f3n. En 1965 se desarroll\u00f3 la primera tira reactiva de glucosa, llamada \u201cDextrostix\u201d, pero, debido a su escasez y su costo, se limitaba a consultorios m\u00e9dicos, cl\u00ednicas y hospitales.<\/p>\n\n\n\n

Durante d\u00e9cadas, el monitoreo de la glucosa en gotas de sangre ha sido una pr\u00e1ctica ampliamente utilizada. El primer gluc\u00f3metro capaz de determinar, mediante tiras reactivas, los niveles de glucosa empleando una gota de sangre fue inventado en 1971; su comercializaci\u00f3n se consolid\u00f3 en la d\u00e9cada de los 80. El mecanismo inmerso en este tipo de dispositivos refleja la relevancia de la electroqu\u00edmica aplicada, ya que la glucosa se estimaba a partir de la corriente el\u00e9ctrica producida cuando la gota de sangre reacciona con las enzimas de la tira reactiva. Al depositar una gota de sangre en la tira reactiva del gluc\u00f3metro, inducimos la oxidaci\u00f3n de la glucosa, lo que genera una corriente el\u00e9ctrica que se convierte en una lectura digital de la glucosa en sangre.<\/p>\n\n\n\n

Si bien los gluc\u00f3metros han permitido un mejor monitoreo en la poblaci\u00f3n con diabetes, su principal inconveniente es la necesidad de realizar punciones repetidas. Este hecho no solo es inc\u00f3modo, sino que tambi\u00e9n conlleva otras complicaciones, como dolor, endurecimiento de la piel y alteraciones de la sensibilidad. Otra desventaja destacable es que el sistema de monitoreo es intermitente: solo se puede estimar el nivel de glucosa tras cada punci\u00f3n.  Como alternativa a estas limitaciones, se han dise\u00f1ado gluc\u00f3metros no invasivos. Mediante espectroscopia, estos aparatos realizan un escaneo para estimar los niveles de glucosa. Sin embargo, al ser un lector de contacto indirecto, presenta baja precisi\u00f3n en la cuantificaci\u00f3n. <\/p>\n\n\n\n

Por otra parte, la tecnolog\u00eda actual ha permitido dar un salto con el desarrollo de sistemas de monitoreo continuo de glucosa (CGM, por sus siglas en ingl\u00e9s), que han sido un parteaguas en comodidad y portabilidad para el monitoreo, seguimiento y tratamiento de la diabetes.<\/p>\n\n\n\n

Estos sistemas normalmente constan de tres partes:<\/p>\n\n\n\n

1.   Sensor: es un peque\u00f1o sensor desechable que se inserta debajo de la piel, por lo general, este sensor es una peque\u00f1a aguja que se sujeta por medio de un parche adhesivo (existen algunas versiones donde el sensor se implanta mediante una peque\u00f1a intervenci\u00f3n quir\u00fargica). Los sensores se deben remplazar con cierta regularidad, el periodo de actividad del sensor depende de la marca y modelo, siendo por lo general intervalos de una o dos semanas (a\u00fan los sensores implantables deben remplazarse con regularidad, aunque los intervalos suelen ser m\u00e1s largos).<\/p>\n\n\n\n

2.  Transmisor: el sensor debe conectarse a un transmisor, que es el elemento responsable de enviar inal\u00e1mbricamente la informaci\u00f3n recolectada por el sensor.<\/p>\n\n\n\n

3.  Receptor: Por \u00faltimo, se requiere un receptor, que se encarga de recibir e interpretar la informaci\u00f3n enviada por el transmisor para que el usuario pueda emplearla. Los receptores pueden ser dispositivos independientes, aplicaciones en tel\u00e9fonos inteligentes o incluso bombas de insulina.<\/p>\n\n\n\n

Los sistemas de monitoreo continuo de glucosa, por lo general, no miden directamente la concentraci\u00f3n de la glucosa en sangre, a diferencia de los sistemas de monitoreo en gota de sangre, sino en un l\u00edquido debajo de la piel que rodea a las c\u00e9lulas, llamado \u201cl\u00edquido intersticial\u201d, el cual es un fluido que se forma a partir de sustancias que se van expulsando de los capilares; una de estas sustancias es la glucosa (Figura 2).<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Ilustraci\u00f3n 2: Monitoreo continuo de la glucosa mediante un sensor CGM. Imagen propia.<\/p>\n\n\n\n

La glucosa llega primero al torrente sangu\u00edneo y despu\u00e9s se filtra al l\u00edquido intersticial, por lo que puede haber un retraso de aproximadamente 10 min en la medici\u00f3n de la glucosa con respecto a las pruebas de sangre; esto es especialmente notorio cuando hay cambios repentinos en los niveles de glucosa. El uso de este l\u00edquido, en lugar de la sangre, permite que el sensor sea mucho m\u00e1s peque\u00f1o y su aplicaci\u00f3n sea considerablemente m\u00e1s sencilla, ya que basta con insertarlo justo por debajo de la piel, en lugar de asegurarse de que penetre hasta un vaso sangu\u00edneo.<\/p>\n\n\n\n

Considerando el uso del gluc\u00f3metro frente al monitor continuo de glucosa, podemos asociar algunas desventajas (Figura 3). El monitor continuo presenta como principales desventajas el corto periodo de vida \u00fatil, el reemplazo frecuente y el costo considerable de cada sensor reemplazado.<\/p>\n\n\n\n

Sin embargo, el monitoreo constante de la glucosa en tiempo real permite la toma de decisiones certeras y m\u00e1s precisas tanto sobre la ingesta de alimentos como sobre la administraci\u00f3n de las dosis de insulina. Estos novedosos dispositivos permiten, adem\u00e1s, el an\u00e1lisis de los rangos de glucosa mediante su proyecci\u00f3n en gr\u00e1ficos que ilustran la tendencia, los cuales pueden ser compartidos de manera remota, por tel\u00e9fono celular o correo electr\u00f3nico, con el equipo m\u00e9dico y nutricional de manera r\u00e1pida. Adicionalmente, la extracci\u00f3n repetida de sangre capilar mediante punci\u00f3n no es necesaria, lo que mejora la calidad de vida del paciente.<\/p>\n\n\n\n


Con el desarrollo tecnol\u00f3gico alcanzado, es posible incrementar la popularidad de estos dispositivos a fin de mejorar la calidad de vida de la poblaci\u00f3n afectada por este padecimiento.<\/p>\n\n\n\n

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Ilustraci\u00f3n 3: Consideraciones entre el gluc\u00f3metro y el monitor continuo de glucosa. Imagen propia.<\/p>\n\n\n\n

Los controles precisos de nuestros niveles de glucosa son un aspecto crucial en el control y la prevenci\u00f3n de la diabetes, lo que permite tomar decisiones m\u00e1s acertadas sobre factores como la dieta y el ejercicio. Ante la disponibilidad de distintas estrategias de monitoreo de glucosa, la decisi\u00f3n sobre el uso de cualquiera de ellas depende del estilo de vida y de las necesidades de cada paciente.<\/p>\n\n\n\n

Palabras clave:<\/strong> diabetes, glucosa, monitoreo continuo, sensores.<\/p>\n\n\n\n

Autores<\/strong><\/h2>\n\n\n\n

1<\/sup>Sara Ch\u00e1vez Vera: <\/strong>Tesista del Laboratorio de Electroqu\u00edmica y Electros\u00edntesis del Centro Conjunto de Investigaci\u00f3n en Qu\u00edmica Sustentable UAEM\u00e9x \u2013 UNAM (CCIQS UAEM\u00e9x \u2013 UNAM). Facultad de Qu\u00edmica, UAEM\u00e9x. Contacto:schavezv291@alumno.uaemex.mx,ORCID: https:\/\/orcid.org\/0000-0003-2892-964X<\/p>\n\n\n\n

2<\/sup>Alejandra P\u00e9rez Nava: <\/strong>es Investigadora Posdoctoral SECIHTI en Laboratorio de Electroqu\u00edmica y Electros\u00edntesis del Centro Conjunto de Investigaci\u00f3n en Qu\u00edmica Sustentable UAEM\u00e9x \u2013 UNAM (CCIQS UAEM\u00e9x \u2013 UNAM). Sus \u00e1reas de inter\u00e9s engloban el desarrollo de biomateriales micro y nanoestructurados, enfocados en la ingenier\u00eda de tejidos, la liberaci\u00f3n de f\u00e1rmacos y las aplicaciones avanzadas. Contacto: alejandra.perez@iquimica.unam.mx   ORCID: https:\/\/orcid.org\/0000-0003-4285-5763<\/p>\n\n\n\n

3<\/sup>Bernardo Antonio Frontana Uribe: <\/strong>Investigador de tiempo completo adscrito al CCIQS UAEM\u00e9x \u2013 UNAM. Siendo titular del Laboratorio de Electroqu\u00edmica y Electros\u00edntesis, perteneciente al Departamento de Qu\u00edmica Org\u00e1nica de dicha dependencia. Sus l\u00edneas de investigaci\u00f3n se centran en la electroqu\u00edmica anal\u00edtica para la detecci\u00f3n de contaminantes, el desarrollo de m\u00e9todos sint\u00e9ticos ecoamigables y el dise\u00f1o de materiales electroresponsivos para aplicaciones m\u00e9dicas. Centro Conjunto de Investigaci\u00f3n en Qu\u00edmica Sustentable UAEM\u00e9x \u2013 UNAM. Contacto:bafrontu@unam.mx<\/a>,  ORCID: https:\/\/orcid.org\/0000-0003-3796-5933<\/p>\n\n\n\n

Referencias bibliogr\u00e1ficas<\/strong><\/h2>\n\n\n\n

Basto-Abreu, A., L\u00f3pez-Olmedo, N., Rojas-Mart\u00ednez, R., et al. (2023). Prevalencia de prediabetes y diabetes en M\u00e9xico: Ensanut 2022. Salud p\u00fablica de M\u00e9xico, 65, s163-s168.<\/p>\n\n\n\n

Feldman, B., & Care, A. D. (2003). Electrochemical blood glucose test strips for people with diabetes. Diabetes Technol. Ther.<\/p>\n\n\n\n

Freckmann, G., Pleus, S., Grady, M., Setford, S., & Levy, B. (2019). Measures of accuracy for continuous glucose monitoring and blood glucose monitoring devices. Journal of diabetes science and technology, 13(3), 575-583.<\/p>\n\n\n\n

Mihai, D. A., Stefan, D. S., Stegaru, D., et al. (2022). Continuous glucose monitoring devices: A brief presentation. Experimental and therapeutic medicine, 23(2), 174.<\/p>\n\n\n\n

OMS, A. \u00bfComo diagnosticamos la diabetes en el siglo XXI?. Diabetes, 5(6.4), 6-6.<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Ch\u00e1vez Vera Sara1, P\u00e9rez Nava Alejandra2,Frontana Uribe Bernardo A.3 Fechas de recepci\u00f3n: 15-3-2026 Fechas de aceptaci\u00f3n: 14-4-2026 Qu\u00edmica\/Epistemolog\u00eda social Resumen 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