Type 2 diabetes / Prediabetes

Type 2 Diabetes / Prediabetes

Type 2 diabetes is a chronic hyperglycemia primarily associated with overweight and a sedentary lifestyle.
The disease is becoming increasingly more widespread throughout the population, leading to serious complications related to the heart, blood vessels, eyes, kidneys and nerves.
Prevention is possible at the prediabetes stage, and rely on hygiene and dietary measures. Its treatment also requires a lifestyle change in combination with pharmacological treatments which may become more significant as the disease evolves.

 

Hyperglycemia linked to lifestyle

A chronic disease, type 2 diabetes results from the body’s inability to properly use or sufficiently produce insulin. Insulin is a hormone secreted by the pancreas. Theoretically, it helps to regulate sugar level in the blood, which is why diabetic patients are at risk for hyperglycemia (elevated glucose level).
Unlike type 1 diabetes, which is a genetic disorder, type 2 diabetes is strongly linked  to lifestyle. Overweight and inactivity pave the way for the disease to develop, typically from the age of 40 to 45; however, it has also begun to affect teenagers and young adults.

 

Diabetes pandemic

More than 8.5% of the adult population suffers from diabetes (10% type 1, and 90% type 2), the direct cause of 1.6 million deaths each year. And the epidemic is spreading: WHO estimates that more than 592 million people will be affected in 2035, versus 425 million today (2015 data).
In France, more than 3.7 million people are treated for diabetes, with an annual growth rate of nearly 3%.
It should be noted that the number of cases in low- or middle-income countries is increasing at a faster rate, due to unhealthy living conditions.

 

Asymptomatic disease with serious complications

The development of type 2 diabetes often goes unnoticed due to its asymptomatic nature. The disease is discovered late and by chance, following a physical exam or the appearance of complications. An increased concentration of glucose in the blood begins to essentially attack the body, potentially leading to heart attack, cerebral vascular accidents, blindness, foot ulcers with the risk of amputation, erectile dysfunction or renal failure.

 

Type 2 diabetes treatment

After onset and diagnosis, type 2 diabetes is treated, first and foremost, through hygiene and dietary measures similar to those applied to prediabetes: balanced diet and physical exercise.
As second-line treatment, oral antidiabetic medications are prescribed to help control glycemia. If the disease continues to progress under treatment, insulin injections are introduced as the best option to compensate for deficiencies.

Type 2 diabetes is hard to manage once it is installed. But preventing the disease is possible, with an early and appropriate intervention at the prediabetes stage.

Prediabetes, the second epidemic

Type 2 diabetes is always preceded by a long phase (5 to 10 years according to studies) known as “prediabetes”. Blood glucose levels are higher than normal but have not yet reached the disease threshold. The diagnosis is easy, with a single blood test. Like type 2 diabetes, prediabetes is a worldwide epidemic.

 

Worldwide

500

million people may be prediabetic.

United-States

86

million people may be prediabetic.

EUROPE

82

million people, at least, may be prediabetic.

FRANCE

1,5

million cases, with a probable underestimation related to the lack of screening.

Prediabetes: a reversible disorder, key for the prevention of diabetes

Prediabetes is reversible, as long as it is efficiently managed with a long-term corrective intervention on lifestyle. The main measures target the prevention of overweight, or its decrease. A balanced diet, healthy eating habits (3 meals a day without snacking), physical activity on a regular basis and quitting smoking are the cornerstones of a good health and limit the risk for hyperglycemia. A necessary preventive approach since more than 70% of prediabetics will develop type 2 diabetes.

 

Sources: WHO (who.int/fr/news-room/fact-sheets/detail/diabetes); Invs (invs.santepubliquefrance.fr/Dossiers-thematiques/Maladies-chroniques-et-traumatismes/Diabete); Centre européen d’étude du diabète (ceed-diabete.org/fr/le-diabete/les-chiffres/ ); Fédération des diabétiques (federationdesdiabetiques.org); IDF (Diabetes Atlas, 2013-2015); Ismail-Beigi F.,  N Engl J Med, 2012; Tabak AG et al., The Lancet, 2012; HAS (has-sante.fr/portail/upload/docs/application/pdf/2013-02/reco2clics__diabete_type_2.pdf

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