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Diabetes – the preventable epidemic

Eat well and exercise. That is the simple message that could help reverse the spread of one of Europe’s most troubling epidemics – Type 2 diabetes.
Type-1 diabetes sufferers monitor their blood glucose levels several times a day. © Shutterstock

‘As a scientist, I want to understand what causes Type-2 diabetes, but sometimes I think my time would be better spent persuading people to eat less and exercise more,’ said Professor Frances Ashcroft, a British physiologist based at the University of Oxford, UK.

Diabetes occurs in some for no apparent reason, but the most common form, Type-2 diabetes, could often have been prevented. In 90 % of cases, it is linked to eating too much fat, sugar, and salt, and not exercising enough.

The disease now affects about one in 20 Europeans, and this number is said to increase if people keep on eating an unbalanced diet too rich in sugar in particular, and as obesity rates soar.

In fact, the number of European sufferers will increase by over a fifth in the next 20 years, according to the International Diabetes Federation, an umbrella organisation of national diabetes associations in over 160 countries.

The European Union has spent close to EUR 420 million on research to tackle diabetes and related health problems under its 2007 to 2013 funding programme, known as FP7. About EUR 135 million of that is devoted specifically to projects that tackle diabetes and obesity together, a field known as diabesity.

FP7 has funded projects like PCDIAB, where researchers who have produced an artificial pancreas are now working on reducing the size of their prototype and embedding the software into the device.

DALI, another EU-funded project, is looking into diabetes during pregnancy, a condition that affects almost a fifth of pregnant women in some countries and can cause babies to have growth disturbances and breathing problems. Researchers are looking at the impact of diet, exercise and vitamin D intake on the disease.

The EU has also singled out health as one of the major issues it wants to tackle under its next round of funding, known as Horizon 2020, which will run from 2014 to 2020.

The European Parliament adopted a resolution in March 2012 calling on the European Commission, the EU’s executive arm, to implement a strategy on diabetes prevention, diagnosis, management, education and research.

It also called on Member State governments to tackle diabetes and dedicate more funds to research. Yet today, not all EU Member States have launched health programmes to tackle diabetes.

‘If the EU does not sharpen its response, even more people will die and others will suffer avoidable complications like blindness, kidney and heart failure, and limb amputation,’ said Sarah Ludford, a Member of the European Parliament who co-chairs the EU Diabetes Working Group (EUDWG), a committee on tackling diabetes in Europe.

Type 1 – Type 2

Diabetes is a disease in which the normal working of the hormone insulin – the chemical substance that changes glucose, or sugar, into a form that can be used as an energy source by cells in the body – is disrupted. In that case, sugar levels build up. Insulin is produced by the pancreas.

Type-1 diabetes results from a deficiency of insulin production because the cells in the pancreas that generate this hormone are destroyed. Type-2 diabetes results from a loss of effectiveness of insulin in the body, particularly following weight gain or inadequate physical activity.

The greatest increase has been in Type-2, the most common form of the disease and the one linked with excessive weight and obesity, as well as with middle aged or elderly people. Type-1 diabetes is less common, affecting 5 % of all sufferers, but it too is increasing.

The treatments differ from one type of diabetes to the other. In Type-1, diabetics monitor their blood glucose several times a day. They test the sugar level in a drop of blood (after pricking a finger). Following the readings on the meter, they inject themselves with insulin to regulate blood sugar, taking into account the nature of meals and foods they plan to have in the very near future.

For Type-2 diabetics, the treatment usually begins with a lifestyle change, such as weight loss, increased physical activity, or dietary modification. If that is not enough, insulin injections may also be prescribed.

If untreated, diabetics face many possible complications. For example, diabetic coma, damage to the retina, a dysfunction of the nerves, kidney failure or hypoglycemia (too little sugar in the blood), which can cause sudden fatigue, dizziness and a loss of consciousness.

More info

European Commission, Diabetes and Obesity

International Diabetes Federation, EU Diabetes Working Group (EUDWG)

European Parliament Resolution on diabetes and EUDWG

PCDIAB (Portable bihormonal closed loop for diabetes)

DALI (Diabetes and pregnancy vitamine D and lifestyle intervention for gestational diabetes mellitus prevention)

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