The Silent Threat of Diabetes
Written by Marianthi Archaniotaki, MD PhD, Specialist Pathologist, Scientific Manager of the Pathology Department and Diabetes-Diabetic Foot Clinic at the Inter-Balkan Medical Center of Thessaloniki
Every year on November 14, World Diabetes Day is celebrated as a resounding awareness campaign against the silent threat of Diabetes. This date was chosen because it is the birthday of the great Canadian Nobel Prize winner in Medicine Sir Frederick Banting, who isolated insulin in 1921 and saved a 14-year-old child from a diabetic coma. It was a scientific revolution that transformed the lives of millions of people, giving them the right to survive, to participate equally in life, and to fulfill their dreams. Moreover, it was an act of profound humanity, as Banting granted the patent rights for the symbolic sum of one dollar (!), so that everyone could have access to the new treatment.
World Diabetes Day – A reminder of life
November 14 is a social mobilization for coordinated interventions to stop Diabetes. It is not a simple reminder of the danger, but a promise of victory with the collective statement: “we fight together.” The blue circle, the Diabetes logo, symbolizes the international community that embraces and supports patients and researchers, caregivers and doctors, children and adults to manage the disease with courage, knowledge, strategy, innovative treatments and digital applications. This year’s theme of World Diabetes Day is: “Diabetes and Well-being” with a focus on the work environment and the need to take supportive measures for a safe and enjoyable life.
The metabolic pandemic of the 21st century
Diabetes has acquired the dimensions of a metabolic pandemic, as the global diabetic population is estimated at 537 million and is projected to reach 643 million in 2030. In Greece, it is estimated that 1,200,000 people have Diabetes. In 90% of cases, Diabetes is type 2, affecting overweight and obese individuals and is due to insulin resistance and defective insulin secretion. In 5%-10% of cases, Diabetes is type 1, affecting mainly children, adolescents and young adults and is due to a lack of insulin due to autoimmune destruction of the β-cells of the pancreas. There is also Gestational Diabetes, LADA, MODY and other very rare hereditary types.
Causes and aggravating factors
To the reasonable question of whether heredity or the environment is more responsible, the answer is that it is a complex interaction between each individual’s unique genetic material and exogenous conditions.
The explosive spread of Diabetes is attributed to increased energy intake and reduced physical activity, to a rapid increase in obesity and to exposure to new socioeconomic and behavioral factors. Potentially diabetogenic effects include sleep disorders, shifting work schedules, light pollution, inorganic and organic non-biodegradable pollutants, increased consumption of processed and/or genetically modified foods, early feeding with cow’s milk and gluten, exposure to pesticides and insecticides through the food chain, vitamin D deficiency and adverse intestinal flora from overconsumption of sugar, starches and animal fats.
When honey becomes a sting! Diabetic complications
Diabetes, although “Sugar”, often writes bitter scenarios when it is not treated promptly and effectively. It silently and insidiously erodes the body, leaves indelible marks on the entire vascular tree and leads to dangerous complications that are divided into microvascular (nephropathy, neuropathy, retinopathy) and macrovascular (infarctions, strokes, lower limb arteriopathies). Diabetic ulcers pose a great threat due to a combination of vasculopathy, neuropathy, trauma and inflammation. Skin, musculoskeletal and respiratory complications, early cognitive impairment and frequent infections reduce the duration and quality of life.
A new era in treatment
The modern therapeutic landscape is changing radically, both with new antidiabetic drugs that reduce the risk of cardiovascular and renal complications and with injectable treatments that are given once a week and reduce weight, fat, sugar and complications. New insulins and insulin pumps, adhesive sensors for continuous and painless recording of sugar, “smart” applications on mobile phones and new decision support systems based on artificial intelligence, are valuable allies in the management of Diabetes. New therapeutic horizons are being opened up by the “artificial pancreas”, 3-D printing of pancreatic islets and a multitude of parallel developments.
The power of prevention and education
Education, early intervention and a therapeutic alliance with specialist doctors remain valuable over time. Diabetes does not define or limit the journey of life! It is a way of life and a game of balance that allows for an active, creative and happy life.
