Monday, January 24

The diabetes epidemic is upon us, can technology save us?

The coronavirus pandemic has been at the forefront of the health agenda for more than a year, but another epidemic has been facing us head-on for several decades and is arguably an even bigger concern: diabetes.

The World Health Organization estimates that it affects 422 million (1 in 11 adults) worldwide, that compared to coronavirus infections, diabetes affects three times as many people.

The number of people living with diabetes is expected to increase to 700 million worldwide by 2045.

Diabetes “is already a full-blown epidemic with such dynamics that the number of people with diabetes has almost quadrupled in the last 30 years,” Dr. Gojka Roglic, medical officer for diabetes management, told Euronews. World Health Organization.

Chronic disease has entered the WHO’s 10 leading causes of death, following a significant percentage increase of 70% since 2000.

Noncommunicable disease not only increases the risk of premature death, it can also cause strokes, blindness, heart attacks, kidney failure, and amputations.

A complex disease

It is well known that diet and lifestyle can play a critical role in type 2 diabetes, but the disease is much more complex.

For starters, there are 14 types of diabetes, which occur when the body’s ability to make or respond to the hormone insulin is impaired. Type 1 and type 2 are the most common and there is also gestational diabetes, which can develop briefly during pregnancy.

Type 1 is an autoimmune condition in which the body cannot make enough insulin and often affects children. The reasons why it develops are not fully understood.

Type 2 diabetes is where the body can make insulin but cannot use it well. It develops with age and can be caused by genetics and lifestyle. This type is responsible for 90% of diabetes cases but there are solutions to control it.

The main risk factors for type 2 are aging, obesity and physical inactivity, said Dr. Roglic, but emphasized that “these risk factors are not easy to address or control … because despite being conceptually simple, they are not easy to implement. “

But he said there are many things governments can do, such as planning cities, education, transportation and food policies, such as taxes on sugar.

On April 14, the same day that insulin was discovered 100 years ago, WHO will implement a diabetes agenda called the Global Diabetes Compact, which will support countries in implementing programs, focus on reducing obesity and aims to improve access to medicines and technologies. particularly low- and middle-income countries.

Raising awareness is key, as many people do not know they have diabetes until it is too late.

“We have like an iceberg of diabetes floating in Europe, we have such a large group underwater that those who don’t know they have it,” Professor Chantal Mathieu, president of the European Diabetes Forum, told Euronews.

In Europe, 60 million adults have diabetes (1 in 10 Europeans), which is projected to increase to 69 million by 2045.

Professor Mathieu said that because diabetes cannot show symptoms at first, many people only seek treatment when their kidneys have already been destroyed and need dialysis.

“We need to move from a reactive approach, where you react when all the damage is done, to a proactive approach,” he said.

To do so, he said, better data collection and sharing, better access to health care, advising policy makers and new technologies are needed.

Innovative technological solutions

Diabetes is invasive in your daily life. It requires you to treat yourself with pills or insulin and you must control your glucose levels and blood pressure.

Traditionally, this involves pricking your finger on a daily basis, which is time consuming and can be painful.

But technology has advanced in recent years, and smart glucose sensors have made diabetes care easier.

The current market leader is the FreeStyle Libre from the American medical company Abbott. It is used by three million people in more than 50 counties.

The small circular sensor attaches to the back of your upper arm, which is then scanned with your smartphone to get a glucose reading.

“Compared to traditional blood glucose monitoring, this is a major step forward in making glucose monitoring perfectly suited to a person’s daily lifestyle,” said Ansgar Resch, divisional vice president of diabetes care. from Abbott for business operations in Europe, the Middle East, Africa and Pakistan.

One of the reasons it has become popular is not only because of its ease of use, but also because it allows people to better control their health.

“As soon as people see information, for example their glucose levels go up or down after taking certain foods, they make changes,” he told Euronews.

Data can also be securely shared with physicians for telehealth appointments. This has become more important for diabetes patients since the coronavirus pandemic because diabetics are generally more vulnerable to the dangers of Covid-19.

“The combination of widespread telehealth with sensor-based technologies could transform the way we treat the condition, also long after the pandemic passes,” Resch said.

‘Too expensive and too few’ solutions for everyone

Even though FreeStlye Libre is cheaper than other similar products, starting at around € 111, and some healthcare systems reimburse it in full or in part, not everyone can afford it and even traditional fingerstick devices can be too much. expensive for some.

Other drugs and technologies for diabetes care are evolving. Some of the newer technologies include artificial / closed-loop pancreas systems, which constantly measure your blood glucose and regulate your insulin level with little information required by people living with diabetes.

“But they are not yet widely available or accessible to most people,” said Sabine Dupont, senior consultant for the European division of the International Diabetes Federation.

There are many problems in accessing technologies and medicines and they are not only due to cost.

Other important factors are how to evaluate the benefits of new technologies to determine reimbursement. Discussions between manufacturers, payers and the healthcare system must also take place at European level to ensure that citizens have full access to medicines and technologies.

“I think one of the barriers is that innovation is still very often seen as a cost rather than an opportunity,” he told Euronews.

More transparent procurement mechanisms are also needed, he said, because it can take time for new drugs and technologies to hit the market. There are also large disparities as to when the same new drug / technology will be available in all European countries.

This is partly because once new drugs / technologies have been approved for use at the European level, it can take even longer to go through further approval at the national level to get reimbursed.

But if these problems were fixed, living with diabetes could be much easier.

“If you have access to and affordable access to the necessary medications and technologies, you can live a very healthy life with diabetes,” said Dupont.

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