Diabetes is a chronic, and largely preventable, disease that can lead to cardiovascular disease, blindness, kidney failure, loss of limbs and loss of life. It causes suffering and hardship for the approximately 60 million people in the European Region currently living with the disease, while also straining the Region’s economies and health systems.
Prevalence of diabetes is increasing in the European Region, already reaching rates of 10-12% of the population in some Member States. This increase is strongly associated with increasing trends towards overweight and obesity, unhealthy diets, physical inactivity and socioeconomic disadvantage. These risk factors also contribute to the development of the other three noncommunicable diseases (NCDs) that have become international public health priorities (cardiovascular disease, chronic respiratory diseases and cancer), making it imperative that the prevention of diabetes be integrated into population approaches to prevent NCDs as a group.
What is diabetes?
Type 1 diabetes
Type 1 diabetes is characterized by deficient insulin production and requires daily administration of insulin. Type 1 diabetes is not preventable with current knowledge.
Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes and fatigue. These symptoms may occur suddenly, and the disease may present as an acute condition.
Type 2 diabetes
Type 2 diabetes results from the body’s ineffective use of insulin (insulin resistance). It accounts for 90% of people with diabetes around the world and is largely preventable. Excess body weight - especially around the waist, physical inactivity and a high intake of saturated fatty acids all independently increase the risk of insulin resistance. This risk is heightened even with modest weight increases within the normal range (Body Mass Index under 25). Development of type 2 diabetes has also been associated with other factors, such as ethnic group, experiences and influences in early life, and socioeconomic factors.
Symptoms may be similar to those of type 1 diabetes, but are often less marked. As a result, the disease may be diagnosed several years after onset, once complications have already arisen.
Type 2 diabetes was until recently seen as a disease of middle-aged and elderly people, but its frequency has escalated in all age groups and the condition is now increasingly seen in adolescence and childhood.
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.
Gestational diabetes is hyperglycaemia with onset or first recognition during pregnancy.
Symptoms of gestational diabetes are similar to type 2 diabetes. Gestational diabetes is most often diagnosed through prenatal screening, rather than reported symptoms. It is generally temporary, but women with gestational diabetes may develop type 2 later in life.