World Diabetes Day is celebrated every year on November 14 and aims to raise global awareness about a disease that affects a growing part of the population. This anniversary has been celebrated around the world since 1991 by the International Diabetes Foundation (IDF) and the World Health Organization (WHO), given the worrying increase in the incidence of diabetes around the world. This date was chosen to coincide with the birth of Frederick Banting, the doctor and researcher who, together with Charles Best, conceived the idea that would lead to the discovery of insulin in 1921.
Despite information campaigns and knowledge about diabetes, the figures on the incidence of this disease continue to be discouraging. According to data from the International Diabetes Federation, the total number of adults with this disease was 108 million in 1980, a figure that rose to 151 million in 2000 and in 2021 it would already reach 537 million people. The WHO points out, for its part, that diabetes and diabetic nephropathy alone caused 2 million deaths in 2019 and warns that it is an important cause of blindness, kidney failure, myocardial infarction, stroke and limb amputation. lower. This organization also remembers that "it is possible to treat diabetes and avoid or delay its consequences through physical activity and a healthy diet, along with medication and periodic testing."
Diabetes is a disorder that, overall, is characterized by high blood glucose levels, but that can manifest itself in different ways depending on its cause, which leads to differentiating different types of diabetes. "We could generalize by saying that there will always be a problem in the functioning or production of the main hormone that regulates it, which is insulin," explains Dr. María José Picón, a physician in the Department of Endocrinology and Nutrition at the Virgen de la Victoria University Hospital. in Malaga, and first vice president of the Spanish Diabetes Society (SED).
We can distinguish between several different types of diabetes, but the two most commonly known are type 1 and type 2 diabetes, although "there are many other types of smaller diabetes, but with which we must have a significant level of alert to avoid not to confuse the diagnoses and, therefore, the treatment," explains the doctor. Picón also explains that "type 1 diabetes occurs when the body is unable to produce insulin, which in all cases requires lifelong insulin treatment." Although there are several hypotheses about what the risk factors could be, at the moment their exact causes are not known.
"Type 2 diabetes, on the other hand, is due to a situation of insulin resistance. In this second case, the person's insulin levels may be very high to compensate for this resistance situation. Although in some cases it is necessary to put insulin in the treatment, the majority of patients are going to be treated with drugs other than insulin, which can be oral or injectable," explains the vice president of the Spanish Diabetes Society. This type of diabetes "is associated with obesity, although there is also a non-negligible genetic component."
People with a family history of diabetes, obesity or those women who have suffered from diabetes during their pregnancies (gestational diabetes) are at risk of developing the disease throughout their lives. "But this risk is not necessarily a certainty. We have it in our power to make a change in our own prognosis by adopting a balanced and healthy diet, as well as trying to avoid a sedentary lifestyle," explains Picón, who recalls that the Mediterranean diet reduces the risk of suffering from this sickness.
Recent research carried out by the University of Cambridge has shown that those people who say they follow this type of diet have a considerably lower risk of suffering from type 2 diabetes. In fact, other studies had already corroborated this link, but until now the analyzes were uncertain due to the subjectivity of the subjects when self-assessing their adherence to the Mediterranean diet. Thanks to this study by the University of Cambridge, a series of biomarkers have been established, which can be detected through a simple blood test, which certify the following of the Mediterranean diet and, in this case, also its link with a lower incidence of type 2 diabetes. Picón regrets, for his part, that "it is not because we live in the Mediterranean area that we usually follow this dietary pattern" and urges both those who have already been diagnosed with type 2 diabetes and those who want to prevent it to "regularly consume of fruits, vegetables, legumes, fiber and nuts, as well as avoiding high-calorie foods, fats or ultra-processed products.
There are also numerous scientific studies that link poor eating habits with a greater risk of suffering from type 2 diabetes. One of them, carried out by Tufts University in the United States, estimates that a poor diet caused more than 14.1 million cases of type 2 diabetes in 2018. The insufficient intake of whole grains, the excess of refined rice and wheat and the excessive consumption of processed meat are decisive in the increase of this disease worldwide, as revealed by this research, which also points out some lower incidence factors, such as excessive consumption of fruit juices and insufficient intake of non-starchy vegetables, nuts or seeds.
Once the disease has been diagnosed, the diet must be accompanied by good habits that include regular physical exercise and proper sleep hygiene, in addition to personalized pharmacological treatment. "Once diabetes has developed, it is important to implement pharmacological treatment that controls glucose levels in all cases to avoid progression towards diabetes that is more difficult to control. But it is important to keep in mind that the best of drugs will fail if we do not maintain a healthy lifestyle," continues Picón.
Currently, you can have a good quality of life having diabetes, both type 1 and type 2. Technological advances have meant that patients with type 1 diabetes, despite requiring insulin treatment, "manage to have improvements in aspects as important as the quality of sleep, depressive symptoms, anxiety or fear of low glucose, something that patients appreciate equally or more than good control of their glucose," says Picón. Regarding type 2 diabetes, "there is an arsenal of drugs that also treat and improve obesity, which means that a patient can lose weight while controlling their diabetes, something that until a few years ago It was unthinkable."
