World Diabetes Day (WDD) was originally established in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO). In 2006 the United Nations made November 14 of each year official as the birthday of Sir Frederick Banting, who discovered insulin.

We recognize the risk, we act in time

“Diabetes is the most serious metabolic disease of today. A disease with a particularly high frequency worldwide, but also a disease that is accompanied by a multitude of macroangiopathic and microangiopathic complications”, emphasize Andreas. Melidonis Co. Director of the Metropolitan Hospital Diabetes Center – President E. KO. WITH. N., Stavros Liatis Director of ESY APPK University of Athens – Dia. Laikou Center, M. Meletiadou Head nurse – President omm. Work Apt. of Health E. KO. WITH. N., who on the occasion of World Diabetes Day talk and inform about DM as a whole.

This year’s campaign aims to raise awareness, promote coordinated – collective action to prevent and/or delay the disease, better manage it, prevent its complications, by informing the public about the causes , symptoms and treatment.

What is Diabetes?

DM is a chronically evolving metabolic disease, with a heterogeneous and multifactorial substrate, characterized by high blood sugar, insulin resistance and insulin deficiency.

Etiologically, it is classified into four categories, of which 2 are the main ones:

• DM type 1 (5% of people with DM). It is characterized by a lack of insulin production from the pancreas
• DM type 2 (90% of people with DM). It is characterized by tissue resistance to insulin action
• Gestational diabetes
• Other types of diabetes: Caused by genetic disorders of β-cell function, insulin action, endocrinopathy, infections, diseases of the exocrine pancreas, drugs or chemicals.

“If DM is not diagnosed and treated early, it can lead to serious and potentially life-threatening complications. It is the first cause of: Blindness in adults due to diabetic retinopathy, kidney damage requiring hemodialysis due to diabetic nephropathy, myocardial infarction and ischemic stroke, amputation of the lower limbs due to peripheral vasculopathy and neuropathy” points out Mr. Andreas Melidonis : Comp. Director of the Metropolitan Hospital Diabetes Center – President E. KO. WITH. N.

“Prevention is the best cure and World Diabetes Day comes to ‘sound the alarm’,” he adds.

The numbers speak

• Diabetes costs lives.
• 537 million adults (1 in 10) were living with diabetes in 2021. This number is expected to rise to
643 million by 2030 and
783 million by 2045.
• Almost 1 in 2 adults (44%) with diabetes remains undiagnosed.
• 541 million adults are at increased risk of developing type 2 diabetes.
• Caused 6.7 million deaths in 2021.
• $966 billion spent on health in 2021.

In our country: Recent data from the EOPYY electronic database, published by researchers at the Diabetology Center of the People’s Hospital, showed that approximately 8% of adults in Greece are taking medication for diabetes. This percentage exceeds 20% in the over 65 age group. The pan-Hellenic epidemiological study EMENO, carried out by researchers from the University of Athens in collaboration with the Greek Diabetology Society, comes to similar numbers. EMENO showed that 12% of the adult Greek population suffers from diabetes, with the percentage reaching 30% in those aged 70 and over. In rural areas the percentage of people with diabetes reaches 14% (probably also due to the higher average age). Just 40 years ago, in a study of the population in Aigaleo, Professor Nikos Katsilambros and his colleagues found that the rate of diabetes was 2.4% (considered excessive at the time), while, a little earlier, Professors Karamanos, Christakopoulos and their collaborators found in the Greek rural population, a percentage of the order of 1.25%!!! That is, there is a tenfold increase in the frequency of diabetes in Greece in the last 40 years.

Who should be checked and when?

• People who are overweight or obese, who have at least one of the following factors: family history of DM in 1st degree relatives, history of hypertension, cardiovascular disease, dyslipidemia, women with polycystic ovary syndrome,
• History of prediabetes,
• History of gestational diabetes,
• All persons over 35 years of age,

The control definitely requires a sugar curve (75g glucose load test) which is the best control test for DM.

If screening results are normal, they should be repeated at least every three years, with possible more frequent screening depending on initial findings and risk factors.

Recognize the warning signs, act early

Warning signs include:

• polyuria
• polydipsia
• polyphagia
• unexplained weight loss
• fatigue easily
• lack of interest and concentration
• vomiting, epigastralgia
• tingling or numbness in the hands or feet
• blurred vision
• frequent infections
• wounds that are slow to heal.

Diagnostic criteria

• Fasting plasma glucose ≥126 mg/dL
• 2-hour plasma glucose (during the 75g glucose challenge) ≥200mg/dL
• Random plasma glucose measurement ≥200 mg/Dl, in a person with DM with typical symptoms of hyperglycaemia (polyuria, polydipsia, polyphagia unexplained weight loss) or hyperglycaemic crisis
• HbA1c ≥6.5%

Know your risk for type 2 DM (Test2prevent)

The IDF has created an online type 2 DM risk assessment. It is designed to highlight a person’s risk of developing DM within the next ten years. It is based on the Finnish Diabetes Risk Index (FINDRISC). Installing the app on a mobile device allows assessing the risk of developing T2DM.

Prevention is the secret

Prevention measures target modifiable environmental factors:

• Reduction of body weight by at least 5%, if it is increased
• Stop smoking
• Integrating exercise into lifestyle
• Balanced diet (reduce total fat to <30% of daily energy intake, reduce saturated fat to <10% of daily energy intake, increase fiber intake)
• Regulation of blood pressure
• Cholesterol regulation
• Regular screening, especially for people with one or more of the risk factors.

In conclusion: “DM is undoubtedly the serious metabolic disease of the 21st century with a multitude of complications when it is unregulated. Today we must and can recognize the disease in time, act in time to regulate DM and avoid its complications and to establish a relationship of friendship and coexistence with a regulated and controlled DM”, conclude Andreas experts. Melidonis Co. Director of the Metropolitan Hospital Diabetes Center – President E. KO. WITH. N., Stavros Liatis Director of ESY APPK University of Athens – Dia. People’s Center, M. Meletiadou Head nurse – President omm. Work Apt. of Health E. KO. WITH. N.

*E.K.O. WITH. N. (Hellenic College of Metabolic Diseases)