Comment le diabète de type 2 est-il diagnostiqué et traité ?

In France, more than 4 million people live with diabetes. Worldwide, it is estimated that it affects 1 in 10 adults between the ages of 20 and 79, or 537 million people.

A major public health issue, diabetes is a chronic disease characterized by an excess of sugar in the blood (hyperglycemia), caused by a malfunction of the pancreas. More precisely, it is an imbalance between the glucose storage hormone, insulin, and the hormone that releases it, glucagon.

There are 2 forms of diabetes: “type 1” diabetes (T1D) which is an autoimmune disease affecting about 6% of diabetics, and “type 2” diabetes (T2D) which generally occurs after age 40.

On the occasion of World Diabetes Day on November 14, 2022, the medical and research teams of the ICAN IHU inform you about type 2 diabetes, which affects 92% of diabetic patients and has increased considerably in France in recent years.

What is type 2 diabetes?

Insulin is a hormone naturally secreted by the pancreas, whose role is to regulate blood sugar levels at normal values, for the proper functioning of the body.

Sometimes the body’s cells misuse insulin. The individual has insulin resistance, where the pancreas is no longer able to adjust and secrete insulin normally. This causes an increase in blood sugar levels (hyperglycemia), and the development of type 2 diabetes (T2D).

  • 3.5 million patients have T2D in France,
  • About 1 million people would be undiagnosed in France.

What causes type 2 diabetes?

This disease can be induced by multiple causes:

  • Family environment, with a history of diabetes in the family,
  • Environmental factors, depending on the level of physical activity and sedentary lifestyle,
  • Diet and weight gain,
  • Age, aging is a risk factor for developing type 2 diabetes.

How is type 2 diabetes diagnosed?

Type 2 diabetes often develops very gradually, silently over many years. Most of the time, elevated blood sugar levels do not cause any noticeable symptoms for the patient.

The diagnosis is made by a simple blood test to measure the blood sugar level, when the general practitioner considers it necessary, depending on the patient’s risk factors. Certain symptoms can also lead to a check-up:

  • Feeling of thirst
  • Regular urge to urinate
  • Weight loss

How is type 2 diabetes treated?

Treatments for type 2 diabetes are designed to help insulin work better to regulate blood sugar, or to increase the ability of the pancreas to produce insulin.

In recent years, scientific advances have made it possible to develop several types of treatment, resulting in personalized medicine based on each patient’s: lifestyle, existing pathology(ies), appetite for the proposed treatment, etc.

1. Hygienic and dietary measures

In the treatment of type 2 diabetes, the first step is to respect hygienic and dietary measures to improve the evolution of the disease:

  • Weight reduction and control through a balanced diet,
  • Regular physical activity,
  • Stop smoking.

2. Oral and injection treatments

If these measures are not sufficient, 2 types of treatment exist:

  • Oral treatments: anti-diabetic drugs in tablet form,
  • Insulin injection treatments: insulin pump, refillable insulin pen, pre-filled pen, insulin syringe…

What are the complications of type 2 diabetes?

Failure to manage the disease can lead to serious long-term complications in:

  • The eye: development of diabetic retinopathy or “diabetes in the eye”, which can lead to blindness if not treated,
  • Kidney: development of diabetic glomerulopathy, which can lead to chronic kidney disease, renal failure and, in advanced stages, the need for dialysis (artificial blood purification),
  • Vessels in the heart, brain or leg arteries: possibility of developing a heart attack, stroke, or arteritis in the legs.
  • Feet: severe complications of diabetic foot wounds, which can lead to ulceration and amputation of the lower limbs.

These severe complications usually appear after 5 to 10 years of untreated diabetes.

Do you have risk factors? If in doubt, talk to your doctor. A simple blood test allows the diagnosis.

What about type 1 diabetes?

More rare than type 2 diabetes, type 1 diabetes often appears in childhood or early adulthood. It affects less than 10% of patients with diabetes.

“Diabetes has lived with me for a very long time, more than 30 years. The announcement of a disease, no matter what it is, is an upheaval in one’s life. You wonder why it’s happening to you. You ask a lot of questions, you’re a bit angry, disoriented (…) I’ve had to adapt as technological advances have come along, and at different times in my life.” (birth of a child, travel, professional activities…).“This is what it’s like to live with diabetes.” Testimony of Betina, a patient in the diabetes department of the Pitié-Salpêtrière Hospital

“With the huge technological advances of the last few years, the mental burden is decreasing tremendously, and the quality of life is improving incredibly (…) The doctor is a partner, he is involved in our life. When things don’t work out, he’s there to listen and support me. And when it does work, he’s going to be there to rejoice with me too!” Betina, patient in the diabetology department of the Pitié-Salpêtrière Hospital