Two types of diabetes
1-Type 2 diabetes (T2DM)
The vast majority, at least 90% of diabetic states are constituted by a rather ill-defined disease, long asymptomatic (“the silent disease”) which typically occurs after the age of fifty, more particularly in people who are overweight or who have a family history of the same disease:
2-Type 1 diabetes
Type 1 diabetes is much rarer. It is a brutal and noisy attack in its symptomatology: difficult to miss: pee as if it were raining, incessant thirst and weight loss, feeling of intense fatigue are the main symptoms.
Classically it occurs in young children or adolescents, more rarely in young adults.
But the borders are blurred today, we find type 1 diabetes later in adults and T2D earlier in the youngest.
Type 2 diabetes risk factors
• One of the very first factors explaining the increase in the occurrence of diabetes worldwide is the aging of populations.
• The second factor is weight gain (it has been continuous since the last third of the 20th century), regardless of the age group.
Of course, weight gain is only likely to produce diabetes if it occurs on a susceptible genetic ground, which is unfortunately very common.
A few figures to take stock of the problem:
Many factors are likely to contribute to the explosion of diabetes cases:
In 30 years, the number of T2DM has increased from 100 to 400 million worldwide.
The most important explanatory factor is probably the so-called “nutritional transition”.
The nutritional transition combines two factors:
Indeed, almost everywhere in the world, the end of food shortages, the global installation of Western food in the world (the price of a McDonald’s meal is a comparative economic index, in most countries of the world) allows affordable food, especially since it is of low nutritional quality (energetically dense, because it is too fatty and too sweet but devoid of high added value elements, for example vitamins or micronutrients).
- A reduction in physical expenditure
The transformation of the nature of work with industrialization has taken us since the Second World War from physical work that expends a lot of calories to sedentary work requiring in theory far fewer calories, but we still have the same appetite.
- In 70 years, the modification of our way of life with the development of technology and the almost permanent use of transport (car or bus instead of walking or cycling) has made us collectively lose the notion of physical exercise and expenditure.
Who has not used or does not yet use the car for small daily journeys (like fetching bread or bringing the children to school under the pretext of saving time, the watchword of our current civilization)
In short, this “nutritional transition” leads to the storage of excess energy which manifests itself in the accumulation of excessive fat mass.
If the prevention of obesity is a matter of societal measures, the prevention of its evolution towards diabetes or its complications, in people predisposed to this disease or already diabetic, requires important modifications in the way of life which can only be obtained through regular support by medical teams (doctor, nurse, dietician, physiotherapist) competent in the field.
How is the Diabetology consultation going?
Above all, it is fundamental for me to know you in order to help you better.
Of course, all your medical history is fundamental, but your way of life and your character will also influence your care. I will of course endeavor to balance your diabetes as best as possible thanks to the therapeutic arsenal at our disposal (each drug has a specific place in the treatment strategy) but know that you are also and above all an actor in your disease and that my goal is to train you to have the right reflexes in food, monitoring, and physical activity to best prevent the complications of the disease.
