Diabetology is the medical speciality dedicated to the study of diabetes, its causes, its treatments and its complications. First and foremost, it allows for such complications to be prevented and patients at risk to be screened.
Diabetes is characterised by an abnormal increase in blood glucose (the level of sugar in the blood); normal fasting blood glucose should be 5.5 mmol per litre (or in grams, 1 gram per litre). We refer to diabetes if this level exceeds 7 mmol/l on at least two occasions.
A hormone called insulin (secreted by a part of the pancreas known as the endocrine pancreas) helps to regulate blood glucose and keep its levels within the norm.
Its action is essential because it facilitates the use of sugar by the body’s cells.
There are two main types of diabetes: type 1 diabetes and type 2 diabetes.
Type 1 diabetes:
As a basic principle, this type of diabetes appears during childhood, adolescence or early adulthood. It affects approximately 5 to 10% of people with diabetes.
The cause of this type of diabetes is an insulin deficiency resulting from the pancreas, which is usually destroyed by an autoimmune process: the body attacks its own organs.
One of the first signs is weight loss, together with intense fatigue, excessive thirst and excessive urination (polyuria). From the outset, treatment will involve insulin therapy administered by a daily injection.
Type 2 diabetes:
This usually occurs in adulthood and affects 90 to 95% of people with diabetes.
As a general rule, the cause of this type of diabetes is resistance to insulin action. To compensate for this resistance, insulin will sometimes be produced in large quantities. The danger is that this may exhaust the pancreas in the mid or long term. In the majority of cases, this resistance is caused by excess weight.
The symptoms, which are mainly thirst and polyuria, may appear later on, with the disease sometimes remaining silent for a long time. This is why it is important for a diagnosis to be made as soon as possible, especially in patients who are at risk (those who have excess weight, a family history of diabetes, etc.).
Dieting, weight loss and physical activity are the key elements involved in treatment.
If this is not enough, such treatment will be combined with oral and, where necessary, injectable medication (there are several classes of antidiabetic medications). Sometimes, insulin will also need to be used.
Diabetes is rising sharply worldwide (there were approximately 425 million diabetic patients in 2017). We are talking about a real "pandemic"; in some countries in the Middle East, more than 20% of people suffer from diabetes.
In Switzerland, diabetes affects approximately 5% of the population; type 2 diabetes, which is the most common type, affects approximately 500,000 people, while type 1 diabetes affects approximately 40,000 people.
Therefore, it is essential for an early diagnosis to be made and suitable treatment to be initiated as soon as possible. This is because diabetes increases the risk of cardiovascular events; it may be responsible for certain serious complications (including microvascular ones and complications in the eyes, nerves and kidneys).