One third more diabetics live in Germany today than 15 years ago. One of the most serious reasons is the increase in obesity -. There is still no medication against it.
T he figures are alarming: around six million people in Germany suffer from diabetes, a third more than 15 years ago. "Diabetes is a widespread disease," said Thomas Danne, chief physician at the Children's and Youth Hospital on the Bult in Hanover and chairman of the board of German Diabetes Aid.
750 people contract new cases of diabetes every day, and three people die from the disease every hour. About 95 percent of those affected suffer from type 2 diabetes – formerly called adult onset diabetes. Type 1 is much rarer, however, the numbers are also increasing here.
For Matthias Tschop, diabetes researcher at Helmholtz Zentrum Munchen, the cause of the rapid increase in type 2 is obvious: the growing number of overweight people. "We simply can't get a grip on the problem," says Tschop. Obesity is considered one of the main causes of type 2 diabetes. "To date, we do not have any drugs against obesity," explains the physician. Only surgical interventions such as a gastric bypass are possible.
There are genetic reasons for obesity, many affected have no chance at all with Willem alone.
Tschop therefore wants to develop drugs that combat obesity and diabetes at the same time. "We need drugs that are much more effective than they are today."
The various types of fatty tie in the body are supposed to help here. "There are fat cells that do not store fat, but burn it," Tschop explains. For some time now, the physician and his colleagues at Helmholtz Zentrum have been investigating in more detail how the "good" brown adipose tie can be distinguished from the "bad" white tie.
"We have to manage to convert white fat cells into brown fat cells – that is, cells that store calories convert into cells that burn calories."But the scientists do not yet know exactly how this works.
Not just drugs and therapies
It is important to Tschop not to label diabetes patients with the motto: "It's his own fault." And he emphasizes: "There are genetic reasons for obesity, many affected people have no chance at all with will alone."
Some overweight people never get diabetes, while others suffer from the disease even if they are not overweight. "Life is not fair there," says pediatrician Danne. Many diabetes patients do not dare to go public with their disease for fear of being ostracized.
For Danne, diabetes is therefore also a social problem that cannot be tackled by new drugs and therapies alone. "Our society doesn't make healthy living easy," says Danne. A national diabetes action plan aims to change this. "18 EU countries already have it, Germany is lagging behind."
With such a plan, Danne wants to bind the interests of the various lobby groups – whether doctors, politicians or the food industry. Early detection should also get better. Many people only notice diabetes when they are already suffering from secondary diseases. "High sugar doesn't hurt," explains Danne.
Metformin for diabetes
The pediatrician also calls for a central diabetes registry. "We still know far too little about how people are treated." The Federal Council came out in favor of a national diabetes plan this summer. Danne now sees the ball in the court of the federal government.
Diabetes is often concealed at work
It is also a fact that many people with diabetes conceal their illness at work because they fear losing their job. "However, you can't judge the occupational risks of an affected person or even conclude that he or she is not fit for work based on the diagnosis of diabetes alone," says Kurt Rinnert, head of the company medical service of the city of Cologne.
At the same time, those affected can do almost any job. "Several statistics, such as those from health insurance companies, show that people with diabetes do not have more accidents at work in their everyday working lives, nor are they less able to perform than others."
While at work, however, diabetics may occasionally experience hypoglycemia. In the run-up, those affected often feel listless, they sweat or tremble, have ravenous appetites, concentration and speech problems or are easily irritable. However, hypoglycemia and even fainting are rare during working hours – as are secondary diseases of the eyes, kidneys, nerves or blood vessels.
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The risk of hypoglycemia increases in occupations that involve heavy physical exertion. "What's problematic is when there's no way to take a break, measure blood sugar and take glucose," says Rinnert. "For example, in the case of a firefighter on a rescue mission, because he has to wear protective clothing due to the heat and is under great time prere. "
Alternating shifts are also a challenge for people with diabetes because they then work, sleep and eat at irregular times. "Insulin has a different effect at different times of the day. This makes it difficult to determine the appropriate amount of insulin," explains Professor Karsten Mussig from the Department of Endocrinology and Diabetology at Dusseldorf University Hospital.