November is World Diabetes Day.
Diabetes affects millions of people in Germany. The rarer type 1 already affects children. A great deal of discipline is required of you in the process.
Dusseldorf. His day begins with measuring blood glucose and ends with it. "It's been part of my daily routine for twelve and a half years," says diabetic Sven Muller (15) from Leichlingen near Cologne, Germany. "Measuring blood glucose six or seven times a day, even at night – that's normal for me."Before eating, they determine the carbohydrate content of their food and drink, calculate their insulin requirements, and inject themselves with the necessary dose of insulin. "It's a pain, but I've got it under control and don't have to do without anything."
The widespread disease is spreading dramatically. The German Diabetes Society (DDG) points this out on the occasion of World Diabetes Day on 14 December.November. Nationwide, more than six million people are undergoing treatment; by 2030, the figure will be eight million, she says. In addition, there is a worrying number of unreported cases of one to two million people affected – undiagnosed and therefore untreated. The most common form is type 2, often caused or promoted by an unhealthy diet, obesity and lack of exercise.
Type 1 diabetes often occurs in childhood
The situation is different for type 1, with a good 300.000 cases: The autoimmune disease, which occurs particularly in childhood, causes the pancreas to produce no insulin at all; without this hormone, the body cannot absorb sugar, which is a source of energy. Sven was diagnosed with type 1 diabetes when he was four years old. "As a small child, I found it hard. Everyone else was able to eat just like that, only I wasn't allowed to."
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A mini-box is attached to his abdomen, from which a small needle is inserted into the abdominal wall. From this, the patient constantly receives a small basic amount of "basal insulin" as well as any necessary additional amounts. Sven uses a mobile phone-shaped device – the bolus calculator – to calculate and control his intake. From time to time, he also reaches for the injection (pen). "If I feel weak on my feet, that's a warning sign, then I have to measure and eat quickly."
The widespread disease can have immense consequences
Diabetes can have serious consequences – stroke, heart attack, blindness, foot amputation, kidney failure. In 2013, 24 died.257 people diagnosed with diabetes, as DDG expert Eva-Maria Fach reports. Most of those affected are "people of advancing age," explains Ralph Ziegler, spokesman for the DDG's Pediatric Diabetology Working Group. In young people, there is a particular risk of hypoglycemia, which can lead to unconsciousness.
The metabolic disease type 1 have about 32.000 adolescents up to the age of 19. Ziegler emphasizes that 2,500 new cases are diagnosed every year. How many adolescents have type 2 is uncertain, she said, but "the problem is underestimated."Around 200 new cases per year are known.
Is diabetes easy to handle? The insulin pump is a step forward, says Ziegler, who has a practice in Munster that specializes in young diabetics. "And we have modern insulins that work faster in. Unfortunately still not fast enough."A new development is a permanent microdevice, a CGM sensor with a tiny needle. It measures the sugar level every three minutes and can also sound the alarm. "We expect and hope that the insurance companies will soon cover the costs for this," says Ziegler. Researchers are working on combining the pump and CGM into a single device that can then manage optimal insulin delivery – without the patient's intervention.
Nutrition at the center of World Diabetes Day
This time, World Diabetes Day puts nutrition at the heart of the chronic disease. In type 2, healthy eating and exercise could help prevent and treat diabetes. For type 1, both are at least helpful. "Healthy foods should be cheap, unhealthy ones like sweets more expensive," says Ziegler. Since household sugar is consumed excessively and is found in many products, a "sugar tax" could make sense. "It would be important to ban misleading advertising for overweight-promoting foods directed at children."
It often gets difficult during puberty, knows DDG expert Fach. Breaking away from parents, first love or testing alcohol sometimes lead to "imprudent risk behavior. Hormone changes and blood sugar fluctuations also threw a lot of things out of whack.
Sven has become a health professional through his diabetes. How long BMX bike jumping affects his energy balance, or how many carbohydrate units are in food, he knows off the top of his head. "I do not feel restricted. But at parties it is clear: More than one or two beers is not possible.