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In France, over 4 million people live with diabetes. Diabetes is characterized by chronic hyperglycemia, i.e. an excess of sugar in the blood, resulting in excessively high glucose levels. The two main types of diabetes, type 1 and type 2, are distinct illnesses, but both are characterized by excess sugar in the blood, and require serious management. There is no such thing as “minor” diabetes, or diabetes that is more serious than others.

There are two main types of diabetes: type 1, which affects around 6% of people with diabetes in France, and type 2, which affects 92%. Other types of diabetes account for the remaining 2% (MODY, LADA, gestational or secondary diabetes).

Type 1 diabetes (T1DM) is often diagnosed in children and young people under the age of 20, but can occur at any age. It results from the progressive disappearance of the islets of Langerhans containing the beta cells of the pancreas, responsible for producing insulin. Over time, a total insulin deficiency sets in.

The body no longer recognizes these cells and destroys them via autoantibodies: type 1 diabetes is an autoimmune disease. As glucose cannot enter the cells, it concentrates in the blood. Blood glucose levels rise, causing hyperglycemia.

Causes of type 1 diabetes

It is not known precisely why this destruction of the islets of Langerhans occurs in some people and not in others. There may be a genetic predisposition.

But with the progress of science, we now have several leads to explain the progression of this autoimmune disease. It could be linked to a number of environmental and lifestyle changes: increased maternal age at the birth of the first child, type of breast-feeding (breast-feeding, infant milk) in the first months of life, changes in intestinal flora, exposure to toxins, etc. The factor most clearly implicated in the progression of this autoimmune disease is the age of the mother.

The factor most clearly implicated to date is the rate of infection by certain viruses.

Treatment:

As the body no longer manufactures insulin, the only treatment is to administer insulin several times a day :
Either in the form of injections ;
or with an insulin pump (pump therapy), either external or implantable, delivering insulin continuously.

Type 2 diabetes generally occurs after the age of 40, but more and more teenagers and young adults are affected in France. Overweight, obesity and lack of physical activity are the main triggers of type 2 diabetes in genetically predisposed individuals.

Sneaky and painless, the development of type 2 diabetes can go undetected for a long time: it is estimated that an average of 5 to 10 years elapses between the appearance of the first hyperglycemia and diagnosis.

Two abnormalities are responsible for hyperglycemia:

• Either the insulin produced by the pancreas acts poorly, and we speak of insulin resistance;
• Or the pancreas still produces insulin, but not enough to match blood glucose levels, and this is known as insulinopenia.
  These two mechanisms prevent glucose from entering the body’s cells and concentrate in the bloodstream.

Treatments for type 2 diabetes

Initially, treatment begins with lifestyle modifications: regular physical activity and a varied, balanced diet. When hygiene and dietary measures alone are no longer sufficient to stabilize diabetes, appropriate anti-diabetic drugs are prescribed.

Type 2 diabetes evolves naturally over time. After a gradual increase in anti-diabetic drugs, insulin injections may become necessary.