415 million people worldwide are affected by diabetes according to the International Diabetes Federation. It describes the phenomenon as a true pandemic because the progression is considerable. Thus, the World Health Organization predicts 622 million diabetics by 2040. In France in 2013, more than 3 million French people have diabetes, of which 92% have type 2 diabetes. Between 2009 and 2013, the increase in diabetes in France was 2.3%. This progression is not to be taken lightly! Another trend to note is the explosion of type 1 diabetes cases in children. Indeed, in 20 years, the number of children under 5 years old with diabetes has almost doubled.
Diabetes: What You Need to Know
Diabetes is a progressive metabolic disease characterized by chronic hyperglycemia, meaning abnormally high blood glucose (sugar) levels. Insulin is the hormone that usually regulates blood sugar. A diabetic person suffers from inadequate insulin production: blood sugar remains high. According to criteria defined by the WHO, diabetes is defined by a blood glucose level greater than 1.26 g/l (7 mmol/l) after an 8-hour fast and confirmed on two occasions.
Type I Diabetes
In children, type I diabetes is caused by the definitive and total disappearance of insulin. It is therefore insulin-dependent diabetes mellitus (IDDM). This disappearance is due to the total destruction of beta cells in the pancreatic islets of Langerhans (which produce insulin) located in the pancreas. Type 1 diabetes is an autoimmune disease whose origin is not yet fully understood. The absence of insulin causes an elevation of glucose (sugar) levels in the blood. To compensate, a person with type 1 diabetes must inject insulin several times a day for life to regulate their blood sugar.
Type II Diabetes
Type II diabetes, also called "non-insulin-dependent diabetes" (NIDDM), represents about 90% of cases. Also called "fat" or "maturity" diabetes, type II diabetes usually appears after the age of 50. However, the disease is constantly increasing in children. Its development seems to be the result of environmental factors, mainly dietary and behavioral factors (overweight, sedentary lifestyle).
This disease is characterized by hyperglycemia, that is, chronic excess sugar in the blood. The disease evolves insidiously and remains asymptomatic for a long time. Thus, many diabetics are unaware of their condition. Type II diabetes acts on several levels. Initially, a state of insulin resistance develops. The body gradually develops resistance to the action of insulin and must produce increasing amounts to maintain constant blood sugar levels. In the long run, it will be essential to provide additional insulin. Many complications related to diabetes develop, including glycation phenomena.
Glycation and Diabetes
Glycation is directly related to diabetes. Protein glycation is a reaction between a sugar (carbohydrate) and a protein. It generates glycated proteins that cannot be destroyed or released from the cell in which they accumulate. Glycation has consequences throughout the body. Glycated proteins lose all functionality, depriving the body of part of its synthesizing, repairing, structural, hormonal, enzymatic, immune, and transport powers. Insulin itself can become glycated and lose its effectiveness. Insulin receptors can also become glycated and become ineffective.
Main Complications Generated by Glycation
Even greater production of free radicals that destroy new proteins, but also lipids. Cells are attacked on several fronts. A chain reaction is initiated. Only specific measures will be able to stop this vicious circle.
The production of interferons (notably gamma) which further facilitate chronic inflammation.
Alterations at the genome level.
Accelerated degeneration and aging
Many phenomena of accelerated degeneration and aging directly result from glycation:
Arterial aging: arteriosclerosis and its complications (degeneration of the retina leading to blindness, myocardial infarction, stroke, renal failure).
Some forms of cataracts.
Probably a significant percentage of Alzheimer's disease, nicknamed "type II diabetes" by some North American experts. Indeed, it is now known that people with Alzheimer's disease are specifically sensitive to sugar. One of the avenues followed by some experts consists of modifying their diet by opting for a ketogenic diet (rich in fats and low in sugars). Such a diet also appears suitable for diabetic individuals.
Sources/References: www.afd.asso.fr. INVS: Type 1 diabetes in metropolitan France: characteristics, vascular risk, frequency of complications, and quality of care. Entred 2001 and Entred 2007. (1) www.afd.asso.fr/diabete/world-figures. (2) Lévy-Marchal C, Fagot-Campagna A, Daniel M. Epidemiological surveillance of childhood diabetes. Saint-Maurice: Institut de veille sanitaire;2007. 66 p. (3) The Ketogenic Diet, www.lanutrition.fr.