Leading diabetes organizations called for a National Diabetes Plan to mark World Diabetes Day. But can such a master plan really stop the supposed diabetes epidemic?

Current figures on the frequency of diabetes teach the health system to fear. According to the ärzte Zeitung, around 270.000 people develop diabetes every year, which corresponds to over 700 new cases every day (1). In order to finally put a stop to the disease, leading diabetes organizations are calling for a National Diabetes Plan. While the International Diabetes Federation (IDF) has already presented an action plan, the German Diabetes Society (DDG) is now also presenting the first drafts for a corresponding catalog of measures. He sees a need for action primarily in primary prevention, early detection, care and research as well as information and training.

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Researchers at the University of Michigan recently reported that a glucose sensor can be used to determine the sugar content in tear fluid. As a result, people with diabetes mellitus could do without daily blood tests. However, the German Diabetes Society (DDG) sees this method as no alternative to conventional blood sugar measurement. According to the DDG, this can be carried out gently, with little pain and reliably if patients take a few tips into account.

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INSIGHT Health on insulin consumption in Germany

A current supply analysis by the information service provider INSIGHT Health shows considerable regional differences in the outpatient prescription of insulin. With a total of 11,9 million insulin prescriptions in the statutory health insurance (GKV), 171 insulin prescriptions across Germany were settled per 1.000 GKV insured persons last year. The region of the Association of Statutory Health Insurance Physicians (KV) Mecklenburg-Western Pomerania achieved the top value with 294 prescriptions per 1.000 insured persons. The other new federal states are also well above the average (245-280 prescriptions / 1.000 insured persons). The KV regions of Bavaria and Baden-Württemberg have the lowest prescription density, each with around 130 prescriptions per 1.000 insured persons.

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Current figures from the database of the American drug agency FDA indicate an increased risk of pancreatitis and pancreatic carcinoma with "incretin-based" forms of therapy

In recent years, doctors have been using more and more drugs based on an endogenous hormone, an “incretin” produced in the intestine, to treat type 2 diabetes. This "glucagon-like peptide" GLP-1 can either be injected under the skin in a modified form. However, there are also inhibitors in tablet form that suppress the breakdown of the GLP-1 produced in the body, which prolongs the effect of the body's own GLP-1. GLP-1 releases the body's own insulin that is still present and at the same time suppresses the blood sugar-increasing glucagon. This lowers the blood sugar level into the normal range. "The special thing about the GLP-1-based forms of therapy is that they do not lead to the often feared hypoglycaemia and there is no increase, with the GLP-1 analogues even weight loss," explains Professor Helmut Schatz, Bochum, media spokesman for the German Society for Endocrinology. A recent analysis of the US Food and Drug Administration database now indicates the possibility of rare but serious side effects from this new group of drugs.

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A current statement from the German Diabetes Society

DDG and diabetesDE warns type 1 diabetics about a dubious offer on the Internet: There, Prof. Ulrich von Arnim offers a “new type of treatment scheme for type 1 diabetes”. This should cure those affected in 80 percent of cases. The successes are documented with studies, names of diabetes experts in Germany and statements from patients who have been cured. However, neither the studies nor a collaboration with the named diabetes experts exist.

"So far there is no scientific evidence that diabetics benefit from the therapy offered," emphasizes Professor Dr. med. Thomas Danne, President of the DDG and CEO of diabetesDE. Scientists around the world are working to prevent or cure type 1 diabetes. There are several promising partial results in research on this. However, the ultimate goal has not yet been achieved: To prevent the body from destroying the insulin-producing cells in the pancreas or to permanently replace destroyed cells.

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Two eggs a day improve numerous blood values

Animal protein, fat and cholesterol - for many, eggs are still one of the foods that should rarely be on the menu. A new study from Australia shows that the fruit before the egg is unfounded not only for healthy people, but also for type 2 diabetics (Pearce, KL et, Brit J Nutr 2010, online on December 7.12.10, 65). For this, 2 overweight type 590 diabetics ate a moderately low-calorie, protein-rich diet that contained either two eggs (100 mg cholesterol) or 213 g lean meat (XNUMX mg cholesterol) instead.

After three months, both groups had lost the same amount (6 kg). The "bad" LDL cholesterol was unchanged, although half of the participants had eaten almost three times as much cholesterol. This shows how well the body's own regulation of cholesterol levels works. Many other risk parameters (blood pressure, triglycerides, apo-B, HbA1c and fasting sugar) also improved in both groups. But there were also differences: the "good" HDL cholesterol only increased in the egg-eaters. Those who had not eaten eggs had dropped it - an undesirable effect. The supply of the B vitamin folic acid and the carotenoid lutein (good for eye health) was also better in the egg-eaters.

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Recent studies show that people with diabetes and depression die earlier. The reason for this is that diabetics with depressive disorders have a significantly increased risk of damage to their blood vessels and associated diseases. Depression or other mental illnesses are often recognized late or not treated adequately. How doctors can successfully help affected diabetics was a topic of the 4th autumn conference of the German Diabetes Society (DDG), which took place together with the 26th annual conference of the German Obesity Society (DAG) from November 4th to 6th, 2010 in Berlin .

About ten percent of the general population will experience depression at some point in their lives. Diabetics are twice as likely to suffer from it. Depressive disorders are among the most common mental illnesses and pose a major problem in connection with diabetes mellitus: It is difficult for depressed diabetics to actively work on successful diabetes therapy. "Early recognition of depression and the initiation of appropriate treatment are decisive for the quality of life and the prognosis of the patient," emphasizes private lecturer Dr. medical habil. Rainer Lundershausen, President of the DDG Autumn Conference. However, depression in the general population and in diabetics is often recognized late.

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Hypoglycaemia is the most common acute complication of diabetes mellitus. When blood sugar levels fall, diabetics can lose consciousness, have seizures, and injure themselves if they fall. The consequences of a complication are just as dangerous: according to new studies, those affected have limited mental performance and an increased rate of dementia. Severe hypoglycaemia can also damage the heart and blood vessels.

The current findings on hypoglycaemia and how this can be successfully prevented in at-risk diabetics is a topic of the 4th autumn conference of the German Diabetes Society (DDG), which is held together with the 26th annual conference of the German Obesity Society (DAG) from 4th until November 6, 2010.

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Two elaborate studies acquit the saturated fats

Saturated fatty acids, which naturally occur primarily in butter, cream, tallow, coconut and palm kernel fat, have been considered unhealthy for decades. The margarine lobby, among other things, made sure of that. While the panic about these fats was initially fueled by their influence on cholesterol levels, another accusation has recently been added: saturated fats are said to cause insulin to no longer work properly in the body. So-called insulin resistance is indeed a major problem because it is at the heart of numerous health disorders, most notably Metabolic Syndrome. But is it really the butter or coconut oil on our plates to blame when insulin loses its effectiveness?

Solid human evidence for this claim has never been available. Two complex intervention studies are now giving the all-clear: In the LIPGENE study (Tierney, AC et al: Int J Obesity doi: 10.1038/ijo.2010.209), a good 400 Europeans with metabolic syndrome were encouraged to reduce their consumption of saturated fatty acids, but without doing so to reduce calorie intake. There was no effect on insulin sensitivity. Cholesterol levels and inflammatory markers did not change either.

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If diabetics develop secondary diseases, such as nerve disorders, kidney and eye damage, a vitamin B1 (thiamine) deficiency is probably also often involved: as scientists reported at a symposium in the run-up to the annual meeting of the German Diabetes Society in Stuttgart Patients with diabetes have a 75% lower concentration of thiamine in their blood plasma compared to healthy people. The cause of the thiamine problem: Even at a very early stage of the disease, the increased blood sugar impairs kidney function, which means that the vitamin is lost in large quantities in the urine.

In the case of a thiamine deficiency, however, more aggressive sugar breakdown products can accumulate in the body. This accelerates the destructive effects of elevated blood sugar on nerves and blood vessels.

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The new comprehensive brochure on type 2 diabetes mellitus provides valuable nutrition tips

Every minute, an average of two diabetics in the world lose a foot or a leg due to their illness, because many people affected are not aware of the importance of healthy feet in their illness.

Most diabetics are now aware that their illness makes them more susceptible to cardiovascular disease and more likely to have a heart attack or stroke. Far fewer people are aware that the limbs also suffer from high blood sugar levels. Diabetes mellitus is one of the most common causes of foot amputations worldwide. Much of it would have been avoidable. But the diabetic foot syndrome still receives too little attention.

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