The type 2 diabetes associated with the obesity “pandemic” causes the appearance of cases at increasingly younger ages, according to the president of the Spanish Diabetes Society (SED), Francisco Javier Ampudia-Blascowho defends the need to reactivate prevention programs to prevent at-risk patients from developing this ailment.
“If before we diagnosed a patient with type 2 diabetes at 50, 55 or 60 years old, now We are seeing people over 30 and even teenagersdue to the significant levels of obesity that we have in our country,” says the head of the Endocrinology and Diabetes section at the Hospital Clínico de València in an interview.
40% of those affected are unaware of it
According to him, the Diabet study showed that approximately 14 percent of the population over 18 years of age in Spain has diabetes, and of that percentage, almost half were unaware of being affected by a disease that, in more than 90 percent of cases, It is type 2 (insulin resistance).
Diabetes constitutes a very important “health problem” in all the industrialized countries around us and particularly in Spain, says Ampudia-Blasco, who adds that because of how common it is and because this ailment has been normalized, he believes that ” “the health authorities look the other way.”
Above all, type 2 diabetes is a “problem of national magnitude and has a great impact on health budgets,” says the also professor at the Faculty of Medicine of the University of Valencia, for whom the “best treatment for diabetes is prevent its appearance, trying to improve the progression factors in patients at risk.
Diabetes is considered the “invisible killer” because of the complications it may entail. So, 85 percent of diabetic patients “die from cardiovascular diseases which can largely be preventable and which cause significant morbidity to patients and, therefore, incredible healthcare costs.
In his opinion, Diabetes prevention can “without a doubt be improved” and explains that before the covid-19 pandemic there were very active campaigns by Primary Care doctors who have “got a little lost”, and there are clinical markers that can identify at-risk patients.
He also considers that the population “is not aware. Many people think that only patients who take insulin have diabetes and that the other thing is not diabetes, when it is just as serious. People tend to minimize the problems associated with diabetes out of pure ignorance and, therefore, an awareness campaign is needed.
“This is not being done well and we must improve, because in the long run it will result in a significant overload on the health system’s expenses,” says Ampudia-Blasco, who considers diabetes a “pandemic” because it is a highly prevalent disease in around the world and is expected to grow in parallel with the increase in obesity.
He emphasizes that Treating obesity “prevents many serious events such as a myocardial infarction or a stroke,” and if the population increased their physical activity and had a good diet “many cases of diabetes could be prevented.”
In his opinion, the institutions “have done things at the time, such as trying to limit the consumption of soft drinks, but I think the real impact of this type of measures on society is small.” He advocates working in schools and families “on what good nutrition should be and promoting healthy lifestyle habits.”
This, he adds, is something that is very present in the countries of northern Europe, but in Spain there are areas where the problem of obesity is “very real” such as Murcia, the Canary Islands, Andalusia, Extremadura or the Valencian Community, compared to autonomies such as the Basque Country or Cantabria. “The further south you go, the greater the prevalence of obesity.”
There is a lack of specialists in Endocrinology
He recognizes that there is a lack of doctors in all specialties, not only in Endocrinology and Nutrition, but considers it “curious” that despite being a “relatively minority” number, they have a “very important” role in the treatment of tremendously prevalent diseases.
“There are really very few specialists, in general we are very deficient. At the moment there are no unemployed colleagues, you finish the specialty and you have a job immediately,” he highlights, adding that the needs are three specialists per 100,000 inhabitants or two for each 300 hospital beds.
As he explains, in Valencia there are “clearly deficient” health departments such as Gandia or Requena and he points out that he knows that in some health areas doctors who are internists perform Endocrinology functions because there are not enough endocrinologists to cover all the positions.
He also points out that in Primary Care, where they have to care for a large volume of patients, “when the problems become complicated, they do not have the capacity to resolve them adequately and in the end, logically, they are referred to the hospital. It is something that happens in all specialties medical”.
To improve this situation, he explains, they are working in the health department of the Clínico-Malvarrosa through the so-called ‘care routes’ to work collaboratively and expedite the care “of a patient who belongs to no one, belongs to everyone, It is the center of health care.
Research and treatments
“The best treatment for diabetes is to prevent it from appearing,” says Ampudia-Blasco, who explains that there has been “a lot of progress” in both research and treatments to address this disease and, thanks to this, there are new medications to treat the disease. diabetes.
Thus, at the end of 2022, the use of a drug (teplizumab) to prevent the progression of type 1 diabetes was approved in the United States, at least for a period of two years in a study, and it is being evaluated by the European Agency for Medicine.
“This is the first time that a drug has been approved that can prevent the progression of type 1 diabetes in a patient at risk because they are a first-degree relative of someone who has it,” he emphasizes.
He adds that in type 2 diabetes there are currently two therapeutic forms of Semaglutide, a GLP-1 receptor agonist indicated in patients with obesity: Ozempic, sold out in pharmacies because it has been used “inappropriately” to treat obesity in individuals without diabetes and who is injectable once a week; and Rybelsus, orally and daily administration.
In addition, on May 1, Wegovy was marketed, also a weekly injectable for use in obesity and not financed by the National Health System.
Objectives at the head of the SED
Among his objectives as head of the Spanish Diabetes Society, Francisco Javier Ampudia-Blasco highlights achieving greater internationalization of its activities, opening bridges of collaboration with other related foreign entities, as well as promoting the communication of issues related to diabetes to the society, and promote collaboration with patient associations.
They also seek to improve the relationship with other scientific societies that also deal with diabetes, among other diseases, especially with Primary Care to jointly contribute to better training specialists at that health level, “who in the end are the ones with the most patients.” come with diabetes, since the most prevalent form is type 2.
Likewise, they want to strengthen more collaborative ties with other specialties involved in the treatment of diabetes with serious complications such as cardiology, nephrology or neurology.