Diabetes: insulin use often comes six years too late

  • Injections and the risk of hypoglycemia worry sufferers.
  • This delays the necessary introduction of insulin.

 

“Although the discovery of insulin as a treatment for people suffering from diabetes won the Nobel Prize 90 years ago, there remains too much misplaced hesitation surrounding it when it actually becomes essential. It’s thought that on average, in Belgium, diabetics start using insulin two to six years later than they should.”

 

According to Professor André Scheen, head of the diabetic medicine division at Sart-Tilman university hospital in Liège and president elect of the French-speaking Diabetic Society, the use of insulin, when necessary, commonly increases patients’ quality of life: “They will often feel less tired.”

 

Today, there are at least 600,000 diabetics in Belgium, of which a third are still unaware they have the condition, as it can take hold without obvious symptoms. Nine out of ten patients suffer from type 2 diabetes. “There are three main factors: heredity, a sedentary lifestyle and age, as the pancreas can no longer produce enough insulin to process the sugar,” explains Scheen. “To treat a type 2 diabetic, changes to the patient’s lifestyle must first be encouraged: a balanced diet, weight loss, physical exercise. But that is often quite difficult. After that, oral medication, the most well-known of which is metformin, is required to reduce the resistance to insulin that gradually develops. The natural insulin in the body then becomes more efficient. But you sometimes have to change medication. The earlier these kinds of treatment are put in place, the greater the effect and time saved in the progression of the illness.”

 

“Less restrictive”

The expert continues: “But, for a large number of patients, between 100,000 and 120,000, injections of artificial insulin are necessary. This step is often delayed because the patient wrongly sees it as a threat or a punishment for not having followed his previous treatment correctly. There’s also a fear of injections. However, the injection pens available now are almost painless. The patient also fears the risk of hypoglycemia and losing consciousness. And yet, the risk is minimal, thanks to the sugar level monitoring function offered by these lightweight devices. And also because the variety of artificial insulin allows the user to inject himself one to four times a day, with slow-acting insulin that works through the night and quick-acting insulin that one can practically take at the beginning of a meal. The patient’s level of discipline is a restrictive factor, but much less so than before. And there’s the fact that 85 % of general practitioners who have not yet begun insulin treatment with a patient would like training on how to do so.”

 

As far as Scheen is concerned, it is time to put aside all of our prejudices relating to insulin, the late use of which can reduce life expectancy and result in additional costs: “The treatment only represents 20 % of the overall cost of diabetes, due to complications that can lead to numerous hospitalizations.”

 

FRÉDÉRIC SOUMOIS

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