'The fight against diabetes must be won'

The diabetes pandemic will have a huge negative impact on the development of nations across the globe within a short time, a scientist has warned. He said there was no choice but to win the battle against this debilitating disease as it will affect an incredible one billion people within 19 years. In an e-mail interview, Dr Stefano Del Prato called for immediate action as diabetics are also at risk of developing complications that can affect their quality of life. The scientist is the chairperson of the Programme Committee for the World Diabetes Congress in Dubai in December this year. Dubai won the bid to hold this important conference against stiff competition. Article continues below The scientist called for changes in the general awareness regarding diabetes in the region. "There is an obvious need to design strategies both culturally and socio-economically appropriate for improving or addressing lifestyle issues on a large scale. These strategies should be directed at the community in general as well as the high-risk groups," he said. The professor said lifestyle changes aimed at the community or even vulnerable ethnic groups will need implementation at an early age, during school years. "There is an urgent need to introduce a formal programme on lifestyle, including nutrition and exercise." Asked whether the fight against the disease can be won, he pointed to the startling figures. "Therefore, there is no choice: the fight against diabetes must be won. To do so we need to improve our capacity of effectively treating the disease and prevent long-term complications. Most importantly we need to improve our capacity to prevent development of diabetes," he said. Perception change The scientist noted the fight requires a complex and integrated strategy. This includes a change of perception of the disease, improvement of lifestyle, community programmes, and individual preventative treatment. He said major steps have been taken that will facilitate the implementation processes of these manoeuvres. "Of great importance with respect to this, is the diabetes declaration of the Organisation of the United Nations and the more recent Non-Communicable Disease Alliance launched by the International Diabetes Federation and the World Health Organisation," he noted. Dr Del Prato said diabetes is still too often regarded as a mild disturbance of glucose metabolism but that the number of people suffering from complications of chronic hyperglycaemia is incredibly large. "Diabetic complications can hamper ability to work resulting in significant financial loss and could be a potential cause of discrimination." Diabetes is a disease that works slowly in the background of a person's life, he said. "Some years ago, studies have calculated that the diagnosis of diabetes is usually preceded by eight to 12 years of unrecognised diabetes. It is also known that for any two persons with diabetes there is at least another one with undiagnosed diabetes." Search for a solution Asked if there is any hope of discovering a cure for diabetes, the scientist said understanding of the pathogenesis of diabetes has grown stronger in the past few decades providing better background for the search for a solution for diabetes. "Replacement of the beta-cell function in Type 1 diabetes remains the main goal of the research," he said, and it includes the development of miniaturised artificial pancreas. The professor said Type 2 diabetes is an even more complex condition. "The new treatments are rarely resolving while they may be expensive. Therefore, diet and physical exercise remain the cornerstone of an effective treatment in Type 2 diabetes," he noted. "More recently, bariatric surgery has offered a novel opportunity for obese diabetic people," said the scientist. "The effect of this procedure is not limited to the effect of body weight loss." Award winner Dr Stefano Del Prato is chairperson of the Programme Committee for the World Diabetes Congress to be held in Dubai in December 2011. Professor of Endocrinology and Metabolism at the School of Medicine, University of Pisa and chief of the section of diabetes, University of Pisa, Italy. His research interests have been concerned with diabetes and the physiopathology and therapy of Type 2 diabetes and insulin resistance syndrome. He has been awarded the Prize of the Italian Society of Diabetology for outstanding scientific activity.