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Photo: Helen Edvall
Today, November 14 is World Diabetes Day.
We have a duty to provide the treatment that saves lives. A person with type 2 diabetes presents a risk of heart attack, stroke and premature death four times higher than people without type 2 diabetes.
New research shows that this risk can be eliminated if the patient receives the appropriate treatment.
Nearly half a million Swedes live with diabetes and 90% of them have type 2 diabetes. And their numbers are steadily increasing: about 80 Swedes get diagnosed daily by their doctor type 2 diabetes.
It has already been shown that a good treatment to reduce blood sugar starts with fewer heart attacks and saves lives. Thanks to new research results, it is now possible to prevent the risk of recurrence of cardiovascular disease with the right treatment. The results are so remarkable that recently (October 2018) a consensus document from the European Diabetes Association (EASD) and the United States (ADA) appeared to clarify and address the link between diabetes and cardiovascular disease.
Now, Sweden must also start treating type 2 diabetes in this way. The Swedish treatment guidelines have already been changed, but they are not allowed by the patient. Nevertheless, so-called SU preparations are used to give high blood sugar, weight gain and no documented protection against cardiovascular disease. Also known as DPP4 inhibitors, used with diligence, they offer some protection against the relapse of cardiovascular events.
Between 2006 and 2014, the cost of diseases in Sweden doubled for type 2 diabetes, from 5.5 billion to 11.6 billion kroner. One of the main reasons is the increase in complications and complications. The cost of anti-diabetic medicines, which can fight complications, remained stable for the entire period 2006-2014.
Type 2 diabetes is a multifactorial disease, which means that many factors play a role in the development of the disease. A recent study from the Swedish National Diabetes Registry, the largest registry of people with diabetes, analyzes the effects of five high-risk factors on premature death:
• Long-term blood glucose (HbA1c)
• Cholesterol levels
• Blood pressure
• Egg white in the urine
• smoking
The more risk factors that normalize, the better. For those with type 2 diabetes but none of the risk factors, there is no increased risk of death or cardiovascular disease!
This is not a criticism of Swedish general practitioners, they do everything they can in an economic and political system that does not benefit from the treatment of complicated chronic diseases. The fact is, however, that if we treat according to Swedish and international research results and guidelines, we get diabetic patients in good health.
Anders Frid
medical doctor and one of the leading Swedish researchers on diabetes
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