SYMPTOMS OF DIABETES: HOW EARLY DETECTION?

It is estimated that at least 500,000 French have diabetes they ignore.However, it is essential to detect diabetes before the onset of complications associated with this disease. Professor Patrick Vexiau * indicates clearly the symptoms suggestive of diabetes and those most at risk.

Can you have diabetes without knowing it? How then carried the diagnosis of diabetes?

Professor Patrick Vexiau: YES, you can be reached from diabetes without knowing it. It is currently estimated that there are at least 500,000 people with diabetes are unaware that in France, in addition to 1 to 2 million known diabetics. Specifically, data from the UKPDS (United of Kingdom Prospective Diabetes Study) showed that the actual onset of diabetes ahead of them 8 to 10 years the diagnosis of the disease. Over 80% of cases, diabetes is diagnosed during a blood test requested as a routine. In the cardiac intensive care units, 20% of patients are actually suffering from diabetes and half of them are diagnosed at this hospital, and therefore acute coronary complications. Thus, in many people, the diagnosis of diabetes is made on the occasion of a complication of the disease, knowing that it occurs ten years or more after the onset of diabetes, thus confirming the diagnosis is often overlooked during an entire decade.

How to spot symptoms of diabetes?

Professor Patrick Vexiau: The symptoms suggestive of diabetes are the existence of a syndrome polyuria polydipsia, that is to say the appearance of a large thirst due to the fact that the patient urinate frequently, especially at night, who wakes up and needs to stand up. However, these symptoms only appear when the sugar appears in the urine, which occurs when blood glucose exceeds 1.80 g / l. In practice this means that blood sugar is well above 2 g / l when these symptoms are visible. So often associated weight loss. Thus, when these symptoms appear, the diagnosis is already very late. We must therefore insist that it is not on the symptoms directly related to diabetes need to discuss the disease, but before the events that predispose to diabetes :

• It is above all the existence of family history. If a parent has become diabetic known to the age of 50 years and was ignored for 10 years, the disease has therefore emerged around the age of 40. Then 35 years from a systematic search should be performed periodically in children.
• The existence of other abnormalities such as dyslipidemia, high blood pressure or unexplained inflammation, should be investigated, metabolic syndrome, which is frequently associated with diabetes.
• Finally, lack of physical activity and overweight are major factors indicating a genetic predisposition to diabetes. Patients are less active and / or overweight should regularly check the existence of diabetes, especially when obesity is android (abdominal obesity).
• We know that diabetic patients have often had big babies at birth. Thus, any woman who had a baby weighing more than 4.5 kg should be periodically scan diabetes.

It is only a screening and systematic research that can happen to diagnoseearly enough and therefore to treat diabetes, to avoid complications.

In the absence of screening and treatment of diabetes, what are the risks?

Professor Patrick Vexiau: in the absence of screening and treatment of diabetes, the main risk is that the disease is revealed by a complication. Most often, this is a complication of vascular order (coronary heart disease, heart attack, stroke, peripheral arterial disease). It could also be affected small vessels of the retina with a decrease in visual acuity, renal impairment with onset of albumin in the urine and renal patent (diabetes becomes the first cause of ESRD and thus placing the artificial kidney). It may still be a nerve damage (neuropathy), an accident such as facial paralysis or impairment of visuo-motor skills. In the case of neuropathy with peripheral nerve damage, there are signs of polyneuropathy and a burning sensation in the feet or the feeling of walking in cotton. And finally, acute complications are favored by uncontrolled diabetes and therefore undiagnosed. It can be for example an infection from a wound that heals with difficulty. The diabetes is an insidious disease which causes low noise reached a particular vessel responsible for complications. The goal is diagnosed early to avoid the risk of complications, and even a diagnosis of prediabetes stage to address the measures lifestyle modifications even before diabetes appears. * Professor Patrick Vexiau is secretary general of the French Diabetes Association (AFD) and Head of Diabetes and Endocrinology Service of Hospital Saint-Louis in Paris (AP- HP).