New concepts and treatments for diabetes

“NEARLY 100 years ago, the discovery of insulin and its use as a medicine seemed to be the solution to diabetes mellitus,” said Coen Stehouwer, internal medicine specialist at Maastricht University Medical Center, The Netherlands. “Yet, here we are in 2018, and the size of the problem continues to increase worldwide.” Dr Stehouwer addressed delegates during the ESCRS/EURETINA Symposium: The Diabetic Eye, on Saturday afternoon. He summarised the key issues of diabetes regarding not only the complications of the disease, but also the often significant side effects of common treatments. “Weight gain and hypoglycaemia are frequently encountered and are directly attributable to the medications administered in diabetic care,” he said, which adds to patient distress and lowers quality of life. “And despite the large strides that have been made in managing the disease, diabetics lose an average of 10 years of life in type 1 diabetes, and three to five in type 2 diabetes,” said Dr Stehouwer. These data are derived from Sweden, a country considered to be equipped to deliver excellent care. However, there are reasons to be optimistic. “On the other hand, if all risk factors are well controlled, there are hardly any increased risks of early death,” he said. And, with respect to the eye, “The old rule that all diabetics will have diabetic retinopathy after 20 years of disease no longer seems to ring true.”