TYPE 2 DIABETES MELLITUS
Diabetes is one of the most widespread diseases worldwide. The Czech Republic is one of the countries with the highest number of patients in Europe. It has been estimated that there will be approximately 1.3 million diabetics in the Czech Republic in 2030. The most common type is type 2 diabetes, which in 85% of cases usually occurs in adulthood. Type 1 diabetes starts in childhood and must be treated with insulin.
Diabetes is not a homogeneous disease. Patients may suffer from thirst and weight loss in spite of having normal appetites; due to an inconstant blood glucose concentration, some patients may experience “wolf hunger” attacks, frequent nocturnal urination, infections and fatigue. A high blood glucose level (hyperglycemia) leads to frequent complications, such as cardiovascular diseases (heart attack, stroke), neuropathy (dysfunction of nerves and loss of sensitivity of the lower limbs in particular), eye problems (diabetic retinopathy) and kidney problems (diabetic nephropathy) that may result in renal failure. The integrity of the skin, especially of the lower extremities, may be impaired. Purulent diabetic ulcers often require limb amputations. In the Czech Republic alone, almost 10,000 diabetics had a lower limb amputated in 2016.
More effective treatment
Thanks to the progress in diabetes treatment, we are now able to prevent dangerous and costly complications or delay their onset. Patient education is very important because diet and physical activity are as important as medications.
More than 20 new medicines have been approved and marketed over the past 13 years. The introduction of insulin pumps (currently available for type 1 diabetics only) or blood glucose level sensors has significantly helped patients to accurately monitor their blood sugar level and to dose their insulin.
“Combining different classes of medications into one pill has greatly simplified dosing, which has helped to adhere more thoroughly to the treatment plan and thus to increase treatment effectiveness,” says Mgr. Jakub Dvořáček, MHA, executive director of the Association of Innovative Pharmaceutical Industry (AIFP).
Diabetics’ life expectancy is now comparable to that of the rest of the population. The life expectancy of patients is increasing (to 79 years in 2018) and so is the total number of patients with diabetes in the population. Despite the higher prevalence, the number of hospitalized patients keeps declining and more than half of patients return from the hospital in less than a week.
An increase in ability to work and a reduction of expenses
Treatment of diabetics burdens the healthcare budget. The biggest problem, both from a health and economic point of view, are the late complications of diabetes, which can be averted or delayed by good quality treatment.
Current treatment also saves money on disability pensions. Patients are able to remain economically active longer and do not need to receive a disability pension. “Between 2010 and 2018, cumulative savings on disability pensions for type 2 diabetes amounted to 171.7 million Czech Crowns. The number of hospitalized patients decreased by 28,000 between 2010 and 2017. In 2030, thanks to innovative medicinal products, the state could save up to 40 million Czech Crowns per year on disability pensions paid to diabetics,” adds Jakub Dvořáček.