Diabetes, its treatment and proliferation across the globe was the subject of the latest instalment of the Grand Rounds Series at Weill Cornell Medicine – Qatar (WCM-Q). The lecture, entitled ‘Diabetes, The Ticking Time Bomb’, was delivered by Dr Alexandra Butler, adjunct professor of medicine/endocrinology at the Diabetes Research Center, which is part of the Qatar Biomedical Research Institute.
Dr Butler explained that more than 8% of the global adult population have diabetes – around 366 million adults – but with three new cases diagnosed every ten seconds, that figure is projected to rise to 552 million by 2030. In Qatar – where the prevalence of diabetes is well-documented and higher than the global average – the majority of cases involve type 2 diabetes, although cases of type 1 diabetes are also on the rise.
Speaking before an audience of students and fellow healthcare professionals, Dr Butler explained how the two types present themselves differently.
Type 1 diabetes tends to have a rapid onset and symptoms are often severe; whilst there are two peaks in incidence, in preschool and teenage years, type 1 diabetes can occur at any stage of life. By contrast, the onset of type 2 diabetes is typically slower, often occurring over several months, with symptoms that vary in severity. A family history of type 2 diabetes is more often present in new sufferers, and whilst the disease usually strikes people over the age of 20, there is a recent trend for type 2 diabetes to appear in the teenage and even pre-teen years.
However, although different in their clinical presentation, both type 1 and type 2 can cause the same microvascular complications, typically nephropathy, neuropathy and retinopathy. There are also potential macrovascular complications that can lead to an increased risk of strokes and heart attacks.
Laboratory tests can also help to distinguish which type of diabetes their patient is suffering from, and this is vital in order to institute appropriate treatment.
According to Dr Butler, distinguishing between the two types matter because of treatment. Type 1 diabetes must be treated with insulin whereas the treatment of type 2 diabetes always starts with lifestyle management. If that is inadequate, then usually the drug metformin is considered to be the drug of choice; after that, you have a range of drugs to choose from, one of which may be insulin, although this usually comes later in the treatment plan.
Whatever the treatment, good diabetes control is vital to preventing complications from the disease.
Dr Butler also discussed future treatment options, notably stem cell therapy for the treatment of diabetes, something that is being actively pursued in the Diabetes Research Center Stem Cell Group at QBRI.
The lecture was accredited locally by the Qatar Council for Healthcare Practitioners-Accreditation Department (QCHP-AD) and by the Accreditation Council for Continuing Medical Education (ACCME). For more information about the WCM-Q Grand Rounds Series, visit qatar-weill.cornell.edu.