Britain is in the midst of an explosion in type 1 diabetes, with the number of cases set to rise by a third over the next two decades, experts have warned.
Researchers estimate that more than 100,000 more Britons will be affected by the deadly disease in the coming years – reaching a total of 420,500 by 2049.
The number of cases has already risen by about 25 percent since the early 2000s, official figures show.
Unlike type 2 diabetes, the condition is not caused by obesity, lack of exercise and poor diet.
Rather, Type 1 is an autoimmune problem that typically develops during childhood.
It occurs when the body produces little or no insulin – the hormone responsible for converting sugars in food into energy.
Although scientists have not yet identified a single cause for the increase, they believe a combination of environmental factors could be to blame, including viral infections during childhood, air pollution and always chemicals.
“This increase is happening too quickly to be explained by changes in our genes alone,” Dr. Rosiered Brownson-Smith, an expert from King’s College London, told the Daily Mail.
‘Instead, researchers think that changes in our environment and exposure in early life may interact with genetic susceptibility.
The NHS has approved teplizumab – a new therapy that delays type 1 diabetes for up to three years
‘Research is being conducted into a number of factors, including childhood obesity, viral infections, changes in the gut microbiome and reduced exposure to microbes early in life, air pollution and certain chemicals.
However, she added that experts still don’t know what exactly is causing the increase.
“It’s unlikely that a single environmental factor is responsible,” she explained.
‘The most likely explanation is that several factors may work together in people who are genetically predisposed to type 1 diabetes.’
Researchers have examined a number of possible triggers, including viral infections in childhood, changes in gut bacteria, the widespread use of antibiotics and even early exposure to cow’s milk.
Other studies have suggested that air pollution may influence the risk of developing autoimmune diseases, although the evidence is still inconclusive.
The latest research – which will be presented at the annual meeting of the European Association for the Study of Diabetes in Milan – also predicts a sharp increase in the global burden of the disease.
It is estimated that the number of new cases worldwide will increase by 14 percent per year, from about 530,000 to more than 605,000.
The projections were generated using a modeling tool that estimates rates of type 1 diabetes around the world, taking into account treatment availability and survival.
The international team, led by experts from the University Hospital of Southern Denmark, said one of the main reasons why type 1 diabetes is becoming more common is that more people are surviving and living longer with the condition thanks to improvements in diabetes care.
‘The number of people with type 1 diabetes is expected to increase for a number of reasons,” Dr Brownson-Smith said.
‘The main reason for this difference is probably that people with type 1 diabetes live longer.’
The disease can increase the risk of kidney disease, stroke, blindness and nerve damage.
But decades of advances in insulin therapy, blood glucose monitoring and specialized diabetes care have dramatically improved patient outcomes.
While early studies suggested that people with type 1 diabetes typically live 15 to 20 years less than their healthy peers, more recent studies put this figure closer to 11 years, indicating survival gains in recent decades.
‘“With access to specialist diabetes care (insulin, glucose monitoring), many people diagnosed at a young age will be able to live with the condition for decades,” said Dr Brownson-Smith.
Treatment for diabetes involves daily injections of insulin, which allow sugar from the bloodstream to enter the body’s cells where it can be used for energy.
Doctor checking blood sugar level with glucometer
Without enough insulin, glucose builds up in the bloodstream to dangerous levels.
This can lead to a life-threatening condition called diabetic ketoacidosis (DKA), in which the body begins to break down fat for energy, causing harmful acids known as ketones to build up in the blood.
Symptoms include severe thirst, vomiting, abdominal pain, confusion, breathing difficulties and, in severe cases, coma and death if left untreated.
The increase in prevalence is expected to be particularly pronounced in poorer countries, where access to treatment is limited.
Meanwhile, the US is expected to record one of the largest increases in the number of people living with the condition, with the number of cases rising from almost 1.5 million today to more than 2 million by 2049, researchers predict.
The team has urged policymakers to ensure that the rising tide of patients has access to the treatment they need.
Dr. Brownson-Smith said the findings should serve as a warning for healthcare systems to prepare for a growing number of patients requiring lifelong support.
‘The key implication is that the NHS needs to plan for more people with type 1 diabetes in the long term,’ she said.
‘People with type 1 diabetes need lifelong access to care, including insulin, blood glucose monitoring and specialist support to manage their condition.
‘As the number of people living with the disease increases, this will create greater demand for diabetes services.’
This is expected to include increased pressure on specialist diabetes teams, glucose monitoring technology, diabetes education programs and services that support patients throughout childhood and into adulthood.
“The NHS needs to think about how many people will be diagnosed next year and how many people will need diabetes care in the coming decades,” she added.
Symptoms of type 1 diabetes usually appear quickly, within a few weeks, and start with intense thirst, frequent urination and unexplained weight loss.
Later symptoms include fatigue, blurred vision, itching, and slower than normal healing of wounds.
People with the autoimmune disease require insulin injections or an insulin pump, which delivers small amounts of insulin throughout the day and nights.
Patients also need regular tests and check-ups with their diabetes care team.
Despite this, nearly 450 million people with diabetes remain untreated, according to a recent study published in The Lancet. This is three and a half times as much as in 1990.
In Great Britain paraurine tests for type 1 diabetes is not yet available on the NHS.
Instead, people are likely to discover that they are at risk through blood tests done for other medical reasons or because the condition runs in their family.
But since most of those diagnosed do not have a close family history, experts believe that environmental factors may also play an important role.
