Society
How does type 1 diabetes affect our society and what can we do to prevent and cure it?
An increasing number of people are affected by type 1 diabetes (T1D) and it is one of the most common chronic diseases among children in Northern Europe. T1D places a significant burden on individuals, families, healthcare systems and society. In Denmark and Sweden alone, it is associated with annual societal costs amounting to billions of kroner through healthcare expenditure and lost productivity.
DiaUnion’s program for early detection is a crucial step toward the ultimate goal of preventing and eventually curing T1D. The earlier intervention occurs, the better the chances of delaying disease progression and significantly improving the quality of life for children with T1D in particular – and their families.
New therapies that can delay the clinical onset of T1D have been approved in Europe. However, they require individuals to be identified in the early stages of T1D, before symptoms develop, which is precisely what early detection programmes help to achieve.
Unlike type 2 diabetes, T1D is not a lifestyle disease and cannot be prevented through lifestyle changes. It is an autoimmune disease often developing several years before symptoms appear and a diagnosis is made. T1D requires lifelong insulin treatment and only 25-30% meet the desired treatment goals.
DiaUnion’s program for early detection also helps identify the risk of related autoimmune diseases such as celiac disease (gluten intolerance) and autoimmune thyroid disease.
Type 1 Diabetes on the Rise
An increasing number of people are developing type 1 diabetes (T1D) and it is particularly concerning that the disease is being diagnosed at increasingly younger ages.
The Nordic region has some of the highest rates of T1D in the world, with Finland and Sweden among the countries most affected. At the same time, the incidence of T1D is rising globally, although rates vary considerably between different regions and populations.
The reasons behind this increase remain unclear. The rapid rise observed over recent decades suggests that genetics alone cannot explain the trend. Researchers believe that environmental factors may also contribute, including changes in lifestyle, environmental exposures and patterns of childhood infection.
The table below shows prevalence for selected countries. Aside from Finland, which has an unusually high prevalence, approximately 500 out of 100,000 people have T1D – equivalent to 0.5% of the population. Based on this prevalence, an estimated 2.2 million people in the EU and 3.7 million across Europe live with T1D.
Treatment Goals
Across the Nordic region, it remains a challenge that many people with type 1 diabetes (T1D) do not achieve the recommended treatment targets. Continued investment in research, new technologies, and political support for both patients and healthcare systems is therefore essential.
The aim of current treatments is to keep blood glucose levels as close to normal as possible. Blood glucose levels that are too low can lead to severe hypoglycaemia or coma, while excessively high blood glucose levels increase the risk of diabetic ketoacidosis (DKA).
A cornerstone of assessing treatment outcomes in people with T1D is achieving optimal glycaemic control. Periodic measurement of glycated haemoglobin (HbA1c) remains the standard method for assessing long-term glucose control.
HbA1c reflects average blood sugar levels over the preceding 2–3 months and has been the primary metric for assessing glycemic control for decades. The landmark Diabetes Control and Complications Trial (DCCT) and its follow-up studies have demonstrated that achieving the treatment goals significantly (50–76%) reduces the risk of complications such as eye disease, kidney disease, and nerve damage.
Regional data (Dansk Diabetes Database) indicate that fewer than 25% of patients meet the national treatment target in Denmark (HbA1c should be ≤53 mmol/mol).
In Sweden the treatment target is slightly lower at <52 mmol/mol and regional statistics (Nationella Diabetesregistret) show that less than 30% of patients achieve this goal.
Blood glucose control
Data from international registries also highlight ongoing challenges and across both European and U.S. datasets, adolescents experience the greatest difficulty in achieving glycemic targets.
It is a complex task to manage T1D and people living with the disease must:
- Monitor blood glucose levels multiple times daily using a blood glucose meter.
- Administer daily insulin injections via pen or pump.
- Adjust diet and physical activity accordingly.
Continuous glucose monitoring (CGM) provides additional metrics such as time in range (TIR), time above and below range, mean glucose levels, and glycemic variability.
These parameters allow for a more nuanced and precise assessment of glycemic control, benefiting both patients and caregivers in managing T1D effectively.
Early Detection to Prevent
Political support for early detection of type 1 diabetes is growing across the Nordic region. In both Denmark and Sweden, policymakers, healthcare leaders and patient organisations have increasingly recognised the potential of identifying individuals at risk before symptoms appear.
Discussions are now shifting from research and pilot initiatives towards how early detection can be integrated into healthcare systems to improve outcomes for children, families and society.
In DiaUnion and as part of The Alliance for Early Detection of T1D in Denmark, as well as collaboration in Sweden, we work to increase awareness of early detection of T1D in order to:
- Reduce the risk of diabetic ketoacidosis (DKA) and other serious comorbidities of T1D.
- Improve blood glucose control after T1D diagnosis.
- Enable individuals to prepare themselves and their surroundings for a life with T1D.
- Increase the opportunity for early intervention.
