World Diabetes Day has grown from humble beginnings to become a globally-celebrated event to increase awareness. This year the occasion is concerned with diabetes in children and adolescents.

Money and property, or the lack thereof, are not the only assets that we might inherit from our family of origin. Our genetic make-up is also a mixture of inherited material coming both from our maternal and paternal sides of the family.

‘However, we estimate that there are from 35,000 to 50,000 people suffering from the condition locally, if not more’- Consultant diabetologist Mario Cachia

For some it’s the tell-tale colour or shape of the eyes or tilt of the jaw, for others it’s the undesired shape of the nose or curve of the hips and thighs. Whatever it is, it is something we can do very little about no matter how hard we try.

The tendency to develop certain conditions is also inherited in the same way. People who have a family history of heart disease, blood pressure, asthma, eczema, certain cancers and many other conditions are more prone to develop those same conditions than others who do not. Diabetes mellitus, or the inability to regulate blood sugar levels efficiently, is one such condition. It is known to affect millions worldwide and is one of the leading causes of morbidity and mortality due to the complications it can set off.

Locally, thousands of individuals from all age groups and all walks of life are afflicted by this condition. “We do not know the exact figures since no proper epidemiological study has been carried out,” explains consultant diabetologist Mario Cachia. “However, we estimate that there are from 35,000 to 50,000 people suffering from the condition locally, if not more; it is also evident that there is an increase in incidence both in the childhood and the adult forms from the increasing number of appointments we get at the Diabetes Clinic and also taking into consideration that people are now living longer,” he adds.

There are two types of diabetes mellitus. One form, type 1 diabetes mellitus (T1DM) is insulin dependent, usually affects children and very young adults and results from a complete paucity of insulin in the blood; such patients usually require lifelong insulin treatment. The other form, type 2 diabetes mellitus (T2DM) is not insulin dependent, affects older individuals and comes about due to a decrease in the effectiveness of insulin secreted in the blood. In these cases initial treatment in the form of tablets that increase the secretion of insulin is the norm. Treatment is also a lifelong necessity.

According to Dr Cachia, although the numbers of T2DM cases increase exponentially with age, there has been a recent increase in incidence of this condition in younger individuals. “The cause of this is probably lifestyle,” he says with emphasis. “Sadly nowadays most of us live on ‘high-voltage’ stress levels, sit most of the time and work very long hours leaving little time to choose, prepare and eat healthy food.”

“In fact we usually end up choosing the wrong food especially if the unhealthy variety comes cheaper and some established food myths do not help either, for example most people go about believing that food with no added sugar is sugar free when in actual fact it is not,” he says.

The trend in health nowadays is to promote prevention rather than treat as this has also proved to be more cost-effective. Diabetes as a chronic condition is no exception in this scenario. “The best way to avoid this condition is to concentrate on these two main points”, Dr Cachia explains. “The first is to look at the family history and start making adequate lifestyle choices at an early age if diabetes is found to make part of the family genetic pool; the second is to advocate specific lifestyle changes like a minimal amount of exercise every day, especially if the person has a sedentary job, watch one’s weight considering that obesity increases the risk of developing both diabetes and its complications and eat a healthy balanced diet - the impetus is to start to move and to eat healthily as young as possible”, he concludes emphatically.

Dr Cachia believes that if people opt to look after themselves then the risk of getting the condition is dramatically reduced. “People suffering from diabetes should also do regular checks at their doctor taking care to check their blood pressure and blood levels of cholesterol, kidney function and blood sugar,” he explains. “Care should also be taken to control other risk factors like smoking, alcohol and obesity as this goes a long way in preventing the onset of the complications of the disease”.

Preventing the onset of the condition, and getting affected with its complications once the disease sets in, can mean radical lifestyle changes which is not something that can be done at the flick of a button. That is why it is essential to start teaching our children from a very young age to eat healthily and do regular exercise but to do so we have to understand the rationale behind it ourselves. Failing that, I believe that as a society and especially as health-care professionals and family members of diabetic individuals we are duty-bound to support these individuals when the going gets tough for them to affect such changes. Diabetes can be a condition one can live with if controlled well but if not it can turn into a relentless monster of self-destruction and even death.

Today, the World Health Organisation is celebrating World Diabetes Day for this purpose, to raise worldwide awareness on this condition and to futher educate the public in general on the best ways either to prevent it or live with it. Let us not allow this day to pass unnoticed. With the high incidence of diabetes on our shores, not to mention the soaring rates of obesity and tendency to unhealthy lifestyles, it could spell a different quality of life altogether both for ourselves and for our children.

Key facts

• Type 2 diabetes is much more common than type 1 diabetes.

Type 2 accounts for around 90 per cent of all diabetes worldwide. Reports of type 2 diabetes in children – previously rare – have increased worldwide. In some countries, it accounts for almost half of newly diagnosed cases in children and adolescents.

346 million

More than 346 million people worldwide have diabetes. There is an emerging global epidemic of diabetes that can be traced back to rapid increases in overweight, obesity and physical inactivity.

• A third type of diabetes is gestational diabetes.

This type is characterised by hyperglycaemia, or raised blood sugar, which has first appeared or been recognised during pregnancy.


More than 80 per cent of people with diabetes live in low- and middle-income countries. In developed coun­tries most people with diabetes are above the age of retirement, whereas in developing countries those most frequently affected are aged between 35 and 64.

• Cardiovascular disease is responsible for between 50 per cent and 80 per cent of deaths in people with diabetes.

Diabetes has become one of the major causes of premature illness and death in most countries, mainly through the increased risk of cardiovascular disease (CVD).

• Diabetes is a leading cause of blindness, amputation and kidney failure.

Lack of awareness about diabetes, combined with insufficient access to health services and essential medicines, can lead to complications such as blindness, amputation and kidney failure.


Diabetes is predicted to become the seventh leading cause of death in the world by the year 2030. Total deaths from diabetes are projected to rise by more than 50 per cent in the next 10 years.

• Type 2 diabetes can be prevented.

Thirty minutes of moderate-intensity physical activity on most days and a healthy diet can drastically reduce the risk of developing type 2 diabetes. Type 1 diabetes cannot be prevented.

• Dr Mizzi is one of the medics at a top cosmetic clinic.

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