Le diabète de type 2, également appelé diabète non insulinodépendant (DNID). Il correspond à un excès de concentration de glucose dans le sang sur le long terme (hyperglycémie chronique).
En France, on estime que 5% de la population est atteinte de diabète, dont 90% des cas sont des diabétiques de type 2. Mais la maladie est silencieuse et beaucoup de personnes demeurent non diagnostiquées (20 à 30% des adultes diabétiques) (1).
L’incidence du diabète de type 2 augmente avec l’âge. Effectivement, la maladie se manifeste généralement après 40 ans et elle est diagnostiquée autour de 65 ans.
C’est une maladie grave de par ses complications, notamment sur le cœur, les vaisseaux sanguins, les reins et les nerfs. En effet, le risque de survenue d’un infarctus du myocarde est multiplié de 3 à 5 %.
Le mode de vie joue un rôle important dans la survenue du diabète et donc dans sa prévention. C’est pourquoi, la prise en charge du diabète passe notamment par la mise en place d’une alimentation équilibrée et une activité physique, ainsi que des traitements médicamenteux.
Le diabète de type 2 se propage de plus en plus, notamment du fait de l’augmentation de l’espérance de vie et d’une mauvaise alimentation. Ces facteurs, ainsi que la sédentarité, résultent des changements dans nos modes de vie. En conséquence, une mauvaise hygiène de vie se développe exposant à des risques sanitaires.
Nataliya Vaitkevich depuis Pexels
Comment se manifeste le diabète ?
L’hyperglycémie à l’origine du diabète de type 2 fait suite à une diminution de la sensibilité des cellules à l’insuline. L’insuline est l’une des hormones qui permet de réguler le taux de glucose dans le sang.
Suite à un repas, le taux d’insuline augmente car le pancréas sécrète de l’insuline afin de stocker ce sucre. Sans cette hormone, le taux de sucre dans le sang resterait élevé tout le temps !
Dans le cas de la maladie, il y a une demande de plus en plus forte en insuline afin de prendre en charge l’excès de glucose sanguin. Pour répondre à cette demande, les cellules qui sécrètent de l’insuline (cellules du pancréas) en produisent jusqu’à s’épuiser. En conséquence, la production d’insuline devient insuffisante et le glucose s’accumule dans le sang.
Il ne faut pas confondre diabète de type 1 et celui de type 2. Le diabète de type 1 quant à lui, survient lorsque le pancréas ne produit plus d’insuline. Cette anomalie est liée à un dysfonctionnement du système immunitaire qui détruit les cellules du pancréas chargées de produire l’hormone.
Quelle en est la cause ?
Le principal facteur de risque du diabète de type 2 est l’hygiène de vie.
Elle se traduit par une alimentation trop grasse et trop sucrée, combinée à la sédentarité. Il ne faut pas oublier que les habitudes alimentaires se mettent en place dès le plus jeune âge. Les enfants sont alors exposés à des risques sanitaires graves lorsqu’ils s’habituent à consommer des produits sucrés et à ne pas faire d’exercice. Il semblerait également que certains médicaments, comme les neuroleptiques, peuvent participer au déclenchement d’un diabète de type 2.
Quelles sont les conséquences sur la santé ?
Le diabète entraîne des complications graves à long terme, pouvant survenir après 10 à 20 ans de déséquilibre glycémique.
La maladie accélère en effet l’athérosclérose, à l’origine d’infarctus du myocarde, d’AVC ou d’artérites des membres inférieurs. Le diabète est également à l’origine de rétinopathies (atteintes de la rétine), de neuropathies, de néphropathies (insuffisances rénales), de maladies hépatiques (stéatose non alcoolique ou « maladie du foie gras ») (1).
Sans oublier que le diabète de type 2 mène à l’obésité qui constitue en elle-même un facteur majeur de risque de diabète !
Le diagnostic
On observe généralement aucun signe clinique avant plusieurs années. L’hyperglycémie est déjà installée depuis longtemps et l’impact sur la santé également.
Pour détecter un diabète tôt, il faut faire des mesures de la glycémie à jeun fréquemment :
- 1,10 – 1,26 g/L : patient prédiabétique.
- La glycémie dépasse 1,27 g/L lors de deux dosages successifs : diabète déclaré.
Le traitement prioritaire est l’hygiène de vie, vient ensuite le traitement médicamenteux et l’insulinothérapie.
Photo de couverture : Nataliya Vaitkevich provenant de Pexels
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