But is it true that diabetes only comes to the elderly? Here's what to know and how to reduce the risk

'Diabetes is a disease of the elderly'. Who has never heard this sentence? In reality, things are a bit more complex. Although the most frequent form, type 2 diabetes, is more common in old age, this disease can occur at any age and in recent years a significant increase in cases has been observed even among adolescents and young adults. Therefore, no age group can truly be considered exempt from the risk of developing diabetes.

Diabetes mellitus is a chronic disease characterised by increased blood sugar levels (so-called 'blood sugar'). This occurs because the body is unable to produce or utilise insulin, the hormone that regulates the entry of glucose into cells, properly. Insulin works like a 'key': it opens the cell door and allows glucose to enter to be used as energy. When this mechanism fails, glucose remains in the blood and glucose levels rise. The most common forms are type 1 and type 2 diabetes. Type 1 diabetes is an autoimmune disease that occurs mainly in children and young adults: in this case, the body attacks the cells of the pancreas that produce insulin. Type 2 diabetes, on the other hand, develops more often in adulthood and depends on a combination of insulin resistance (the cells become 'less sensitive' to insulin and find it harder to use it to bring in sugar) and reduced insulin production. There is also gestational diabetes, which appears during pregnancy, and a group of rarer forms linked to genetic causes or pancreatic diseases. In addition, there is increasing talk of prediabetes, a condition in which glucose levels are higher than normal but not yet high enough to qualify as full-blown diabetes: a phase that can go on for a long time and that, in some cases, evolves over time into full-blown diabetes. In the early stages of type 2 diabetes, certain lifestyle changes may favour a remission of the disease, i.e. a return to normal blood glucose levels even in the absence of medication. Clinicians prefer the term 'remission' to 'cure' because the duration of this condition and the possibility of relapse are not yet fully predictable.

With ageing, the efficiency of sugar metabolism decreases and the prevalence of risk factors such as sedentary lifestyle, overweight, hypertension and high cholesterol increases. This is why type 2 diabetes is more frequent after the age of 65. However, in recent decades, an increase in cases has been observed among children, adolescents and young adults, often associated with an increase in obesity and poor eating habits since childhood. Moreover, in paediatric age, type 2 diabetes tends to manifest itself with more aggressive pictures and a more rapid progression to complications than in adults.

In the early stages, especially in type 2 diabetes, symptoms may be absent. When present they include intense thirst, frequent need to urinate, marked fatigue, unexplained weight loss, blurred vision and frequent infections or difficulty healing wounds. In the presence of these signs, the family doctor should be consulted for a blood glucose check-up. Even in the absence of symptoms, it is advisable to monitor values periodically when risk factors such as overweight, family history or hypertension are present. Diabetes is a disease that should not be underestimated. If left unchecked, it can damage several organs. The heart and blood vessels can be affected, increasing the risk of heart attack and stroke. The eyes can develop retinopathy which, if neglected, leads to loss of vision. The kidneys may progressively lose their function, leading to the need for dialysis. The nervous system can also be affected, with tingling, pain or loss of sensitivity, particularly in the feet, which in turn can lead to ulcers that are difficult to treat. This is why early diagnosis and ongoing treatment is essential.

Preventing type 2 diabetes is possible and depends largely on our daily choices. Following a balanced diet, rich in vegetables, legumes, whole grains and low in sugar and saturated fats, is a first step. Regular physical activity, even just walking every day, helps maintain a healthy weight and improves the effectiveness of insulin. It is also important to avoid smoking and limit alcohol consumption. Even a modest weight loss of about 4-6 kg can have a significant impact on glycaemic levels and metabolic risk. If you already have risk factors such as a family history or high blood pressure, you should periodically monitor your blood glucose and talk to your family doctor to identify the most suitable prevention pathway.