Diabetes Clinical Trial
Official title:
Study of the Factors Favoring the Transition From Prediabetes to Diabetes on Reunion Island. Impact of the "Say No to Diabetes" Intervention.
The management of diabetes and its complications in Reunion island is one of the priority
areas of health. Indeed, the impact of diabetes on the health of the Reunion island
population is major: the prevalence of diabetes treated in Reunion island is the highest in
France (10% of the population), and gestational diabetes is found in 10% of pregnancies.
Reunionese diabetics develop severe complications, in particular cardiovascular (strokes,
myocardial infarction).
This results in 3 times higher mortality linked to diabetes on Reunion Island, in particular
among those under 65 years of age. Despite all the screening and prevention programs put in
place, the weight of diabetic disease continues to increase in our island, and this is more
accelerated than in the other French departments with 4,300 new cases of diabetes / year, 95%
of which type 2 diabetics (T2D). The presentation of type 2 diabetic patients in Reunion
island also differs from the Metropolis with subjects more often female (56%), thinner and
younger at the discovery of diabetes. These data highlight the need to better understand the
factors underlying the diabetes "epidemic" in Reunion island.
The rise in blood sugar until the onset of diabetes is a continuous phenomenon reflecting the
progressive suffering of the organs used to maintain carbohydrate homeostasis. Thus, we talk
about fasting hyperglycemia when the fasting blood sugar is between 1.10 and 1.25 g / L
(6.1-6.9 mmol / l) and glucose intolerance when the blood sugar 2 hours after taking 75 g of
glucose is between 1.40 and 1.99 g / L (7.8-11.0 mmol / l). Subjects with fasting
hyperglycemia or glucose intolerance constitute the target population at very high risk of
developing diabetes (up to 70% of these subjects). They have an increased risk of developing
diabetes at 1 year multiplied by 5 to 10 compared to normoglycemic subjects, hence the name
"prediabetic subjects". This great variability in the risk of developing diabetes highlights
the presence of associated risk / protective factors which it is important to find in order
to adapt the monitoring and management. It is important in Reunion island, in view of the
specificities presented by our population, to understand the pre-diabetes / diabetes
transition and the risk and protective factors.
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