For as long as he can remember, 15-year-old diabetes sufferer Sven Mueller’s day has begun and ended by measuring his blood-sugar levels.
“It has been an integral part of my daily routine for the last 12 and a half years,” he says. “Measuring my blood sugar levels six to seven times a day, including at night, is what I just do.”
Before every meal, the youngster has to determine the carbohydrate value of the food and the drink on the table in front of him in order to calculate what dosage of insulin he needs to inject himself with.
“It’s very time consuming, but I have it under control and can’t afford to miss a step,” says the teenager, who lives in Leichlingen near the western German city of Cologne.
Diabetes harms the body with high levels of blood sugar over prolonged periods. It is becoming more prevalent with more than 6 million people in Germany alone currently receiving treatment for the disease, according to the German Diabetes Society (DDG).
This figure is expected to increase to 8 million by 2030. Experts believe a further 2 million people in Germany remain undiagnosed and, accordingly, are receiving no treatment for their symptoms.
Type 2 diabetes is the most common form of the disease. It is caused by poor diet, obesity and lack of exercise.
Type 1 diabetes, also known as juvenile diabetes, affects around 300,000 Germans and results from the pancreas’s failure to produce enough insulin.
Sven was diagnosed with type 1 diabetes at the age of four.
“I found it difficult to cope as a young child,” he explains. “Other children could eat what they wanted, but I couldn’t.”
Basal insulin is the background level of insulin the body needs 24 hours a day.
As Sven suffers from type 1 diabetes, he has very low or no basal insulin, meaning injections are required to ensure the slow, steady release of insulin needed to control blood glucose and to keep cells supplied with energy when no food is being ingested.
The teenager usually injects insulin into his abdomen and also has an insulin pen for use when he is on the go.
“If I suddenly feel weak on my feet, then it is a warning sign to measure my blood sugar levels and eat something,” says Sven.
Diabetes can cause strokes, heart attacks and kidney failure as well as leading to foot amputations and blindness.
Such serious consequences mostly only affect older sufferers. Young people are more likely to experience loss of consciousness as a result of low blood sugar levels.
The treatment of diabetes has improved with the advent of the insulin pump, which delivers rapid- or short-acting insulin 24 hours a day through a catheter placed under the skin.
The pump helps the diabetes sufferer to keep blood glucose levels within set target ranges.
“We also have modern insulin, which works more quickly, although still not quickly enough,” says Ralf Ziegler from the DDG.
Continuous Glucose Monitoring (CGM) has been available for almost a decade and provides real-time glucose readings, throughout the day and night, allowing people with diabetes to see their glucose levels and track how quickly they’re increasing or decreasing.
Researchers hope to combine insulin pumps and CGM into a single device that can optimise the delivery of insulin to a patient.
A healthy diet and exercise can prevent the onset of type 2 diabetes and also helps in the treatment of type 1 diabetes, which is why Ziegler believes a “sugar tax” should be introduced.
“Healthy food should be cheap while unhealthy food such as sweets and confectionery should be more expensive,” he says.
“It is also important to ban misleading advertising for obesity-causing foods that specifically target children.”
Adolescence is a difficult time for diabetes sufferers, due to hormone changes and a growing sense of independence that often leads to ill-considered risk taking, such as the experimentation with alcohol.
But Sven is aware of the risks and follows a strict regime.
“I don’t feel that I am restricted,” he says. “But I know I can never have more than one or two beers at a party. I can’t afford to lose control.”