It costs an average of €800 a year to treat a diabetic but €4,000 a year for the same patient if s/he neglects his/her diabetes and develops conditions such as heart, kidney and eyesight problems, diabetes expert Geremia Bolli said.
He was speaking to The Times about a recent survey in Finland on patients with Type II diabetes, explaining the importance of controlling the disease.
"Most complications can be avoided by keeping blood glucose within correct levels," he said. The aim is to keep the level of the indicator in the blood to below seven; this is why his lapel badge reads "<7".
There are two main types of diabetes: Type 1 is known as juvenile-onset and requires insulin treatment, while Type II is non-insulin dependent.
Dr Bolli was in Malta to deliver a lecture on the use of Insulin Glargine, organised by Aventis, who make the Lantus brand of this medication. Lantus is now available in Malta.
The lecture at the Upper Barrakka attracted some 200 doctors showing interest in this disease.
Glargine is a synthetic insulin, available since 2000, which has major advantages for patients, he said. It is a very close mimic of natural insulin, a hormone made in the pancreas.
Synthetic insulin is produced by genetically treating bacteria - until 1980 insulin was obtained from pigs. Unfortunately, although the production costs of the synthetic insulin are much lower, the price to the consumer has not gone down as much as it could, he lamented.
However, the cost of the insulin is still relatively low when compared to the cost of monitoring blood glucose.
With Type I diabetes, the patient uses a fast-acting type of insulin at mealtimes, but needs a slow-release insulin during fasting periods. One of the major fears of diabetics is a hyperglycaemic attack overnight. The new insulin is released very slowly, avoiding peaks in levels. The success in treating a Type I diabetic depends on getting the correct balance between the two insulins, he said.
Type II diabetes was in the past treated by dietary control and there was a reluctance to start a patient early on insulin. "But by then complications have appeared. We are now starting to treat Type II very early on," Dr Bolli said.
Type II patients are now being prescribed glargine once a day and may no longer require the other type of insulin at mealtimes.
The incidence of diabetes is growing. Type I accounts for 10-15 per cent of all cases across the world, although Finland and Sardinia have unusually high rates. The tendency is for the incidence to decrease the further south one goes.
Type 1 is not genetic, however, although one must have a genetic predisposition.
"Imagine that the genetic predisposition is a keyhole in a door. You still need a key to open that door. That key is a hostile agent, probably a virus, or something that triggers an auto-immune response," he said.
Type II is more prevalent and is linked to many factors such as obesity, high-fat diets and less physical activity. At a recent meeting on diabetes in Dublin, it was estimated that Type II diabetes would double in the next 20 years. A worrying trend is the growing incidence of Type II in children, now being seen in the US, but which they soon expect to see in Europe, Dr Bolli said.
An estimated 30,000 people have diabetes in Malta.
Aventis is represented in Malta by Charles de Giorgio Ltd.