HEDIMED

Type 1 diabetes (T1D) usually develops in childhood and affects a person for life. It is one of the most common chronic diseases occurring in childhood and adolescence, being frequent in all ages, and its incidence is increasing worldwide. There are an estimated 5 million people with T1D in Europe, and the economic burden of the disease is huge. 

In T1D the immune system destroys the insulin-producing beta cells of the pancreas leading to loss of insulin production. Without daily administration of insulin, the disease is deadly and did kill every one affected until 1922 when 14-year-old Leonard Thompson received the first insulin injection extracted from the pancreas of cattle. 

Although the treatment of T1D has improved to the stage where affected people can live normal lives, the disease causes a significant burden to the patient and the whole family as insulin injections and glucose monitoring are needed daily. T1D patients have a decreased life expectancy and have an increased risk of other chronic diseases such as heart and kidney diseases and neuropathies. The disease is also a huge burden to society costing about 1 million euros per patient to treat. 

More information on T1D: 

https://www.who.int/news-room/fact-sheets/detail/diabetes 

https://diabetesatlas.org/en/ 

https://www.jdrf.org/t1d-resources/ 

Celiac disease is a lifelong immune-mediated condition that may develop at almost any age but is often diagnosed in adulthood. Its incidence is increasing and around 1-2% of Europeans are known to be affected, although the majority remain unrecognized. 

The disease process starts when gluten found in wheat, rye and barley causes an autoimmune reaction against the small-bowel mucosa. The damaged intestine cannot absorb nutrients effectively, which eventually leads to various symptoms and complications. The only available treatment is a strict gluten-free diet. 

The symptoms of celiac disease can be very diverse, making it difficult to diagnose. The later the disease is recognized, the greater the chance of developing long-term complications. 

Celiac disease is known to be associated with specific genetics, but only a fraction of the at-risk population is affected. Also, the true incidence varies markedly between closely located geographic areas and has increased rapidly. These observations support the role of additional unknown environmental factors. 

More information on celiac disease:  

https://www.keliakialiitto.fi/kuluttajat/keliakia/keliakia-sairautena/ 

https://celiac.org/about-celiac-disease/what-is-celiac-disease/

Asthma is the most common chronic disease in childhood, and by far more common in children than adults. The incidence of asthma increased dramatically in Western and Northern Europe in the late 20th century but is now levelling off. However, in Eastern Europe, the incidence is now increasing. In Europe, the rate of asthma remains one of the highest in the world with more than 10% of the population affected in some countries.

Asthma is a chronic condition with swelling in the small airways in the lungs, which is caused by an over-active immune system. In an asthma attack, the problem is made worse since the small airways contract which further limits the passage of air, leading to troublesome symptoms, which can include coughing, breathlessness, wheezing and a feeling of tightness in the chest. Asthma attacks can be triggered by environmental factors like pollen or airway infections, and the attacks are treated with medication to relieve the symptoms. Moderate and severe asthma is also treated with long-working drugs to dampen the immune reaction.

Asthma attacks can be scary, and asthma impairs the life of children, for example by limiting the ability to exercise. The condition also severely affects the family and society as parents often miss work or give up work completely to care for a child with asthma. Although adults with mild asthma can lead a normal life, 10% of adults with asthma suffer from severe symptoms that dramatically limit their every-day life.

Asthma is hereditary but its rapid increase in Europe and the rest of the world can only be explained by the changes happening in our environments and way of life. These changes can ultimately trigger the genetic risk of disease given to us at birth.

More information on asthma: 

https://www.erswhitebook.org/files/public/Chapters/11_childhood_asthma.pdf

https://www.erswhitebook.org/files/public/Chapters/12_adult_asthma.pdf

Allergies are the most common chronic diseases in Europe, and more than 150 million Europeans suffering from chronic allergy. Allergies are becoming more and more prevalent, and it is predicted that half of the European population will be affected by 2025. Predisposition to allergy is hereditary, but the rapid increase in allergy incidence is most probably due to environmental and lifestyle changes.   

Allergic sensitization against environmental allergens often happens at a young age, although it’s also possible to get sensitized later in life. An allergy may persist throughout life. Allergic reactions range from mild ones, for instance, hay fever or localized urticarial rash to life-threatening severe asthmatic or anaphylactic symptoms.  

Allergy can be managed by avoiding the allergen, which may be possible if the allergen is, e.g., some food, animal or drug. However, avoidance is difficult or even impossible, if the allergen is, e.g., bee’s venom or pollen. In these cases, medication is needed to alleviate symptoms. Also, tolerance against some allergens can be built up by desensitization therapy. In any case, allergies cause a decline in quality of life on account of allergen avoidance procedures, allergy symptoms, fear of severe reactions or even death and need of medications or long-lasting desensitization therapies. Management of allergies results in huge expenses for society. 

More information on allergies:  

https://www.eaaci.org/documents/EAACI_Advocacy_Manifesto.pdf