Nearly 1.3 million people across Greece are living with diabetes, medical specialists revealed at a national healthcare conference in Thessaloniki.
Around 50,000 new cases are diagnosed every year in the country, where shifting dietary habits and increasingly sedentary routines continue to fuel a rapid rise in type 2 diabetes.
Kyriakos Kazakos, Professor Emeritus of Internal Medicine and Diabetes Mellitus, presented the latest epidemiological figures during the 39th Conference of the Hellenic Association for the Study and Education of Diabetes Mellitus. Speaking on the sidelines of the medical gathering to the Athens-Macedonian News Agency, Kazakos warned that abandoning the traditional Mediterranean diet in favour of less healthy nutritional choices has sharply elevated disease rates.
Over the past decade, diabetes management has been transformed by the introduction of two major classes of medicine, comprising an oral formulation and an injectable therapy. In addition to regulating blood glucose levels, Kazakos explained that these modern treatments deliver critical cardiovascular and kidney protection, helping doctors address the combined cardiometabolic risks that threaten patients.
Artificial pancreas technology
Advances in wearable medical equipment are also reshaping everyday care for patients. Continuous glucose monitoring devices, which patients wear on the upper arm, now track blood sugar levels in real time and offer vastly more diagnostic data than traditional finger-prick blood tests.
At the same time, automated insulin delivery pumps are advancing to replicate the natural physiological output of a healthy human pancreas. While insulin is best known for controlling blood sugar, medical researchers emphasise that its physiological influence extends across wider metabolic processes.
Developers are now integrating monitoring devices and insulin pumps using smart algorithms and artificial intelligence to create a closed-loop system known as an artificial pancreas. Kazakos estimated that medical science is remarkably close to perfecting the system, adding that artificial intelligence will serve as a decisive catalyst in completing the technology.
Obesity and medication shortages
Medical experts at the gathering stressed that obesity must be treated as a chronic medical condition rather than a temporary lifestyle choice. Kazakos highlighted that clinical evidence links obesity to around 200 distinct diseases, including type 2 diabetes, serious cardiovascular complications, and approximately 12 forms of cancer.
Weight loss achieved through modern medical therapies is often reversed if patients abandon their prescriptions. Because discontinuing medication frequently causes people to regain lost weight, Kazakos stressed that the overall length of any therapeutic course must be supervised directly by an attending physician.
The growing popularity of glucagon-like peptide-1, known as GLP-1, receptor medicines has created fresh challenges for healthcare systems. While these drugs help control blood sugar and promote weight loss, Kazakos warned that people using diabetes-specific drugs purely for weight management could trigger severe supply shortages for patients with diabetes.
Although dedicated anti-obesity drugs exist on the market, Greece does not provide universal state reimbursement for them. Kazakos praised the state-backed Prolamvano preventive healthcare initiative, which temporarily covered therapy costs for individuals suffering from severe obesity and additional medical risks, and he expressed hope that authorities would soon revive the programme.
Hypertension and cardiovascular risk
The critical overlap between diabetes and high blood pressure formed a central theme during the academic sessions. Christina Antza, Assistant Professor of Internal Medicine and Hypertension at Aristotle University of Thessaloniki, reported that nearly half of all patients with type 2 diabetes also suffer from arterial hypertension, with prevalence reaching 75 percent in certain high-risk groups.
This coexistence is not random. Obesity, insulin resistance, metabolic syndrome, and progressive kidney damage interact to drive up blood pressure in diabetic patients, creating a destructive feedback loop that accelerates damage to the heart and renal system.
The clinical challenge comes amid a sharp global escalation in chronic disease. Antza noted that the worldwide population living with hypertension roughly doubled between 1990 and 2019, with millions of patients remaining undiagnosed or inadequately managed, while global diabetes cases are projected to reach 1.3 billion people by the year 2050.
To combat these joint threats, physicians are increasingly turning to SGLT2 inhibitors. Antza explained that these oral drugs lower blood sugar by prompting the kidneys to excrete excess glucose and sodium through urine, which also helps reduce blood pressure. While SGLT2 inhibitors significantly cut hospital admissions for heart failure and slow kidney decline, Antza stressed that they cannot replace standard blood pressure medications.
Incretin therapies and blood pressure
The blood pressure effects of newer incretin-based treatments were detailed by Dimitris Patoulias, Assistant Professor of Internal Medicine at Aristotle University of Thessaloniki. Modern incretin therapies include GLP-1 receptor agonists and tirzepatide, a dual-action agent targeting both glucose-dependent insulinotropic polypeptide and GLP-1 receptors to promote substantial weight reduction and improve blood sugar control.
Clinical studies show that tirzepatide can lower systolic blood pressure by approximately 8 to 10 mmHg. Nevertheless, Patoulias pointed out that the blood pressure reductions offered by incretin therapies remain relatively modest overall and cannot substitute for dedicated antihypertensive drugs.
Patoulias explained that these treatments retain an essential role in type 2 diabetes management because their overall cardiorenal and metabolic benefits remain substantial, regardless of whether a patient has high blood pressure. He noted that patients living with both type 2 diabetes and obesity, as well as those diagnosed with obstructive sleep apnoea syndrome, may experience the greatest blood pressure reductions.
Doctors must exercise vigilance when initiating incretin therapy in patients experiencing intense gastrointestinal side effects. Patoulias warned that severe digestive symptoms create risks of dehydration, reduced intravascular fluid volume, dangerous drops in blood pressure, and complications in absorbing other vital prescription medicines.
World Diabetes Day in Thessaloniki
The Thessaloniki conference coincides with public outreach campaigns organised across the city ahead of World Diabetes Day on November 14. On Friday, November 13, conference delegates will hold a community dialogue with patient advocacy groups to assess patient needs, improve public education, and present an updated Guide for People with Diabetes Mellitus.
On Saturday, November 14, the historic White Tower of Thessaloniki will be illuminated in blue to mark the global awareness day. Health workers will also run an informational pavilion in Aristotelous Square, offering local residents advice on early diagnosis, diabetes prevention, and weight control.
The scientific agenda on Saturday features a special lecture by Professor Francesco Giorgino, president of the European Association for the Study of Diabetes, who will examine the role of obesity in driving the onset and progression of type 2 diabetes.
The conference will conclude with awards for outstanding medical research and a formal ceremony honouring internist and diabetologist Emmanouil Pagkalos for his lifelong contributions to the medical community and the association. Pagkalos will deliver an address reviewing the history, present state, and future prospects of clinical trials in Greece.
