LONDON (Reuters Health) - Primary care physicians need to manage their patients' blood glucose levels much more aggressively if the global explosion in type 2 diabetes prevalence is to be slowed, the International Diabetes Federation (IDF) warned on Wednesday.

Many doctors are "too complacent" about the need for tight control of glucose levels, and this lack of motivation is being passed on to patients, according to the federation, an umbrella organization for 181 member associations.

"If you say to a patient 'you've just got mild diabetes, you don't need insulin,' it sets the scene totally inappropriately," Professor Sir George Alberti, president of the IDF, told Reuters Health on the telephone from a meeting in Montreux, Switzerland. "Type 2 diabetes is not a 'mild' form of diabetes.

"People like myself as diabetes specialists, we try to get people's blood glucose levels normal," he said. "We've got to convince our colleagues that they should do that and at the same time treat all the heart disease risk factors just as seriously. It's a question of not just treating glucose but treating blood pressure, lipids, smoking, lifestyle.

"We need a much more aggressive approach to treating patients."

Type 2 diabetes affects 22.5 million European adults, the IDF estimates, and accounts for 10% to 15% of European healthcare spending. Worldwide, the number of diabetics is expected to double over the next 25 years.

The disease doubles or triples the risk of cardiovascular disease. Untreated, it can result in blindness, kidney disease and limb amputations.

Alberti said increasing rates of type 2 diabetes among adolescents and children are particularly worrying.

"It is terrible, it means that those kids, unless they're dealt with meticulously, are going to die of heart disease or kidney failure in their 30s," he said.

"We've seen the disease already in South Asian immigrants in the UK, and now we're seeing it in fat white kids," Alberti added.

Studies have shown that reducing the blood glucose control marker HbA1c by just 1% cuts the risk of heart attack by 14%, and the risk of eye and kidney damage by up to nearly 45%, the IDF said.

But most patients with type 2 diabetes do not achieve adequate control of their blood glucose levels.

Alberti also stressed the need for better awareness and early detection of the condition.

"Type 2 diabetes is largely a consequence of unhealthy lifestyle," he said. "And it is preventable...but there is very poor awareness of diabetes among the public and we need to improve that.

"Affluent nations should be screening high-risk groups, such as people who are obese, have a family history, or are from ethnic groups pre-disposed to the condition," he said.

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