Diabetes: Understanding the disease and daily life

Worldwide, more than 800 million adults live with diabetes. This number has quadrupled since 1990: the global prevalence among adults has risen from about 7% to 14%, or nearly one in seven adults 1,2. A chronic condition characterized by excess glucose in the blood, diabetes requires rigorous monitoring and daily attention: diet, physical activity, treatments, and prevention of complications. As a major player in Europe in supporting people living with diabetes, Air Liquide Healthcare helps patients better understand their condition and manage it on a daily basis, alongside their healthcare team.

  • Diabetes is a chronic condition characterized by hyperglycemia resulting from a deficiency in insulin production or utilization.
  • There are two main forms: type 1 diabetes (autoimmune, accounting for about 5 to 10% of cases) and type 2 diabetes (the most common, accounting for more than 90% of cases). In addition, there are gestational diabetes, type 3c diabetes (pancreatogenic), and rarer forms (LADA, MODY, secondary diabetes)3,4,5.
  • The WHO estimates that 828 million adults were living with diabetes in 20221,2.
  • Diabetes cannot be cured but can be managed through lifestyle changes, medication, insulin therapy, and regular monitoring; remission is possible in some early-stage cases of type 2 diabetes3,6.
  • Home care, provided by home health care providers in collaboration with a diabetes specialist, helps patients adhere to their daily treatment and contributes to improving their quality of life.

What is diabetes?

A chronic disorder of glucose regulation

Diabetes is a chronic condition characterized by an abnormal and prolonged elevation in blood glucose levels, known as hyperglycemia. In a healthy person, the body uses sugar from food as the primary source of energy for its cells. In people living with diabetes, glucose uptake is impaired, leading to a buildup of sugar in the bloodstream. Without proper management, this condition can gradually worsen and lead to complications; conversely, well-managed diabetes allows people to live full lives and prevent these complications.

The role of insulin

The regulation of blood glucose levels depends primarily on a hormone secreted by the pancreas: insulin. It acts like a key, allowing glucose to enter muscle or fat cells to be used or stored. In diabetes, the pancreas no longer produces insulin, does not produce enough of it, or the body becomes resistant to it. When insulin is absent, insufficient, or ineffective, glucose can no longer enter the cells and accumulates in the blood.

Diabetes by the numbers

The prevalence of diabetes is rising worldwide. According to the World Health Organization (WHO), approximately 828 million adults were living with the disease in 20221,2. 1 in 10 adults (66 million) are living with diabetes in Europe. Over 1 in 3 adults living with diabetes are undiagnosed 4,7. Globally, diabetes and related kidney diseases caused more than 2 million deaths in 20218. Early detection of diabetes is a priority public health issue.

  • 828 million adults

    were living with this disease in 2022

  • 14 out of every 100 adults

    worldwide live with diabetes

The different types of diabetes

Symptoms and diagnosis of diabetes

Warning signs (classic symptoms)

The symptoms of diabetes, collectively known as the cardinal signs/symptoms, appear mainly when blood glucose levels are very high. The classic warning signs are :

  • intense thirst (polydipsia) and frequent, copious urination (polyuria);
  • abnormal and persistent fatigue;
  • rapid, unexplained weight loss despite a normal appetite, which is particularly suggestive of type 1 diabetes;
  • Other symptoms, such as vision problems or slow wound healing, are also sometimes observed.

It is important to note that type 2 diabetes often remains asymptomatic for a long time, which delays diagnosis and increases the risk of early complications5.

How is the diagnosis made?

The diagnosis of diabetes is based on a blood glucose test. According to the WHO and the American Diabetes Association, it can be made based on four criteria:

  • a fasting blood glucose level of ≥ 126 mg/dL (7.0 mmol/L);
  • a blood glucose level of ≥ 200 mg/dL (11.1 mmol/L) two hours after an oral glucose tolerance test (75 g of glucose);
  • glycated hemoglobin (HbA1c) ≥ 6.5% (48 mmol/mol), measured using a standardized method;
  • a blood glucose level of ≥ 200 mg/dL (11.1 mmol/L) at any time of day in the presence of suggestive symptoms.

In the absence of clear symptoms, the diagnosis must be confirmed by a second test5,13.

As a reference, a normal fasting blood glucose level ranges from 70 to 110 mg/dL.

HbA1c: The key indicator for monitoring

Glycated hemoglobin (HbA1c) is the cornerstone of diabetes management. Unlike blood glucose levels, which reflect glucose levels at a given moment, HbA1c reflects the average over the past two to three months3,18. Expressed as a percentage, it helps verify that treatment is appropriate. For many adults, the goal is an HbA1c level below 7%, but this target must be tailored to the individual: stricter for younger people without comorbidities, and more flexible for older or frail individuals or those at risk of hypoglycemia3,18.

For people using a glucose sensor, monitoring also relies on time in range (TIR): the goal is to spend more than 70% of the time between 70 and 180 mg/dL, and less than 4% of the time below 70 mg/dL14.

Complications of diabetes

Microvascular complications: eyes, kidneys, nerves

Over the long term, chronic hyperglycemia damages small blood vessels, leading to microvascular complications:

  • the eyes, with diabetic retinopathy, the most frequent cause of new cases of blindness among adults aged 20–74 years in high-income countries if not treated in time15,19;
  • the kidneys, with diabetic nephropathy, which can lead to severe kidney failure;
  • the peripheral nerves (neuropathy), causing pain, tingling, or loss of sensation, particularly in the lower limbs.

Macrovascular complications: heart, brain, arteries

Diabetes also accelerates the aging of large blood vessels (macrovascular complications) through the accumulation of deposits on the walls of the arteries. Without proper blood sugar control, cardiovascular risk is increased: angina, myocardial infarction, and stroke16. Peripheral arterial disease leads to poor blood flow to the legs, resulting in reduced oxygen supply to the tissues and impaired wound healing.

The diabetic foot

The “diabetic foot” results from a combination of poor blood circulation (arteriopathy) and loss of sensation (neuropathy). In the event of an injury (cut, blister, friction), pain is not felt and the wound is not treated in its early stages. Poor blood flow slows healing, and the wound can become infected, deepen, and develop into an ulcer—or, in the worst-case scenario, lead to amputation if gangrene sets in.

Why regular follow-up is essential

These complications are largely preventable through proactive management:

  • maintaining blood glucose, blood pressure, and cholesterol within target ranges3,16;
  • detecting any complications early through regular follow-up: annual checkups and consultations with an ophthalmologist, nephrologist, cardiologist, and podiatrist.

How is diabetes treated?

Lifestyle and dietary measures

For type 2 diabetes in particular, lifestyle and dietary measures are the first pillar of management3. These involve adopting a balanced and varied diet, limiting simple sugars and saturated fats, combined with regular and appropriate physical activity such as walking, swimming, or cycling.

A healthy diet and regular physical activity work in synergy

Exercise and weight loss—even modest amounts—improve insulin sensitivity; muscles consume glucose, and high-fiber foods slow the absorption of sugars.

Antidiabetic medications

When lifestyle changes are not enough, oral or injectable non-insulin antidiabetic medications are prescribed. Several therapeutic classes work through complementary mechanisms:

  • biguanides (metformin), which increase insulin sensitivity and reduce glucose production by the liver;
  • insulin secretagogues (sulfonylureas, glinides), which stimulate insulin secretion;
  • SGLT-2 inhibitors (gliflozins), which promote the excretion of glucose in the urine;
  • alpha-glucosidase inhibitors, which slow the intestinal absorption of sugars;
  • incretin therapies: DPP-4 inhibitors (gliptins, oral) and GLP-1 analogs or GIP/GLP-1 co-agonists (injectable), which stimulate insulin secretion in the event of hyperglycemia, reduce glucagon secretion, and slow gastric emptying, thereby decreasing appetite.

Recent French and European guidelines recommend early use of SGLT-2 inhibitors and GLP-1 analogs in patients with cardiovascular disease, heart failure, or chronic kidney disease, due to their demonstrated cardio-renal benefits, regardless of HbA1c levels3,16. Note: Thiazolidinediones (glitazones) are no longer marketed in France—rosiglitazone was withdrawn from the European market in 2010 and pioglitazone was suspended in France in 2011; this class is therefore no longer part of the French therapeutic arsenal17.

Insulin therapy and insulin pumps

Insulin therapy compensates for insufficient insulin secretion by administering the hormone subcutaneously to stabilize blood glucose levels. It is a vital treatment for type 1 diabetes and may be necessary in advanced type 2 diabetes or gestational diabetes. Insulin is administered using syringes, pre-filled pens, or pumps. Pumps—either “tubed” or patch-style—are worn continuously and deliver insulin in two modes:

  • a programmed basal rate
  • bolus doses triggered at mealtimes or to correct high blood sugar.

Pumps eliminate the need for repeated injections (the device is replaced only every two to three days), offer high dosing precision, and adapt to unexpected situations. They reduce the mental burden and improve quality of life. Their clinical benefits are well-established: improved glycemic stability, increased time spent within the target range, and a reduction in severe hypoglycemia14.

Self-monitoring and Continuous Glucose Monitoring (CGM)

Monitoring glucose levels is essential for adjusting doses. Traditional meters require a finger prick to measure blood glucose (glucose levels in the blood). Continuous glucose monitoring (CGM) systems have revolutionized this monitoring: a mini-sensor placed under the skin (on the arm or abdomen) measures glucose in the interstitial fluid, rather than in the blood. Since the measurement is based on interstitial fluid, there is a slight delay (about 5 to 10 minutes) compared to blood glucose levels, especially during rapid fluctuations14,20.

A transmitter sends the data in real time to a receiver or a smartphone. Some systems include alarms that warn of impending hypoglycemia or hyperglycemia. Having a continuous glucose monitor promotes better diabetes control and significantly improves quality of life14.

The hybrid closed-loop system (Artificial Pancreas)

The hybrid closed-loop system represents a major advance in the management of type 1 diabetes. It combines an insulin pump, a continuous glucose monitor, and an algorithm. The algorithm analyzes data from the sensor and predicts glucose trends to semi-automatically adjust insulin delivery. The term “hybrid” means that the system is not fully autonomous: the patient must report their carbohydrate intake and physical activity. Studies show an increase in time spent within the target range (70–180 mg/dL) and a reduction in time spent in hypoglycemia, particularly at night14,18. This system, which is highly regarded, can however be more difficult for some people to understand.

Image AI-generated

Living with diabetes on a daily basis

Diet, physical activity, and social life

Living with diabetes requires constant vigilance, but that shouldn’t prevent you from having a fulfilling social life. Contrary to popular belief, people living with diabetes aren’t restricted from eating certain foods: the key is learning to estimate the carbohydrate content of meals in order to adjust insulin doses. Exercise is encouraged, including at a high level, with glucose monitoring before and after exercise and an appropriate snack to prevent hypoglycemia.

Rigid approaches and lists of “forbidden foods” prove counterproductive: they lead to frustration and isolation, especially among younger people, and can contribute to eating disorders21. Healthcare professionals favor a compassionate and holistic approach: active listening, attention to emotional well-being, and peer support help alleviate the mental burden of the disease.

Living with diabetes means facing a significant psychological challenge
The psychological challenge of diabetes
On a daily basis, a person living with diabetes makes a very large number of medical and behavioral decisions (often estimated at around 180 per day25). This constant stream creates a mental burden that, if underestimated, can lead to burnout. 

Patient testimonials 

  • My mission today is to offer women with diabetes a space to openly discuss issues of body image and mental health. My biggest lesson is that together we are stronger.
    Elsa Pardo Garcia
    Founder of Deesses Sucrees

    I was diagnosed at age 17, and at the time, I felt as though I’d been sentenced to prison. The medical guidelines regarding my diet were strict, and they left me feeling deeply isolated and frustrated, pushing me toward eating disorders. Meeting people who share the same language and challenges as I do helped me break out of that isolation and cope with the mental burden of the disease. That’s why I took action by founding the organization Les Déesses Sucrées. My mission today is to offer women with diabetes a space to openly discuss issues of body image and mental health. My biggest lesson is that together we are stronger.

  • Pushing myself through sports has allowed me to overcome a severe diagnosis and regain control over my diabetes—not the other way around!
    Benoît Hoelt
    Content creator @dt1_runner

    I was diagnosed when I was 40. I chose to view this diagnosis as a ‘new life situation’ that I had to learn to manage. Of course, it requires constant adaptation, with about 180 medical and behavioral decisions to make every day. Even the slightest unexpected event—an invitation to dinner or a meeting that drags on—has an impact on your mental load. Pushing myself through sports has allowed me to overcome a severe diagnosis and regain control over my diabetes—not the other way around!  I joined the Type One Running Team and created its Instagram account @dt1_runner to share athletic achievements and inspire others living with diabetes.

  • Over time, I’ve managed to build a life “with” diabetes—and I mean “with,” not “against” the disease. It’s possible to find ways to come to terms with the disease and live life to the fullest.
    Ana Waader
    Screenwriter

    Diabetes is often associated with food, yet this association implies that we “deserve” our illness because we’ve eaten poorly or too much. All we’d have to do is change our eating habits to stop being sick! I’ve always heard these clichés, but diabetes is a complex disease with multiple risk factors, many of which are genetic. For my part, when I was little, to escape this stereotype, I came up with ways to reassure my family and friends because I felt guilty about worrying them so much. Over time, I’ve managed to build a life “with” diabetes—and I mean “with,” not “against” the disease. It’s possible to find ways to come to terms with the disease and live life to the fullest. Know more.

    Escroqueuse, quand l'hypo frappe

Recognizing and managing hypoglycemia and hyperglycemia

Hypoglycemia (blood glucose level below 70 mg/dL) can manifest as sweating, trembling, sudden hunger, or paleness. The recommended course of action is the “rule of 15”: consume 15 g of carbohydrates (for example, three sugar cubes or a glass of fruit juice), then recheck blood glucose levels 15 minutes later and repeat if necessary18,24. In the case of severe hypoglycemia accompanied by impaired consciousness or seizures, do not give the person anything to eat or drink by mouth to avoid the risk of aspiration (accidental swallowing). A trained person may administer glucagon by injection. If the situation is not under control, call emergency services immediately.

Conversely, hyperglycemia (high blood sugar) can cause intense thirst and frequent urination; it requires staying hydrated and correcting blood sugar levels with an insulin bolus as prescribed. In addition, in cases of severe (greater than 250 mg/dL) or persistent hyperglycemia, it is recommended to test for the presence of ketone bodies using urine test strips or a ketone meter. The detection of ketone bodies indicates a risk of diabetic ketoacidosis, a complication that requires prompt medical attention18.

Diabetes and work, travel, and pregnancy

Treatment must adapt to the patient’s lifestyle, not the other way around
  • at work, the pump is adjusted according to work demands (night shifts, stress) and social, cultural, or athletic activities;
  • when traveling, the home healthcare provider is notified in advance to ensure continuity of care;
  • a woman who is already diabetic and pregnant receives specialized care starting in the preconception period, which is distinct from gestational diabetes, which develops during pregnancy.

Therapeutic education to empower your health

Patient therapeutic education (PTE) is essential. Provided by multidisciplinary care teams, it is carried out on a daily basis by healthcare professionals, particularly nurses from home healthcare providers.

  • It includes a technical component: proper use of the pump and sensor, how to respond to an alarm or malfunction;
  • a medical component: carbohydrate counting, anticipating fluctuations related to physical activity, recognizing and managing hypoglycemia and hyperglycemia.

Being able to adjust doses independently brings peace of mind and reduces mental stress.

Diabetes support at home

The role of the home healthcare provider

In the context of insulin pump therapy, the home healthcare provider becomes involved as soon as the medical prescription is issued, even before the pump is started. They serve as a link between the hospital and the patient’s home and support the patient on their path to independence:

  • before hospitalization, the home healthcare provider’s nurse provides pre-training at home, introduces the equipment (pump and glucose sensor), and addresses any concerns;
  • at the hospital, they assist the patient and the team at the initiating center (diabetologist, dietitian) and explain how to configure the pump and handle the supplies;
  • back at home, they provide close follow-up (first catheter change, mastering the procedures), followed by regular visits, with a report sent to the endocrinologist after each visit. They manage the supply of consumables and offer 24/7 technical support.

Through this hands-on support, the home healthcare provider promotes adherence to treatment and prevents isolation in the face of the disease’s complexity.

Coordination with the diabetes specialist and the healthcare team

The home healthcare provider does not replace either the community-based diabetes specialist or the hospital team: it works in coordination with them, sharing information gathered from real-life situations. Scheduled visits provide an opportunity to assess what is working and identify challenges, adjust supplies, or re-explain a protocol. Following each visit, a report is sent to the relevant medical professionals (diabetologist, primary care physician, hospital team).

The benefits of remote monitoring

Connected medical devices transmit data on the patient’s blood glucose control—supplemented by indicators reported by the patient (such as their quality of life)—via secure platforms. Air Liquide Healthcare uses data analysis tools to identify trends in blood glucose control and enable teams to proactively tailor their support in cooperation with the physician. These results make it possible to identify patients requiring close monitoring, intervene quickly, and optimize the physician’s time. Remote monitoring is part of a value-driven healthcare strategy that benefits patients, caregivers, and the healthcare system.

Support provided by Air Liquide Healthcare

Person-centered support

By discussing the patient’s needs, challenges, and quality of life, we tailor our support to help them adhere to their treatment on a daily basis and live as fully as possible. As part of this program,

  • we provide state-of-the-art medical devices,
  • we help facilitate the implementation of the prescribed therapy by tailoring it to the patient's lifestyle,
  • we provide close follow-up and prompt technical support,
  • while working closely with the healthcare team,
We are committed to delivering the health outcomes that matter most to the patient.

Innovations (pumps, continuous glucose monitoring, hybrid closed-loop systems) simplify diabetes management, but adopting them can sometimes require a lengthy learning process for older adults or those unfamiliar with technology. The home healthcare provider therefore plays a central role in training patients and supporting their adoption of these devices.

The SATURN study, supported by Air Liquide Santé International, assessed the satisfaction of people living with type 1 diabetes with the service provided by the home healthcare provider during the installation of a hybrid closed-loop system and over the first three months under real-world conditions: the reported satisfaction levels were 28.9 out of 32 and 29 out of 32 at 30 and 90 days, respectively, which was a high score22 . These results highlight the value of in-home support in addressing each person’s specific questions and needs.

A multi-partner strategy

Air Liquide Healthcare seeks out emerging technologies to facilitate patient access to state-of-the-art devices and is diversifying its partnerships with manufacturers and innovative stakeholders. This portfolio (pumps, glucose sensors, hybrid closed-loop systems) is evaluated at Explor!, our in-house center of expertise. The data and technical specifications are analyzed there and then shared with healthcare professionals to help them choose the right devices.

Our support programs

The approach is holistic and co-developed with patients, including support for emotional well-being. This is particularly important, for example, for adolescents transitioning out of pediatric care. The program follows the care journey:

  • before starting pump therapy: assessment of needs and concerns, online learning modules, self-assessment of quality of life as a baseline;
  • the first month: close monitoring (calls, visits), verification of technical procedures and carbohydrate counting, 30-day follow-up, peer meetings;
  • long term: quarterly follow-up, reminders for screening for complications (eyes, kidneys, feet), monitoring for treatment fatigue, and a report sent to the physician including clinical results (HbA1c) and perceived quality of life.

Our strategy to value in healthcare

With nearly 25 years of experience in diabetes management, Air Liquide Healthcare forges partnerships with innovative stakeholders and develops services centered on medical devices and patient support. Its approach evaluates the overall effectiveness of care by taking into account health outcomes, the patient experience, physician satisfaction, and the cost to healthcare systems.

Frequently Asked Questions about diabetes

What is the difference between type 1 and type 2 diabetes?

Type 1 diabetes is an autoimmune disease in which the pancreas no longer produces insulin; it is most commonly diagnosed in children or young adults (though it can occur at any age) and requires lifelong insulin treatment. Type 2 diabetes (more than 90% of cases) most often develops after age 40 and results from insulin resistance or insufficient insulin production, linked to genetic factors and lifestyle4,5.

What are the early signs of diabetes?

The signs of the “cardinal syndrome” are intense thirst, frequent and copious urination, rapid weight loss despite a normal appetite, and unusual fatigue. In type 2 diabetes, these signs may be absent for years, which is why the diagnosis is often made incidentally during a blood test.

What blood glucose level indicates diabetes?

Diabetes is diagnosed if the fasting blood glucose level is ≥ 126 mg/dL (7.0 mmol/L) on two separate occasions, if HbA1c is ≥ 6.5%, if the blood glucose level 2 hours after an oral glucose tolerance test (OGTT) is ≥ 200 mg/dL, or if the blood glucose level is ≥ 200 mg/dL at any time in the presence of symptoms. A normal fasting blood glucose level ranges from 70 to 110 mg/dL18,13.

Is diabetes a long-term condition?

Yes. Type 1 and type 2 diabetes are recognized as long-term condition by the French national health insurance system, which provides 100% coverage for care related to the disease, according to the conditions defined with the treating physician23.

Can diabetes be cured?

Diabetes is a chronic disease that can be well managed with appropriate treatment; as a general rule, it cannot be cured. In some cases of early-stage type 2 diabetes, a significant lifestyle change can lead to remission, defined as an HbA1c level below 6.5% maintained for at least three months after discontinuing blood-sugar-lowering medications. Remission is not the same as a cure and requires ongoing medical monitoring6.

How should you respond to hypoglycemia?

In the event of hypoglycemia (blood glucose level below 70 mg/dL), accompanied by hunger, sweating, trembling, or dizziness, follow the “rule of 15”: consume 15 g of fast-acting carbohydrates (2–3 sugar cubes, a glass of fruit juice), then recheck your blood glucose level 15 minutes later. Any severe or recurrent hypoglycemia should be reported to your doctor18,24.

What is a home healthcare provider?

A home healthcare provider visits the homes of people using medical devices such as an insulin pump or a continuous glucose monitor. They assist with device setup, provide training, conduct regular follow-ups, and serve as a liaison with the endocrinologist.

How many people have diabetes?

Worldwide, the WHO estimated that 828 million adults were living with diabetes in 20221,2. In France, more than 4.3 million people were receiving care for type 1 or type 2 diabetes in 2022 (Court of Auditors), of whom approximately 3.8 million were receiving pharmacological treatment (5.6% of the population, Santé publique France, 2023). This number has been rising steadily since 2015 4,7.

References
1 NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022. The Lancet 2024;404(10467):2077-2093. 
2 World Health Organization. Urgent action needed as global diabetes cases increase four-fold over past decades. Press release, November 13, 2024.
3 Darmon P, Bauduceau B, Bordier L, et al. Prise de position de la Société Francophone du Diabète (SFD) sur les stratégies d'utilisation des traitements anti-hyperglycémiants dans le diabète de type 2 — 2023. Médecine des maladies Métaboliques. DOI : 10.1016/j.mmm.2023.10.007. 
4 Santé publique France. Diabetes — Data (2023 prevalence: 5.6% of the population; more than 3.8 million people receiving pharmacological treatment).
5 American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl. 1):S27-S49. DOI: 10.2337/dc26-S002. 
6 Riddle MC, Cefalu WT, Evans PH, et al. Consensus Report: Definition and Interpretation of Remission in Type 2 Diabetes. Diabetes Care 2021;44(10):2438-2444. DOI: 10.2337/dci21-0034. 
7 https://idf.org/europe/ 
8 World Health Organization. Diabetes — Fact sheet (2021 mortality: diabetes and kidney disease due to diabetes > 2 million deaths).
10 Hart PA, Bellin MD, Andersen DK, et al. Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol 2016;1(3):226-237. DOI: 10.1016/S2468-1253(16)30106-6.
11 Woodmansey C, McGovern AP, McCullough KA, et al. Incidence, demographics, and clinical characteristics of diabetes of the exocrine pancreas (type 3c): a retrospective cohort study. Diabetes Care 2017;40(11):1486-1493. DOI: 10.2337/dc17-0542. 
12 Petrov MS, Basina M. Diagnosing and classifying diabetes in diseases of the exocrine pancreas. Eur J Endocrinol 2021;184(4):R151-R163. DOI: 10.1530/EJE-20-0974. 
13 World Health Organization. Use of Glycated Hemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus. Geneva: WHO, 2011.
14 Battelino T, Danne T, Bergenstal RM, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care 2019;42(8):1593-1603. DOI: 10.2337/dci19-0028. 
15 World Health Organization. World report on vision. Geneva: WHO, 2019.
16 Marx N, Federici M, Schütt K, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J 2023;44(39):4043-4140. DOI: 10.1093/eurheartj/ehad192.
17 Afssaps (now ANSM). Suspension of the use of medications containing pioglitazone (Actos, Competact) in France, June 2011 (risk of bladder cancer). Rosiglitazone had been withdrawn from the European market in 2010. 
18 American Diabetes Association. 6.  Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: SoC 2026. Diabetes Care 2026;49(Suppl.1):S132–S149. DOI : 10.2337/dc26-S006
19 American Diabetes Association. 12. Retinopathy, Neuropathy, and Foot Care: SoC 2026. Diabetes Care 2026;49(Suppl.1):S261–S276. DOI : 10.2337/dc26-S012
20 American Diabetes Association. 7. Diabetes Technology: SoC 2026. Diabetes Care 2026;49(Suppl.1):S150–S165. DOI : 10.2337/dc26-S007
21 American Diabetes Association. 5. Facilitating Positive Health Behaviors and Well-being: SoC 2026. Diabetes Care 2026;49(Suppl.1):S89–S131. DOI : 10.2337/dc26-S005
22 Hanaire H, Naiditch N, Melki V, Morcel P, Puech N, Scharbarg E, et al. Satisfaction with Home Healthcare Provider Service in Adults with Type 1 Diabetes Using a Hybrid Closed-Loop System: The SATURN Study. EMJ Diabetes. 2023;11(1):57-67. DOI: 10.33590/emjdiabet/10303508. Study supported by Air Liquide Santé International (NCT04635280).
23 Assurance Maladie (ameli.fr). Care for People with Diabetes: The Basics — Diabetes Recognized as a Long-Term Condition (ALD).
24 French Federation of Diabetics. Hypoglycemia: Recognizing the Signs and Responding (the “rule of 15”,  carbohydrate intake, steps to take).
25 Karakuş, K. E. (2023). Effects of Diabetes Technologies on Decision Making Feedback Loop in Type 1 Diabetes