Chronic diseases

Chronic diseases are diseases that last a long time, cannot be completely cured and therefore often require repeated treatment. They include cardiovascular diseases, cancer, dementia, chronic respiratory conditions and diabetes.

Chronic diseases are some of the leading causes of death worldwide, with the global demographic development playing a major role in this. Chronic diseases tend to occur primarily in the elderly and often concurrently (known as comorbidity). Since chronic diseases occur more frequently in later life and the population is ageing overall, these diseases are becoming more significant in economic terms as they swallow up ever more resources in addition to causing suffering for patients and their families. A large proportion of expenditure in the healthcare system is due to the direct costs of treating chronic diseases and caring for people with such diseases.

Cardiovascular diseases

According to the Federal Statistical Office, cardiovascular diseases were the most common cause of death and the third most common reason for hospitalisation in Switzerland in 2016.

Various risk factors are responsible for cardiovascular diseases. There are factors that cannot be influenced, such as hereditary predisposition. Others are dependent on the individual’s behaviour. These include insufficient physical activity, an unhealthy diet, excessive alcohol consumption and smoking. Further research is still needed in order to identify the precise relationships between risk factors, environment and disease processes and to develop optimised therapies.

Diabetes

There are various forms of diabetes, a condition that involves an excessively high level of blood glucose, also known as hyperglycaemia. The two most important forms are type 1 and type 2 diabetes. In type 1 diabetes, the body’s own immune system destroys the cells in the pancreas that produce insulin. Patients are often still very young when a diagnosis is made.

Type 2 diabetes accounts for 90 percent of all cases. Previously referred to as late-onset or adult-onset diabetes, younger people are increasingly developing this form nowadays, not least because the risk factors of excess weight and lack of physical activity may occur at an early age. These and other risk factors can lead to reduced sensitivity to insulin (insulin resistance) and subsequently to hyperglycaemia. As with cardiovascular diseases, the risk factors predisposing to type 2 diabetes can often be actively modified. Diabetes prevention programmes show that lifestyle changes can have a lasting positive effect. It is now also known, however, that the risk of developing type 2 diabetes can be increased by genetic predisposition.

Obesity

Obesity is a chronic disease involving the accumulation of excess body fat – the result of an interplay of genetic, hormonal, and lifestyle factors. Hormones such as leptin, ghrelin, and GLP-1 play a key role in controlling hunger, satiety, and energy consumption. In Switzerland, approximately 42% of adults are overweight or obese. Obesity increases the risk of serious secondary conditions such as type 2 diabetes, cardiovascular disease, and certain types of cancer.

While diet and exercise used to be the only treatment options, the discovery of GLP-1 receptor agonists revolutionized the treatment of obesity. These medications specifically intervene in the hormonal control of appetite. They mimic the effect of the natural intestinal hormone GLP-1, which is secreted after eating and signals to the body that it is full, thereby reducing the feeling of hunger and cutting food intake. Originally developed to control blood sugar levels in type 2 diabetes, it soon became apparent that these active substances not only influence sugar metabolism, but also eating habits. By increasing their natural feeling of satiety and slowing gastric emptying, patients were able to significantly and sustainably reduce their weight – a breakthrough that offered the first hope for the treatment of obesity using drugs.

Research, however, does not stand still. New combination therapies, such as GLP-1/GIP dual agonists, show even better results in studies, with patients losing up to 22% of their body weight. In the future, precision medicine – based on genetic, metabolic, and individual profiles – could make treatments even more targeted and effective. Innovations such as orally administered GLP-1 therapies or implantable systems for continuous release of the active substance are already in the development stage.

For the millions of people affected, this means not only better health, but also improved quality of life and greater participation in society. At the same time, successful therapies also relieve the burden on healthcare systems in the long term by reducing secondary diseases and the associated costs.