The Burden

Diabetes is one of the most common NCDs globally. It is the fourth or fifth leading cause of death in most high-income countries and there is substantial evidence that it is epidemic in many economically developing and newly industrialised countries.

387 million people had diabetes in 2014, and without effective prevention and management programmes this number is expected to rise to 592 million by 2035. 77% of people with diabetes live in low- and middle-income countries.

The Disease

Diabetes is a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. Insulin is a hormone made by the pancreas that enables cells to take in glucose from the blood and use it for energy. Failure of insulin production, insulin action or both leads to raised glucose levels in the blood (hyperglycaemia). This is associated with long-term damage to the body and the failure of various organs and tissues.

Type 2 diabetes makes up about 85 to 95% of all diabetes in high-income countries and may account for an even higher percentage in low- and middle-income countries. The development of type 2 diabetes is marked by insulin resistance. People with type 2 diabetes cannot use the insulin that they produce effectively. They can often manage their condition through exercise and diet. However, in many cases oral drugs are needed and often insulin is required.

Type 1 diabetes, although less common than type 2 diabetes, is increasing each year in both rich and poor countries. In most high-income countries, the majority of people with diabetes in the younger age groups have type 1. Type 1 diabetes is an autoimmune disease characterized by the destruction of the insulin-producing cells in the pancreas. Consequently, people with type 1 diabetes produce very little or no insulin and must take insulin to survive.

Gestational diabetes mellitus (GDM) is common and, like obesity and type 2 diabetes, is increasing throughout the world. GDM is a condition in which women without previously diagnosed diabetes have high blood glucose levels during their pregnancy. GDM affects about 4% of all pregnant women. The risk of developing diabetes is very high in women who have had GDM.

The Socioeconomic Impact

Diabetes creates an economic burden at the personal, national, and global level. In 2013, 10.8% of global health spending was directed at diabetes, and at the national level, the majority of countries dedicate between 5% and 18% of health spending to diabetes. Global health expenditure for diabetes was 548 billion USD in 2013, and this amount is projected to increase to 627 billion USD by 2035.

The Response:

Prevention and risk factors:

Genetics, some environmental factors and viral infections have been shown to increase one’s risk of Type 1 diabetes, though research is still needed to further define Type 1 diabetes risk factors.

Type 2 diabetes risk factors include, but are not limited to: family history of diabetes, being overweight, unhealthy diet, physical inactivity, aging, high blood pressure, and poor nutrition during pregnancy.

Preventative measures can only be taken with Type 2 diabetes. Lifestyle changes in diet and physical activity can be preventative actions with Type 2 diabetes. Additionally, quitting smoking is a positive lifestyle change that can prevent the development of Type 2 diabetes.

For more information on risk factors, click here.

Treatment:
Currently, there is no cure for diabetes and treatment is limited to disease management approaches. Diabetics need to take insulin periodically throughout the day and maintain a healthy diet to maintain healthy blood glucose levels. Frequent and close monitoring of blood glucose levels is very important.

For more about diabetes, visit www.idf.org
Sources: www.idf.org and IDF Diabetes Atlas (6th ed.) 

Photo courtesy: IDF, World Diabete Day 2014, Hungary