Diabetes represents a global health threat

Oct 20 2009

The International Diabetes Federation (IDF) released new data today showing that a staggering 285 million people worldwide have diabetes. The latest figures from the IDF Diabetes Atlas indicate that people in low and middle-income countries (LMCs) are bearing the brunt of the epidemic, and that the disease is affecting far more people of working age than previously believed.

In 1985, the best data available suggested that 30 million people had diabetes worldwide. Fast-forward 15 years and the numbers were revised to just over 150 million. Today, less than 10 years on, the new figures – launched at the 20^th World Diabetes Congress in Montreal, Canada – put the number closer to 300 million, with more than half aged between 20 and 60. IDF predicts that, if the current rate of growth continues unchecked, the total number will exceed 435 million in 2030 – many more people than the current population of North America.

Professor Jean Claude Mbanya, President of the International Diabetes Federation, voiced concern: "The data from the latest edition of the IDF Diabetes Atlas show that the epidemic is out of control. We are losing ground in the struggle to contain diabetes. No country is immune and no country is fully equipped to repel this common enemy."

Type 1 diabetes cannot be prevented. It is an autoimmune disease in which the body destroys its own insulin-producing cells. People with type 1 diabetes require daily injections of insulin to survive. The majority of all diabetes is type 2 diabetes (85%-95%), which in many cases can be prevented. People with type 2 diabetes cannot use the insulin they produce effectively, but can often manage their condition through exercise and diet, although many go on to require medication, including insulin, to properly control blood glucose levels. It is estimated 60% or more of type 2 diabetes could be prevented.

Both type 1 and type 2 diabetes represent a serious health threat. Diabetes claims four million lives every year and is a leading cause of blindness, kidney failure, heart attack, stroke and amputation.

Diabetes explodes worldwide

Diabetes now affects seven percent of the world's adult population. The regions with the highest comparative prevalence rates are North America, where 10.2% of the adult population have diabetes, followed by the Middle East and North Africa Region with 9.3%. The regions with the highest number of people living with diabetes are Western Pacific, where some 77 million people have diabetes and South East Asia with 59 million.

India is the country with the most people with diabetes, with a current figure of 50.8 million, followed by China with 43.2 million. Behind them the United States (26.8 million); the Russian Federation (9.6 million); Brazil (7.6 million); Germany (7.5 million); Pakistan (7.1 million); Japan (7.1 million); Indonesia (7 million) and Mexico (6.8 million).

When it comes to the percentage of adult population living with diabetes, the new data reveal the devastating impact of diabetes across the Gulf Region, where five of the Gulf States are among the top ten countries affected. The Pacific island nation of Nauru has the world's highest rate of diabetes, with almost a third of its adult population (30.9%) living with the disease. It is followed by the United Arab Emirates (18.7%); Saudi Arabia (16.8%); Mauritius (16.2%); Bahrain (15.4%); Reunion (15.3%); Kuwait (14.6%); Oman (13.4%); Tonga (13.4%) and Malaysia (11.6%).

Increasing economic burden

Diabetes has become a development issue. In LMCs, it threatens health and economic prosperity. IDF predicts that diabetes will cost the world economy at least US$376 billion in 2010, or 11.6% of total world healthcare expenditure. By 2030, this number is projected to exceed US$490 billion. More than 80% of diabetes spending is in the world's richest countries and not in the poorer countries, where over 70 percent of people with diabetes now live.

The United States accounts for $198 billion or 52.7% of total diabetes spending worldwide. India, which has the largest diabetes population, spends US$2.8 billion or 1% of the global total. In most LMCs, people with diabetes must pay for their care out of their own pocket because public medical services and insurance are lacking. The diagnosis of diabetes in a low or middle-income country can often drag entire families into poverty.

"The world needs to invest in integrated health systems that can diagnose, treat, manage and prevent diabetes," said Professor Nigel Unwin, who leads the team of experts behind the IDF Diabetes Atlas. "Governments also need to invest in actions outside the formal health sector, particularly in promoting healthier diets and physical activity, to reduce obesity and the risk of type 2 diabetes. Without effective prevention diabetes will overwhelm health systems and hinder economic growth."

Integrating plans for the prevention of diabetes into national health systems and policy frameworks is an important part of the response. IDF warns that many health systems worldwide are not yet equipped to handle the extent of the diabetes threat, and that failure to take action will have serious consequences.

"The epidemic represents nothing short of a global health emergency," said IDF President Mbanya. "It is alarming that world leaders stand by while the diabetes fuse slowly burns. The serious impact on families, countries and economies continues with little resistance. Governments, aid agencies and the international community must take concerted action to defuse the threat now, before the diabetes time bomb explodes."