The Global Scare of Diabetes

Editorial

We are living in an era of rapid technological advancement where sky is the limit to achievements. The world is progressing at a record breaking rate, new satellites, space researches, expeditions,and discoveries are the hallmarks of the 21st century. But it is also the time to ponder on one of the largest global health emergencies of the 21st century which is Diabetes.

The World Health Organization marks the 7^th April as the World Health Day. For the first time in its history the WHO has chosen Diabetes as its theme for 2016. It says “Beat Diabetes” and “Eyes on Diabetes”. It is an alarm for each one of us in every part of the world to be aware of the fast growing epidemic. The number of persons with Diabetes is increasing each year which is a life threatening problem since the complications of this disease include cardio vascular diseases, neuropathy, retinopathy, nephropathy, cerebovascular stroke, blindness and even limb amputations.

According to the latest estimates published by the International Diabetes Federation (IDF), 415 million adults (83%) in Low and Middle Income Countries (LMIC) were living with Diabetes in 2015 and this number is expected to rise to 642 million (or 1 Adult in 10) by 2040. A major concern lies in the fact that about half of the people currently living with Diabetes do not know that they have it and the undetected, undiagnosed Diabetes means that the disease is not well managed, further increasing the risk of complications.

It is ironical to state that despite the alarming numbers the real impact of this disease is still underestimated, misunderstood and ignored. It is also unfortunate to note that many countries are still unaware of the social and economic impact of Diabetes. This lack of understanding is the biggest barrier to effective prevention strategies which may contribute in halting the astonishing rise in the number of diabetics.

Some of the key facts related to this disease are:

• The number of people with Diabetes has risen from 108 million in 1980 to 422 million in 2014.
• The global prevalence of the Diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014.
• The prevalence of Diabetes has been rising more rapidly in developing countries.
• The complications arising from Diabetes take a major toll of lives.
• WHO projects that Diabetes will be the 7th leading cause of death in 2030.
• A healthy diet, regular physical activity, regular screening, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of Type 2 Diabetes.
• Diabetes can be treated with medication, regulating diet with insulin or hypoglycaemic drugs and religious physical activity. Efforts should be directed towards prevention of the disease itself and prevention of its complications.
• Screening pregnant mothers for Gestational Diabetes and identifying persons with Impaired Glucose Tolerance can also go a long way in preventing Diabetes.
• Diabetic Retinopathy is an important cause of blindness and which occurs as a result of long term accumulated damage to the small blood vessels in the retina. 2.6% of global blindness can be attributed to Diabetes.
• Also chronic Diabetics have 2-3 fold increase in heart attack and strokes.

Many cases of Diabetes can be prevented and measures exist to detect and manage the condition, improving the odds that people with Diabetes live long and healthy lives, says Dr. Oleg Chestov, WHO’s Assistant Director General for NCDs and Mental Health, “But change greatly depends on governments doing more, including implementing global commitments to address Diabetes and other NCDs”. These include meeting Sustainable Development Goals (SDG) targets which calls for reducing pre-mature deaths from NCDs including Diabetes by 2030.

The role of WHO:

WHO aims to stimulate and support the adoption of effective measures for the surveillance, prevention, control of Diabetes and its complications, particularly in low and middle income countries. To this end WHO:

• Provides scientific guidelines for the prevention of major NCDs including Diabetes.
• Develops norms and standards for Diabetes diagnosis and care.
• Builds awareness on the global epidemic of Diabetes, marking 14^th November as World Diabetes Day.
• Conducts surveillance of Diabetes and its risk factors.

The “WHO Global Report on Diabetes” provides an overview of the Diabetes burden, the interventions available, to prevent and manage Diabetes and recommendations for governments, individuals, the civil society and the private sector.

The “WHO Global Strategy on diet, physical activity and health” compliments WHO’s Diabetes work by focusing on population wide approaches to promote healthy diet and regular physical activity, thereby reducing the growing global problem of overweight people and obesity.

These were some of the heart breaking realities of the global Diabetes crisis. The widely spread unawareness of this disease needs immediate attention. The risk of developing Diabetes and its complications can greatly be reduced though early and accurate diagnosis of the disease, good blood glucose control, and sound management. The health and nutrition professionals around the world and the people with Diabetes need to be empowered with information and technologies in order to combat this ever rising disease and arrest its incidence the world over. Let us join hands to face this challenge with a new dimension and a new approach to its prevention and management.