November 14th marked World Diabetes Day, a day created by the International Diabetes Federation (IDF) and the World Health Organization (WHO) in response to the alarming health threats posed by rapidly increasing rates of diabetes globally. Diabetes can be fatal and can lead to blindness, kidney failure, heart attacks, stroke and lower limb amputation.
From 1980 to 2014, the number of adults living with Diabetes increased from 108 million to 422 million (from 3.1% to 7.1% prevalence). It caused an estimated 1.6 million deaths in 2016.
Diabetes is no longer a disease attributable to rich nations and is increasing most significantly in low-middle income countries. It has become one of four high priority Non Communicable Diseases (NCDs) targeted for action by world leaders.
Type 2 diabetes comprises the majority of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity. One in three adults is overweight and one in ten is obese.
Policies and initiatives that promote healthy lifestyles and access to quality healthcare are often lacking, making prevention and treatment of diabetes especially difficult. Prevention methods include maintaining a healthy body weight, eating a healthy diet that limits processed foods like sugar and saturated fats, exercising regularly and avoiding tobacco use. Early diagnosis paired with intervention can also help minimize adverse health effects.
Africa in particular presents cause for concern for many health experts. Due to the rapidly growing population of the continent, many fear that inadequate health systems will not be able to combat and slow progression of the disease. Surveys carried out recently in Africa indicate that up to 15% of adults aged 25 to 64 have diabetes. From 1980 to 2014 the number of Africans living with diabetes increased from 4 to 25 million. While much of this increase is due to the demographic shifts, change in diet and decreased physical activity are significant contributors.
“We were alarmed by both the magnitude of the problem, the speed at which diabetes has evolved, and how poorly health systems are responding,” said Rifat Atun, professor of global health systems at the Harvard T.H. Chan School of Public Health (Boston, MA).
Even though diabetes and other NCDs have been problematic in Africa for many decades, combatting them was pushed aside when the surge of the HIV epidemic hit. Diabetes is often a silent condition and a significant number of people are unaware that they have the disease. In Africa, only a quarter of people who are overweight or obese, and only a third who are diabetic had ever had their blood glucose levels measured, according to a study published in the Lancet.
Experts cited in the Lancet article claim that unless services for diabetes and other NCDs are incorporated into the platforms developed for HIV, the disease will remain rampant across the continent.
“It would be truly unimaginative, and too costly, to set up multiple vertical programs to tackle the different chronic diseases. Researchers need to determine how integration of services should take place” said Shabbar Jaffar, author of the article.
As infectious diseases decrease globally, NCDs are quickly becoming the biggest killers. From cardiovascular disease to cancer and diabetes, these chronic illnesses now account for 71% of all deaths globally. We need the global health community’s continuing and increased commitment to innovative and efficient interventions, to stem the dramatic rise of NCDs.