“If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active and avoid excessive weight gain,” said Dr Margaret Chan, WHO director general. “Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes.”
According to Dr Etienne Krug, director of WHO’s department for the management of non-communicable diseases more than one in three people in the world are overweight today and one in 10 obese – many of them in the developing countries where eating habits and activity levels are altering fast. Most of the people like fast food with little or no physical activity.
Things are changing too fast. Many people still grow their own food in those countries but there is also a much larger urban population and also many people living in slums who don’t have the space to do that and who also don’t have the resources to buy healthy food.
People are over-consuming sugary drinks, processed fatty food and sugary food. This is the main reason for overweight and obesity in Latin America, Asia and in some African cities, which is something we didn’t see half a century ago.
Diabetes can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation. In 2012 1.5 million people globally died from diabetes and 2.2 million more died as a result of high blood glucose levels, which can be a precursor of diabetes and increase the risks of heart and other diseases. These are often premature deaths – 43% were before the age of 70, says the WHO report.
So how to control diabetes:
Prevention is key. WHO urges all countries to promote breastfeeding and encourage people to eat healthy food and become more physically active while discouraging them from consuming products such as sugary drinks. “A combination of fiscal policies, legislation, changes to the environment and raising awareness of health risks works best for promoting healthier diets and physical activity at the necessary scale,” says the report.
But more treatment, including essential drugs, is also needed. Even 100 years after the discovery of insulin hormone, the global report on diabetes shows that essential diabetes medicines and technologies, including insulin, are available in only one in three of the world’s poorest countries. Access to insulin is a matter of life or death for many people with diabetes. Improving access to insulin and medicines in general should be a priority not a choice.
Insulin does not have to be expensive – there are cheap versions which are just as good. It is upto the governments that choose to buy, what is available and what they think they should be buying.
Sometimes there is this misconception that more expensive is going to be better. But the higher price is due to the overheads in marketing these drugs. We should make sure that the cheaper forms of insulin, which are just as effective, are widely available in all parts of the world.
In 2012 governments agreed to halt diabetes but the report notes that this looks unlikely to happen at the current rate of progress. We don’t see any simple solutions for addressing diabetes but coordinated, multicomponent intervention can make a significant difference.
Everyone can play a role in reducing the impact of all forms of diabetes. Governments, healthcare providers, people with diabetes, civil society, food producers and manufacturers, and suppliers of medicines and technology are all stakeholders. Collectively, they can make a significant contribution to halt the rise in diabetes and improve the lives of those living with the disease.”