Diabetes, an Underestimated Epidemic

Gauden Galea's simple request is that I write about diabetes to generate interest in a proposed United Nations Resolution for Diabetes which is being run by the International Diabetes Federation. This is a timely request. If it's passed, this will be the first chronic non-infectious disease that will be highlighted by the United Nations.

Why is this important?
Diabetes is a global disease that is increasing in numbers in both the developed and the developing countries. Its growth is due to population growth, longer life expectancies, and increasing prevalence of obesity and physical inactivity. The cost of this disease in terms of human life and resources will be staggering. Diabetes is one of the 5 leading causes of death in most countries. Complications associated with diabetes include heart disease, stroke, kidney disease, blindness, nervous system disorders, and amputations.

In 2007, the world will likely spend between $215 billion and $375 billion on the medical care costs of diabetes and its complications, according to the IDF. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. The graph above depicts the increase in diagnosed cases of diabetes in the United States alone up to 1994. During 1990 to 1998, the prevalence of diabetes in adults in the U.S. increased by 33%, and the numbers are continuing to climb.

The five countries with the largest numbers of people with diabetes are India (35.5 million), China (23.8 million), the United States (16 million), Russia (9.7 million) and Japan (6.7 million), according to 2003 data from the ID. By 2025 the number of people with diabetes is expected to more than double in Africa, the Eastern Mediterranean and Middle East, and Southeast Asia, according to the group. Many of the people who have the disease don't even know that they have it, while others think of it as a "little sugar problem".

Technically the term epidemic applies to infectious diseases. Although diabetes is not infectious, unfortunately, many of the lifestyle factors which contribute to it have spread from the west to the developing countries. These countries will carry an even larger burden of the cost of the disease due to a lower number of health resources. Since behavioral and environmental factors play a significant role in the prevention and management of this disease, the benefit of making the public and policy makers aware of this condition will be significant in saving lives and resources.

Please note that these data apply to type 2 diabetes which is the most common type accounting for 90 - 95% of the cases and not to type 1. The difference will be discussed in future posts. Diabetes is too complex a disease to cover in one post. In honor of November being Diabetes Awareness Month, I will dedicate the next few posts to diabetes.

References: Diabetes Care 2004. Diabetes Care, 2000. Medscape. Applesfor health. Diabetes, A National Plan for Action.