Detailed Analysis of Global Report on Diabetes by WHO

With an alarming increase in the number of diabetics all over the world (nearly four times between 1980 and 2014), WHO has selected diabetes, as the theme for the World Health Day 2016. WHO is marking its annual World Health Day (7 April), which celebrates the Organization’s founding in 1948, by issuing a call for action on diabetes. In its first “Global report on diabetes”, WHO highlights the need to step up prevention and treatment of the disease. The findings of WHO’s Global Report on Diabetes is in concurrence with a study published by the Lancet journal.

What is diabetes?

It is a chronic, progressive noncommunicable disease (NCD) characterized by elevated levels of blood glucose (blood sugar). It occurs either when the pancreas does not produce enough of the insulin hormone (known as insulin-dependent diabetes/ juvenile onset diabetes/ Type-1), which regulates blood sugar, or when the body cannot effectively use the insulin it produces ( non insulin – dependent diabetes mellitus/ adult – onset diabetes/ Type-2).

Key findings of the report

a. The number of diabetics and its prevalence in all regions of the world especially the developing regions is increasing rapidly. In 2014, 422 million adults suffered from diabetes, compared to 108 million in the 1980.

b. The epidemic of diabetes has major health and socioeconomic impacts, especially in developing countries.

c. In the year 2014, more than 1 out of 3 adults with age above 18 years were overweight and more than one in 10 were obese.

d. Diabetes is a chronic progressive disease which gradually gives rise to many complications like heart attack, stroke, blindness, kidney failure and lower limb amputation. For example, rates of lower limb amputation are 10 to 20 times higher for people with diabetes.

e. Diabetes alone caused 1.5 million deaths in 2012. Prolonged abnormal blood glucose levels caused an additional 2.2 million deaths by increasing the risks of cardiovascular and other related diseases.

f. Many of these deaths occur prematurely, before the age of 70 years, and can be prevented by adopting policies to create supportive environments for healthy lifestyles and earlier/ better detection followed by treatment.

g. Good management of diabetes includes use of a small set of generic medicines, different ways to promote healthy lifestyles, patient education to enhance self-care and regular screening for early detection and treatment of complications.

What causes diabetes?

Type – 1 diabetes: This occurs due to the body’s inability to produce insulin (vital hormone responsible for utilization of glucose and its conversion to energy) as a result of the autoimmune destruction of beta cells of the islets of Langerhans in the pancreas. It often begins in childhood, hence known as juvenile. However, this disease can also develop in the late 30’s and early 40’s.

Type – 2 diabetes: It is a metabolic disorder characterised by hyperglycemia, (high levels of glucose circulating in the blood) which is a result of insulin resistance/ low production of insulin in the body (cells, fats and liver do not respond to insulin, thus excess glucose does not get stored in the cells).

Increasing inactivity can cause this type of diabetes at any age, especially in young adults with obesity.

Gestational diabetes: Gestational diabetes is a temporary condition that occurs in pregnancy and carries long-term risk of type 2 diabetes. Gestational diabetes is present when blood glucose values are above normal but still below those diagnostic of diabetes.

Typical symptoms for diabetes: Polydipsia (increased thirst), Polyuria (frequent urination), Polyphagia (increased hunger), unexplained and sudden loss of weight, blurring of vision, fatigue and nausea.

Prevention of diabetes – a systematic approach

a. The advent of diabetes (majorly type – 2) can be prevented with lifestyle changes like increasing physical activity and intake of healthy food and fruits. Also, early detection of the disease and required medical treatment can make the diabetics manage their disease easier and give them a long healthy life.

b. Since the availability of insulin and other medications for diabetes and other non communicable diseases is very less in low income countries (only one of three poor countries), increasing the supply of medical aid is of a priority.

c. Awareness regarding the disease, its symptoms and the available treatment is crucial for people since half of the complicated cases remain undiagnosed for a long time.

d. Countries across the globe are recommended to take action in line with the objectives of the WHO Non Communicable Diseases (NCD) Global Action Plan 2013 – 2020 that will help reach the highest attainable standards of health and productivity at every age.

India’s role in prevention of the global epidemic

a. India contributes nearly one-sixth to the global epidemic burden while China continues to stay on the first position with the highest percentage of diabetics in the country.

b. Apart from obesity, increased consumption of sugar rich and refined foods, sedentary lifestyles and genetic predisposition significantly contribute to an increased risk for diabetes in Indians.

c. With increasing incidences of diabetes every year, the economic burden of diabetes in India is considerable. Thus, efforts should be directed towards prevention and delay in the onset of the disease.

d. Awareness about pre-diabetes where the blood sugar level is higher than normal but not elevated enough to be classified as diabetes is essential. In such cases, with appropriate lifestyle changes and diet improvisations, this condition is totally reversible. This necessitates public awareness especially.

e. Programmes that include free diagnosis of diabetes and primary health care along with complete information (especially in the rural areas) about the disease would be a comprehensive approach in preventing and managing the disease.