Rising Diabetes Epidemic Overwhelming Health Systems and Requires Urgent Action, New Report Warns
In a recent report published by The Lancet, the Institute for Health Metrics and Evaluation of the University of Washington has revealed alarming new estimates about the escalating diabetes crisis. The report indicates that the number of people struggling to control their blood glucose levels has reached an astonishing half a billion worldwide. However, the situation is projected to worsen over the next 30 years, with estimates indicating that the figure will skyrocket to a staggering one billion three hundred million individuals. These double-digit increases are particularly prevalent in North Africa, the Middle East, Latin America, and low-income countries.
The report highlights the overwhelming burden this will place on global health systems. According to the authors, no health system will be adequately equipped to handle this colossal influx of diabetes cases. The risks posed by diabetes are profound, as the disease significantly increases the likelihood of lethal cardiovascular events such as heart attacks and strokes. While only 4 percent of cases will be type 1 diabetes, the rest will be attributed to type 2 diabetes. Unlike type 1, which is an immune-mediated disease typically diagnosed at a young age, type 2 diabetes is often linked to factors such as overweight and obesity, sedentary lifestyles, and poor dietary choices.
The coordinator of the study, Liane Ong, explains that diabetes is a complex condition influenced by genetic, behavioral, and environmental factors that are challenging to address. “Many barriers and social and financial inequalities affect the risk of diabetes – they must be taken into account for true prevention,” Ong emphasized. However, preventive measures can still be effective, starting with individual behaviors.
One crucial aspect of prevention is regular blood sugar monitoring. Without knowing their blood glucose levels, individuals are unaware of their predisposition to prediabetes, a condition that affects at least 4.5 million Italians, as per data presented at the last congress of the Italian Society of Diabetology. Prediabetes increases the risk of developing diabetes within three to five years for 11 to 25 percent of cases. Prediabetes is characterized by fasting blood sugar levels between 100 and 125 mg/dl or impaired glucose tolerance, indicated by blood sugar levels between 140-199 mg/dl two hours after a glucose load curve.
Raffaella Buzzetti, president-elect of the Italian Society of Diabetology, highlights how lifestyle changes, enhanced physical activity, improved dietary habits, and weight control can help normalize blood sugar levels and prevent the progression to diabetes. However, the challenges extend beyond personal choices. The rapid increase of diabetes cases in Italy, according to the Italian Diabetes Barometer Report, is not solely attributed to population aging but also to earlier diagnoses, the impact of the COVID-19 pandemic, and socio-economic and cultural factors. For instance, diabetes prevalence varies significantly across different regions in Italy, with Calabria reporting an astonishing 8.5 percent compared to the 4.7 percent prevalence in the North-East.
Francesco Dotta, head of the Diabetes Unit of the Le Scotte University Hospital in Siena, emphasizes that, in addition to personal choices, effective prevention must consider social determinants of the disease. Urban environments, for example, contribute to the widespread prevalence of diabetes, with factors such as limited opportunities for physical activity, unhealthy food options, and disparities in access to healthcare services influencing the disease’s impact. This disparity is demonstrated by the findings of the Health City Institute survey in Rome, which revealed higher diabetes prevalence in the suburbs, where the population is generally younger. The prevalence of diabetes increased by 140 percent just within five subway stops from the city center to the outskirts.
It is crucial to prioritize diabetes prevention from an early age, as type 2 diabetes is increasingly diagnosed among children. Childhood obesity, prevalent in the southern regions of Italy, contributes to disruptions in glycemic balance and earlier onset of the disease. The COVID-19 pandemic has also had a negative impact, leading to a surge in diabetes diagnoses among individuals under 18, as highlighted by studies conducted in Italy and the USA. Urgent action is needed to address the rising diabetes epidemic, both through effective preventive measures and improved treatment options. With the availability of over one hundred different combinations of drugs, diabetes management has significantly progressed. A tailored approach to treatment, considering individual characteristics and cardiovascular risk, can ensure more effective outcomes for patients.
The rising number of diabetes cases poses a significant threat to global health systems, necessitating swift and comprehensive action. By promoting awareness, implementing preventive measures, and prioritizing accessible healthcare services, it is possible to mitigate the impact of diabetes and alleviate the strain on health systems worldwide. Failure to address this impending crisis could result in devastating consequences for individuals and societies alike.