Home' Trinidad and Tobago Guardian : November 14th 2016 Contents It s a potentially fatal disease whose
risks can in many cases be prevented
through lifestyle measures. So why
has diabetes seen a massive increase
The number of people living with
the potentially fatal disease has
quadrupled since 1980, to more than
400 million, according to the World
Health Organization (WHO).
Worldwide, diabetes killed 1.5 million
in 2012 alone, with high blood-glucose
causing another 2.2 million deaths,
the organisation says.
In its first Global Diabetes Report,
the WHO says a "whole-of-govern-
ment and whole-of-society approach"
is required to tackle the disease, which
costs an estimated US$827 billion
annually in patient care and medicine.
Findings of the WHO report were
published in the medical journal
Lancet, and highlight inequalities
between countries, as diagnoses and
medicine are more accessible in high-
What is diabetes?
Diabetes is a chronic disease caused
by the body s failure to produce enough
insulin to regulate blood glucose---or
Raised blood glucose can eventually
damage the heart, blood vessels, eyes,
kidneys and nerves. Abnormally low
blood glucose can cause seizures and
loss of consciousness.
Type 1 diabetes is not currently pre-
ventable and sufferers require daily
administration of insulin to survive.
Type 2 diabetes---which results from
the body s ineffective use of insulin---
is far more common and can be influ-
enced by lifestyle as well as genetic
and metabolic factors.
Impaired glucose tolerance (IGT)
and impaired fasting glycemia (IFG)
are elevated glucose levels not yet at
the level of diabetes but which
nonetheless increase the risk of heart
attacks and strokes.
Additionally, pregnant woman can
develop gestational diabetes, increasing
the risk of complications and the long-
term risk of type 2 diabetes.
Why is diabetes on the rise?
The WHO says that between 1980
and 2014, the percentage of adults
with diabetes increased from 4.7 per
cent of the global population to 8.5
per cent (from 108 million to 422 mil-
lion). The rise, it says, mirrors "the
global increase in the number of people
who are overweight or obese."
Among the WHO's key
findings about exercise:
• In 2010 nearly a quarter of adults
(18 and older) were classified as "insuf-
ficiently physically active."
• Even more alarming were the fig-
ures on inactivity among adolescents,
with 84 per cent of female adolescents
and 78 per cent of males falling short.
• In 2014, almost one in four adults
aged over 18 years was overweight and
more than one in 10 were obese.
Which countries are most affected?
"Prevalence is growing most rapidly
in low-and middle-income countries,"
the report says.
The biggest estimated percentage
rises were in the Western Pacific,
African, Southeast Asia and Eastern
Mediterranean regions---with the last
having an increase from 5.9 per cent
to 13.7 per cent of the population.
Adult mortality rates from high
blood-glucose increased globally over
the same period, with the African,
Eastern Mediterranean and Southeast
Asia regions worst affected.
What can be done?
"Some risk factors for type 2 dia-
betes---such as genetics, ethnicity and
age---are not modifiable," the WHO
says, but others, such as weight, diet,
exercise and smoking, are.
"At the individual level, intensive
interventions to improve diet and
physical activity can prevent or delay
the onset of type 2 diabetes in people
at high risk."
It says all government sectors must
"systematically consider the health
impact of policies in trade, agriculture,
finance, transport, education and
urban planning---recognising that
health is enhanced or obstructed as a
result of policies in these and other
The WHO suggests, for example,
that urban planning could encourage
physical activity by ensuring non-
motorised transport is accessible and
safe, while taxation---as in the case of
Mexico---could be enacted to try to
reduce demand for sugary beverages.
Early diagnosis in primary health
care settings is also key to avoiding
poor health outcomes, the WHO says
and must be easily accessible.
What about medicine to
Just as basic technologies for diag-
nosis and monitoring of diabetes in
low-income and lower middle-income
countries are less accessible, so too is
insulin, the WHO says.
Limited competition between a small
number of multinational manufactur-
ers can increase prices, with low-
income countries generally paying the
most for the treatment, it says.
"Governments decisions about
insulin purchasing---tendering prac-
tices, choice of supplier, choice of
products and delivery devices---can
have a huge impact on budgets and
on costs to end users.
"Governments may recoup high
costs by charging mark-ups to patients.
In Mozambique, for example, insulin
purchased from local wholesalers was
25 per cent to 125 per cent more expen-
sive than that purchased through inter-
national tenders," the WHO says.
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body & soul
Guardian www.guardian.co.tt Monday, November 14, 2016
WORLD DIABETES DAY
YOUR DAILY HEALTH
News and advice
It says while insulin is reported
as available in 72 per cent of coun-
tries it varied widely by region
"Only 23 per cent of low-
income countries (six countries)
report that insulin is generally
available, in contrast to 96 per
cent of high-income countries (54
"Further, the reported general
availability of insulin in the WHO
Region of the Americas and the
European Region is more than
double that of the WHO African
Region and South-East Asia
Region," the report says.
Any silver lining?
The WHO says the results of
its 2015 Noncommunicable Dis-
ease Country Capacity Survey
give an "encouraging global
impression" that countries are
"Nearly three-quarters (72 per
cent) of countries have a national
diabetes policy that is imple-
mented with dedicated funding,
and countries are also taking
action at the policy level to
address unhealthy diets and
physical inactivity," it says. But
the WHO warns that policy
needs to be translated into
action, with less than half of
countries with national guide-
lines or standards on diabetes
actually implementing them.
A co-ordinated approach is
"Everyone has a role to play---
providers, people with diabetes
and those who care for them,
civil society, food producers, and
manufacturers and suppliers of
medicines and technology are all
stakeholders," the WHO says.
"Collectively, they can all make
a significant contribution to halt
the rise in diabetes and improve
the lives of those living with the
In just over 30 years
Diabetes cases have quadrupled
The WHO says that
between 1980 and 2014,
the percentage of adults
with diabetes increased
from 4.7 per cent of the
global population to 8.5
per cent (from 108
million to 422 million).
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