Worldwide trends in diabetes
Arvind M. Dhople, Ph.D.
Professor Emeritus, Florida Tech
Worldwide trends in diabetes
With Ebola and Zika grabbing so many headlines these days, it may come as a surprise that the biggest global health crisis affecting all nations is not caused by yet another rare virus we have never heard of, or an exotic tropical parasite, but rather something far too familiar to us all – diabetes.
The condition has been the focus of this year’s World Health Day (April 07) – a campaign that aims to increase awareness about the rise of diabetes and the staggering burden it places on health systems, as well as triggering a set of actions to tackle it.
Once a disease affecting mainly richer nations, type 2 diabetes has arisen exponentially in the past two decades in parallel to the obesity epidemic, with more than 80% of diabetes deaths now occurring in low and middle income countries. The number of people living with diabetes in the world has almost quadrupled since 1980 to 423 million adults (8.5% of population). In 2014, more than 1 in 3 adults aged over 18 years were overweight and more than one in 10 were obese.
In 2014, 31 million Americans, or 9.3% of the population, had diabetes. Approximately 1.45 million American children and adults have type 1 diabetes. 1.4 million Americans are diagnosed with diabetes every year. At the same time, in 2014, 87 million Americans age 20 and older had prediabetes condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes.
This dramatic increase of diabetes in the world (and especially in the developing countries) is happening as these countries are struggling to tackle existing and emerging infectious disease such as HIV/AIDS, malaria, Ebola and Zika, along with other diseases such as heart and cancer. Needless to say that this double burden of disease imposes a huge economic strain on health systems, individuals and their families. It also threatens to compromise many of the significant national and international efforts made in the past few decades to reduce the infectious disease burden in these regions.
A new study (published in The Lancetª) has estimated that the cost of diabetes worldwide is $825 billion a year, with half of all cases coming from China, India, Brazil, Indonesia and USA. The global diabetes epidemic seems to be driven largely by a combination of social and economic factors such as rapid urbanization, greater consumption of fatty foods and increasingly sedentary lifestyles.
Obesity is the greatest risk factor for diabetes, and the obesity epidemic too is soaring out of control. A recent study showed that more people in the world now overweight than underweight. This study also found that between 1975 and 2014, the global population’s BMI (Body Mass Index) increased at a rate which correlates with every person becoming on average 3.5lb heavier each decade. Today, 66% of adults in the United States are considered overweight, and among them, more than one third (35.7%) are obese.
The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income people than in high-income people. Research is increasingly demonstrating that diabetes can largely be prevented through healthier lifestyles and diet. However, translating this evidence into policy and practice is not an easy feat and will require significant reform of public health policies, health systems, and changes to the food and build environment.
[ª The Lancet, April 09, 2016]