Diabetes a ‘defining issue for global public health’

The number of diabetes patients has quadrupled worldwide in the past 35 years. The chronic disease is also widespread in Switzerland Keystone

The number of adults with diabetes has quadrupled worldwide in under four decades to 422 million, and the condition is fast becoming a major problem in poorer countries, a World Health Organization (WHO) study showed on Wednesday. 

In Switzerland, where an estimated 500,000 of the 8.3 million total population have diabetes, more than 1,000 people die each year from diabetes and around 3,000 deaths are attributable to high blood glucose, the study found. 

Nevertheless, northwestern Europe has the lowest rates of diabetes, with age-adjusted prevalence lower than 4% among women and at around 5-6% among men in Switzerland, Austria, Denmark, Belgium and the Netherlands. 

In one of the largest studies to date of diabetes trends, the WHO researchers said ageing populations and rising levels of obesity across the world meant diabetes was becoming a “defining issue for global public health”. 

Type 2 diabetes is a long-term condition characterised by insulin resistance. Patients can manage their diabetes with medication and diet, but the disease is often life-long and is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. 

Diabetes

Diabetes is a chronic, metabolic disease characterised by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. 

The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn’t make enough insulin. In the past three decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. 

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. 

(Source: WHO)

Published in The Lancet journal ahead of the United Nations World Health Day on Thursday, the study used data from 4.4 million adults in different world regions to estimate age-adjusted diabetes prevalence for 200 countries. 

It found that between 1980 and 2014, diabetes had become more common among men than women, and rates of diabetes rose significantly in many low- and middle-income countries, including China, India, Indonesia, Pakistan, Egypt and Mexico. 

In Switzerland, diabetes is responsible for 2% of all deaths. Every year its kills 140 men and fewer than 100 women aged 30-69 and 480 men and 630 women aged over 70. 

As for annual deaths attributable to high blood glucose, there are 320 for men and fewer than 100 for women aged 30-69 and 1,300 for men and 1,330 for women aged over 70. 

The main cause of death in Switzerland is cardiovascular diseases (35%) followed by cancers (27%). 

No meaningful decrease 

Margaret Chan, the WHO’s director-general, said the findings showed an urgent need to address unhealthy diets and lifestyles around the world. 

“If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active and avoid excessive weight gain,” she said in a statement from the WHO’s Geneva headquarters. 

“Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes.” 

No country saw any meaningful decrease in diabetes prevalence. 

The largest increases in diabetes rates were in Pacific island nations, followed by the Middle East and North Africa, in countries like Egypt, Jordan and Saudi Arabia. 

The data also showed that half of adults with diabetes in 2014 lived in five countries: China, India, the United States, Brazil and Indonesia. Rates more than doubled for men in India and China between 1980 and 2014. 

On Wednesday Swiss Interior Minister Alain Berset said the cabinet had agreed a joint strategy – with the cantonal authorities and the public sector – to help prevent a further increase in chronic diseases among the Swiss population. The prevention strategy will focus on cancer, diabetes, cardio-vascular and muscular illnesses as well as chronic problems of the respiratory system.