Diabetes - A Modern Epidemic?

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Diabetes - A Modern Epidemic?

Martha Canning 09 November 2020

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World Diabetes Day is observed every year on November 14, in order to bring attention and awareness to the increasing health threat and burden posed by diabetes globally. Past campaigns have promoted such ideas as universal health coverage for diabetes management, education, and access for women globally. The theme for 2020 is The Nurse and Diabetes, which promotes the role of nurses in preventing and managing diabetes. As nurses compose more than half of the global healthcare workforce, they play an increasingly important role in education, prevention, patient care and managing the impact of diabetes.

Diabetes is a disease characterized by increased blood glucose (sugar) levels. We get glucose, which is our main source of energy, from the foods we consume. Our bodies use insulin (produced by the pancreas) to get glucose into our cells, so that it can be used for energy and brain fuel. If the body doesn’t make enough insulin or use insulin efficiently, glucose remains in the blood. Over time, this leads to health problems such as heart disease, stroke, eye disease, kidney disease, nerve damage, dental disease and more.

There are different types of diabetes. The most common are: Type 1 diabetes (the immune system destroys the insulin-producing cells in the pancreas, so that no insulin is produced / insulin drug is required each day for life / usually diagnosed in children or young adults), Type 2 diabetes (can develop at any age, though usually in middle age or older/ insulin is not made or used well by the body / most common type of diabetes), and Gestational diabetes (develops during pregnancy / usually resolves after birth of the baby / can be related to Type 2 diabetes).

Symptoms of diabetes may vary, usually connected to the level of blood sugar elevation. Some people experience no symptoms. Some signs and symptoms of diabetes are: increased thirst, more frequent urination, unexplained weight loss, hunger, fatigue, irritability, slow-healing sores, frequent skin or vaginal infections, and blurred vision.

Risk factors for Type 2 diabetes include being overweight or obese, age above 45 years, high blood pressure, family history, race (African American, Native American, Asian American, Alaska Native, Hispanic/Latino, Native Hawaiian, Pacific Islander), lack of physical activity, poor diet, smoking, history of heart disease or stroke, low level of HDL cholesterol, high level of triglycerides, depression, polycystic ovary syndrome, acanthosis nigricans, history of gestational diabetes or high birth weight baby, and exposure to air pollutants.

Key Facts from the WHO

The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014.
The global prevalence of diabetes among adults over 18 years of age rose from 4.7% in 1980 to 8.5% in 2014.
Between 2000 and 2016, there was a 5% increase in premature mortality from diabetes.
Diabetes prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries.
Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
In 2016, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.
Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. The WHO estimates that diabetes was the seventh leading cause of death in 2016.
A healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of Type 2 diabetes.
Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.

Diabetes mellitus is a leading cause of morbidity, mortality, and reduced life expectancy (it is one of the top 10 causes of death globally). The global burden of diabetes has greatly increased since 1980, according to the WHO. Obesity, unhealthy diet, low physical activity and smoking are modifiable behavioral factors which have been shown to be responsible for the increased incidence of diabetes. As developing countries transition from traditional diets to a higher consumption of carbohydrates, fats and sugars, the incidence of diabetes increases. Taking measures to control the incidence of diabetes is necessary for reducing the global burden. As a high Body Mass Index (BMI) is greatly impacted by diet and physical activity, this allows for policies aiming for improvements in diet and exercise. Incentives for healthy foods and tariffs on less healthy food products are examples of potential policies that could be implemented to encourage healthy eating. Public campaigns and incentives to eat healthy and exercise are also valuable in changing public perception and behavior. Controlling air pollution my also be an important factor in controlling diabetes, as well as other noncommunicable diseases. The 2030 Agenda for Sustainable Development recognizes diabetes and other noncommunicable diseases as threats to sustainable development. As part of this agenda, the objective is to reduce by one third premature mortality through prevention and treatment (SDG target 3.4).

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