There is the only disease that increases the risk of crippling complications such as amputation, vision loss, and kidney failure- Diabetes- It is also associated with cardiovascular disease, dementia, some cancers, and infections such as tuberculosis and severe COVID-19.
Of the 828 million adults with diabetes in 2022, over a quarter (212 million) lived in India with another 148 million in China, followed by the USA (42 million), Pakistan (36 million), Indonesia (25 million) and Brazil (22 million).” The Global study published in The Lancet reveals ahead of World Diabetes Day .
An Additional concern is that 445 million adults aged 30 years and older with diabetes (59%) did not receive treatment in 2022, three and a half times the number in 1990
The study conclusions: (verbatim)
- The global rate of diabetes (type 1 and 2 combined) in adults doubled from approximately 7% to about 14% between 1990 to 2022, with the largest increase in low- and middle-income countries (LMICs).
- Over the same period, rates of treatment for diabetes stagnated at low levels in many of the same LMICs where rates of the disease have drastically increased, resulting in almost 450 million adults aged 30 and over with diabetes globally (59%) who did not receive treatment in 2022.
- Meanwhile, people living in North America, Australasia, central and western Europe, and parts of Latin America and East Asia and the Pacific saw a significant improvement in treatment rates for diabetes from 1990 to 2022, contributing to widening global inequities in diabetes treatment.
- Authors say the study highlights the urgent need for financing of medicines and comprehensive diabetes programmes that enable early detection and effective treatment of diabetes in LMICs.
Senior author Professor Majid Ezzati, of Imperial College London, highlighted the widening global inequalities in diabetes, with treatment rates stagnating in many low- and middle-income countries where numbers of adults with diabetes are drastically increasing.
“This is especially concerning as people with diabetes tend to be younger in low-income countries and, in the absence of effective treatment, are at risk of life-long complications – including amputation, heart disease, kidney damage or vision loss – or in some cases, premature death.” He warned
A unique study
This global study with global data conducted by the NCD Risk Factor Collaboration (NCD-RisC), in collaboration with the World Health Organization (WHO) analyzes the trends in both diabetes rates and treatment which includes all countries; The researchers used the data from over 140 million people aged 18 years or older from more than 1,000 studies in populations of different countries. The authors used statistical tools to bring all the data across different years, ages and countries together, and estimate diabetes rates and treatment in a way that enables comparisons across countries.
Researchers defined Diabetes as having a fasting plasma glucose (FPG) of 7.0 mmol/L or higher, having a glycated haemoglobin (HbA1c) of 6.5% or higher (two commonly used diagnostic criteria options for diabetes according to modern guidelines) or taking medication for diabetes. They defined “Treatment” as taking medication for diabetes.
Global rates of diabetes doubled over the last three decades
“From 1990 to 2022, global diabetes rates doubled in both men (6.8% in 1990 to 14.3% in 2022) and women (6.9% to 13.9%). With the additional impact of population growth and ageing, this equates to an estimated 828 million adults with diabetes in 2022, an increase of approximately 630 million people from 1990, when roughly 198 million adults were estimated to have the disease.” A press release from The Lancet noted
“The changes in diabetes rate from 1990 to 2022 varied drastically across different countries with mostly LMICs experiencing the largest increases (eg. the diabetes rate amongst women in Pakistan rose from 9.0% in 1990 to 30.9% in 2022, the largest increase across all countries). Whilst some higher-income countries, such as Japan, Canada and some countries in western Europe (eg. France, Spain and Denmark), saw no change or even a small decrease in diabetes rate over the last three decades.” The release added.
Obesity and poor diets are important drivers of the rise in type 2 diabetes rates, and its variation across countries, Diabetes rate was either already high or increased more in some of the regions where obesity was or became prevalent between 1990 to 2022, compared to many high-income countries, especially those in the Pacific and western Europe , where, in general, obesity and diabetes rates did not rise or rose by a relatively small amount.
According to Dr Ranjit Mohan Anjana, Madras Diabetes Research Foundation, India, the disabling and potentially fatal consequences of diabetes, preventing diabetes through healthy diet and exercise is essential for better health throughout the world.
“Our findings highlight the need to see more ambitious policies, especially in lower-income regions of the world, that restrict unhealthy foods, make healthy foods affordable and improve opportunities to exercise through measures such as subsidies for healthy foods and free healthy school meals as well as promoting safe places for walking and exercising including free entrance to public parks and fitness centres,” she clarified.
Widening global inequalities in diabetes treatment: The grim reality
What is worrying is the grim reality that three out of five (59%) of adults aged 30 years and older with diabetes, a total of 445 million, were not receiving medication for diabetes in 2022, three and half times the number in 1990 (129 million).
Since 1990, some countries, including many in central and western Europe, Latin America and East Asia and the Pacific, as well as Canada and South Korea have seen vast improvements in treatment rates for diabetes resulting in more than 55% of people with diabetes in these countries receiving treatment in 2022. The most notable information is from Belgium where the highest treatment rates were estimated at 86% for women and 77% for men.
For many LMICs diabetes treatment coverage has stayed low and changed little over the previous three decades, with over 90% of people with diabetes not receiving treatment in some countries in both 1990 and 2022.
Sadly, because of these trends, the yawning gap between the countries with the highest and lowest treatment coverage for diabetes has widened since 1990 to 2022; from 56 to 78 percentage points in women and from 43 to 71 percentage points in men.
“Our findings suggest there is an increasing share of people with diabetes, especially with untreated diabetes, living in low- and middle-income countries. In 2022, only 5-10% of adults with diabetes in some sub-Saharan Africa countries received treatment for diabetes, leaving a huge number at risk of the serious health complications.” said Professor Jean Claude Mbanya, University of Yaoundé 1, Cameroon.
Status in India, China Pakistan, Indonesia and USA
In 2022, almost one third (133 million, 30%) of the 445 million adults aged 30 years or older with untreated diabetes lived in India, more than 50% greater than the next largest number which was in China (78 million) because treatment coverage was higher in China (45% for women and 41% for men) than in India (28% for women and 29% for men). Similarly, Pakistan (24 million) and Indonesia (18 million), the next two countries with the largest number of untreated diabetes, surpassed the USA (13 million), which had higher treatment coverage (65% for women and 67% for men).
The information provided in this unique study will be very useful for public health authorities, particularly in “low and middle-income countries” (LMIC) in using their limited resources more effectively. Government must organize massive, well planned public education programmes, at all levels, with the support and cooperation of NGOs, religious groups and community leaders among others to arrest the
Unbelievable Benefits of Eating Family Meals Together at Home
Among the benefits of eating family meals together at home are
- Lower rates of obesity, overweight and eating disorders.
- Better nutrition and knowledge about a variety of healthy foods.
Can we ignore the elephant in the room?
Uncontrolled sugar intake
- Indian Council of Medical Research (ICMR) in its latest guidelines advise limiting added sugar to 25 g per day or even eliminating it from the diet as it adds no nutritive value to the food other than calories. The normal intake is higher.
- For children aged 2 to 19 years, the dietary guidelines for Americans for 2020-2025 prescribe 12 teaspoons (50g) of added sugar from both food and beverages.
- For kids and young adults (2–19 years old), the average daily consumption of added sugars was already 17 teaspoons in 2017–2018. Excess sugar intake at this age can have a profound adverse impact.
- As a first step, parents should read the labels on packed foodstuffs to estimate the amount of sugar their children consume daily.
- Family dinners taken together at home will help in reducing excess sugar intake. Family Dinnner Projects (FDP’s) constant advocacy of what is good will inspire the participants. They will not ignore this elephant (excess sugar intake) in the room