According a new international study more than 350 million in the world now have diabetes. The analysis, published online by the Lancet on Saturday, adds several tens of millions to the previous estimate of the number of diabetics and indicates that the disease has become a major global health problem.
Diabetes also raises risk of heart disease and strokes, as well as damage to kidneys, nerves and the retina. About three million deaths a year are attributed to diabetes and associated conditions in which blood sugar levels are disrupted.
Scientists believe this increase is due to a spread of a western-style diet to developing nations, which is causing rising levels of obesity. Researchers also say that increased life expectancy is playing a major role. Type 2 is the most common type of diabetes, accounting for about 85-95% of cases, and is often tied to obesity.
One of the study's main authors, Professor Majid Ezzati, of Imperial College London said, “Diabetes is one of the biggest causes of mortality worldwide, and our study has shown that it is becoming more common almost everywhere. It is set to become the single largest burden on world health care systems. Many nations are going to find it very difficult to cope with the consequences.”
Martin Tobias of the ministry of health in New Zealand in an accompanying editorial for the Lancet could not agree more. He said there is “no worldwide surveillance network for diabetes, as there is for communicable diseases such as influenza”. Given the inexorable rise in case numbers that is now occurring, there was now “an urgent need” to establish proper monitoring of the disease, he added.
Diabetes experts say the Government has “no strategy whatsoever” to deal with the burgeoning diabetes. Health Minister Tony Ryall said “a lot” was happening across a wide range of areas to address diabetes in New Zealand. “Progress on diabetes is one of the Government's six main health targets. We are spending around $65 million on keeping children and people active.” That included: the KiwiSport initiative promoting sport for school-aged children; Green Prescriptions which encourage health professionals to advise patients to get active; and nutritional programs including the Healthy Eating Healthy Action programme, he said.
Paul Drury, an Auckland diabetes specialist and medical director of the Society for the Study of Diabetes, expected the problem in New Zealand to get worse. There needed to be some serious public health measures to curb the rise in diabetes, he said. “The present Government removed what few public health attempts there were to tackle obesity and the previous lot weren't much better.”
The study – funded by the World Health Organization and the Gates Foundation – analyzed blood from 2.7 million participants aged 25 and over from across the world over a three-year period. Doctors measured levels of glucose in their blood after they had fasted for 12 to 14 hours – blood sugar rises after a meal. The team then used advanced statistical methods to estimate prevalence rates among the participants. It was estimated that the number of adults with diabetes was 347 million, more than double the 153 million estimated in 1980 and considerably higher even than a 2009 study that put the number at 285 million.
“We are not saying the previous study was a bad one,” said Ezzati. “It is just that we have refined our methods a little more.” In percentage terms, the prevalence of male adult diabetics worldwide rose from 8.3% to 9.8% in that period, with adult females increasing from 7.5% to 9.2%. As to the causes, the team attribute 70% to ageing and 30% to the increased prevalence of other factors, with obesity and body mass the most important. It was found that in the US glucose levels had risen at more than twice the rate of western Europe over the past three decades. In wealthy nations, diabetes and glucose levels were highest in the US, Malta, New Zealand and Spain, and lowest in the Netherlands, Austria and France. Other badly affected countries included many Pacific island nations. Saudi Arabia was also reported to have very high rates. Glucose levels were also particularly high in south Asia, Latin America, the Caribbean, central Asia, north Africa and the Middle East.
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