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Diabetes type 2 up globally: Can our health systems manage?

Kathleen Blanchard's picture
Type 2 diabetes mellitus

A new report shows that type 2 diabetes now affects 350 million worldwide. Researchers say without a focus on better detection and dietary and lifestyle changes, diabetes will continue to present a major burden on lives and our health care systems.

The international study, conducted by an international team of researchers, shows type 2 diabetes rates are significantly higher than those reported in 2009 that estimated 285 million had the disease.

Seventy percent of type 2 diabetes reflects population growth, aging

The rise in number reflects in part, an aging and growing population. The risk of developing type 2 diabetes increases with age as the disease becomes more difficult to prevent.

Dr. Goodarz Danaei, from the Harvard School of Public Health said, “Unless we develop better programmes for detecting people with elevated blood sugar and helping them to improve their diet and physical activity and control their weight, diabetes will inevitably continue to impose a major burden on health systems around the world."

Rates of the disease, found in the report, are highest in the Pacific Island nations. In the Marshall Islands, one in three women have diabetes, and the disease is also high in south Asia, Latin America, the Caribbean, Central Asia, North Africa and the Middle East.

In the study, researchers looked at blood sugar levels of 2.7 million participants, finding blood sugar levels have increased since 1980 on a global scale.

Professor Majid Ezzati from Imperial College London led the study. According to Dr. Ezzati, type 2 diabetes is becoming more prevalent everywhere in the world. “

This is in contrast to blood pressure and cholesterol, which have both fallen in many regions. Diabetes is much harder to prevent and treat than these other conditions."

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The disease claims the lives of over 3 million individuals each year from complications that include heart disease, stroke and kidney disease.

The study found glucose levels were highest in USA, Greenland, Malta, New Zealand and Spain, with the lowest levels found in the Netherlands, Austria and France. Thirty six million diabetics live in the USA and Russia, according to the study findings, with 138 million in China and India.

The authors concluded, “Effective preventive interventions are needed, and health systems should prepare to detect and manage diabetes and its sequelae.”

Doing so means more time spent with patients from providers, ensuring diabetes educators are present in communities, home health settings and hospitals and strict follow-up of patients with diabetes.

Many patients, especially those on Medicare in the US, can’t afford the cost of insulin, diabetic supplies, medications prescribed to treat co-morbidities and co-payments regular follow up with endocrinologists, nephrologists, retinal specialists and cardiology visits.

Dietary adherence also becomes difficult for those living with type 2 diabetes and on a limited income that can’t afford, fresh fruits, vegetables, seafood, lean meats and whole grains needed to manage the disease.

A 2006 study, published in the journal "Clinical Diabetes", states" As a group, patients with diabetes are especially prone to substantial regimen adherence problems." A report from the Cross-National Diabetes Attitudes, Wishes, and Needs (DAWN) Study revealed just 78 percent of type 2 diabetics report adherence to medications and 72 percent said they don't keep their doctors appointments. Thirty five percent said they don't exercise.

The study found there are 350 million people living with type 2 diabetes worldwide. Detecting the disease, teaching diabetics how to manage glucose levels through lifestyle changes and diet are identified by the study authors as necessary to curb the financial and physical burden of the disease. The question is, can our health systems manage the burden of diabetes?

The Lancet: doi:10.1016/S0140-6736(11)60679-X
"National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants"
Goodarz Danaei MD et al