Diabetes: a silent epidemic that kills nearly 7 million of us every year

It’s the silent epidemic that claimed an estimated 6.7 million lives around the world last year – more than the total recorded death toll from COVID-19 since the start of the pandemic. Diabetes is on the march, with experts predicting that one in 10 of us will be affected by 2045.

An estimated 537 million people already live with diabetes and that figure is set to rise to over 780 million by 2045, according to the latest data from the International Diabetes Federation (IDF). The condition is already one of the top 10 causes of death globally.

“Diabetes is a pandemic of unprecedented magnitude spiralling out of control,” said IDF President, Professor Andrew Boulton. “Globally, more than one in 10 adults are now living with diabetes. Moreover, there is a growing list of countries where one-in-five or even more of the adult population has diabetes.”

The World Health Organization marked World Diabetes Day 2022 by calling for urgent action to make insulin - the only treatment for diabetes - universally available worldwide and updating its guidance for the production of insulin.

China, India, Pakistan and the United States had the highest rates of diabetes in 2021, each with over 30 million cases, according to IDF’s latest Diabetes Atlas. The condition is rising fastest in sub-Saharan Africa with the number of cases forecast to increase by 134% by 2045.

The number of people with diabetes in the Middle East and North Africa is expected to grow by 87% in the same period with an increase of 68% forecast in South East Asia.

Diabetes is a serious, long-term condition that occurs when the body cannot produce any or enough insulin or cannot effectively use the insulin it produces. This results in a situation known as hyperglycemia where excessive blood sugar levels can cause a person to slip into a coma.

There are two basic forms of diabetes. Type 1 diabetes cannot be prevented and is caused by an autoimmune reaction in which the body’s immune system attacks the insulin-producing cells of the pancreas. Genetic defects and viral infections are among its known causes.

Around 90% of diabetics worldwide have Type 2 diabetes, which has been linked to obesity and ageing and may have no early symptoms. Changes in diet, increased exercise, stopping smoking and maintaining a healthy body weight can manage and even reverse the condition.

The World Health Organization (WHO) says the number of cases has nearly quadrupled since 1980. When the IDF first published global data in 2000, there were an estimated 151 million people with the condition.

An estimated 240 million people are living with undiagnosed diabetes worldwide, meaning that almost half of all adults with diabetes are unaware they have the condition, says the IDF. Nine out of 10 people with undiagnosed diabetes live in low and middle income countries.

Global health expenditure on diabetes in 2021 was an estimated $966 billion and is expected to reach $1trillion by 2045. The WHO says most of the burden falls on middle and low-income countries which are also seeing the greatest increase in cases.

The United Nations Sustainable Development Goals include a pledge to ensure healthy lives for all people, listing diabetes alongside cancer and heart disease as one of the noncommunicable diseases responsible for one death every two seconds among 30-70 years olds.

But it doesn’t have to be like this. The WHO says that simple blood glucose tests could improve diagnosis and reduce the risk of long-term organ damage which often results from undiagnosed diabetes.

“A series of cost-effective interventions can improve patient outcomes, regardless of what type of diabetes they may have,” says WHO. These interventions include controlling blood glucose levels and blood pressure and regular screening for damage to the eyes, kidneys and feet.

In 2021 the WHO launched the Global Diabetes Compact to ensure people are aware of the risks of developing the condition and urging governments to ensure that anyone diagnosed with diabetes has access to equitable, comprehensive, affordable and quality treatment and care.

The World Economic Forum’s Healthy Cities and Communities Playbook 2021 warns: “Around the world, in every city, poor lifestyle choices, limited opportunities and inadequate financial security have combined to produce poor nutrition, insufficient physical activity and limited rest.

“The outcome of such unhealthy living is seen in rising levels of obesity, diabetes, high blood pressure and high cholesterol levels – the root causes of many preventable diseases.”

Action to promote healthy living and diets could help halt the rise in diseases like diabetes, the report says.