New Numbers Add Urgency to Prevention Ahead of World Diabetes Day

Miriam E Tucker

November 12, 2015

Sounding the alarm about rising rates of diabetes worldwide ahead of World Diabetes Day on Saturday, the International Diabetes Federation has released new data in support of its campaign to convince governments to impose taxes on unhealthful foods — particularly sugar-sweetened beverages — and to use the revenues to further diabetes-prevention efforts.

The full IDF Diabetes Atlas, 7th edition, 2015 will be released December 1 at the IDF's World Diabetes Congress in Vancouver.

But before then, IDF has posted summary data on global and regional findings from the atlas, just ahead of both World Diabetes Day and the Group of Twenty (G20) summit November 15 and 16, where IDF officials will press the case for worldwide attention to the growing diabetes epidemic and to potential solutions.

"One of our arguments to finance ministers this year has been that before too long 10% of your population will have diabetes, and they'll no longer be fit to work in your factories and fight your wars and do what you need your population to do. That's a very cynical approach to take, but sometimes you need these very stark figures to get politicians to take note," diabetologist David Cavan, MD, IDF director of policy and programs, told Medscape Medical News.

The IDF is also targeting its message to patients with diabetes, to the public, and to the medical community.

"Our main message for this year's World Diabetes Day campaign is to promote healthy lifestyles and in particular healthy eating," both in the prevention of type 2 diabetes and to improve management of both diabetes types, Dr Cavan said.

"I think everyone who treats people with type 2 diabetes knows in their heart of hearts that you can write a prescription, but so often people come back and things may have changed a little bit, but they're still overweight and their glucose levels are still too high. The prescriptions won't really work without the other part of the treatment, lifestyle change," he observed.

However, because environments in the Western world — and increasingly in developing countries — surround people with messages that encourage unhealthful foods and high-sugar drinks, "IDF has stepped up engagement with governments, saying you have a responsibility to protect your citizens."

Among the IDF's new 2015 estimates:

  • One in every 11 adults worldwide has diabetes, totaling 415 million, with about half undiagnosed.

  • Diabetes accounts for 12% of global health expenditures, or about $673 billion in US dollars. That's more than the annual US military budget, Dr Cavan pointed out.

  • One in seven births worldwide is complicated by gestational diabetes.

  • Countering the view that type 2 diabetes is primarily a problem of wealthy nations, the IDF estimates that 75% of people with diabetes actually live in low- and middle-income countries, where rapid urbanization and related shifts toward unhealthful diets and sedentary lifestyles are accelerating obesity and diabetes.

  • Every 6 seconds a person dies from diabetes, with annual death rates exceeding those from malaria, TB, and HIV combined.

By 2040, IDF estimates that if nothing changes:

  • One in 10 adults worldwide will have diabetes (642 million).

  • Diabetes-related health expenditures will exceed $802 billion in US dollars.

As part of the build-up to World Diabetes Day, IDF earlier this year issued its "Framework for Action on Sugar," joining the World Health Organization in calling for a limit of sugar consumption to 5% of total daily calories, as well as bans on advertising of sugary drinks to children and teens, sport sponsorships, and on sales in schools.

The framework also recommended government incentives — including taxes — to reduce sugary-drink consumption and instead promote consumption of leafy vegetables, fruit, and clean drinking water.

Dr Cavan pointed to Mexico, where a 2014 tax on sugary drinks has begun to reverse the obesity trend and, if it continues, could reduce diabetes rates there as well. He acknowledged that the issue is very politicized, with voices on the right in the United States and Europe decrying the use of taxes to solve social problems and "dictating how people should live."

However, he pointed out, "Look at other public-health issues — we turned smoking around because of policy action." And the same happened with HIV's transition from a death sentence to a manageable chronic condition. "HIV is no longer a killer disease. Diabetes still is. The solution actually is a lot cheaper with diabetes, but it's very politically difficult."

Yet Dr Cavan is hopeful. "I wouldn't be in my job unless I were optimistic. I think we have to be."

In support of World Diabetes Day, the IDF receives funding from AstraZeneca, Boehringer Ingelheim, Lilly Diabetes, Merck, Novo Nordisk, and Sanofi Diabetes. Dr Cavan has no personal relevant financial relationships.

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