COMMENTARY

Should Diabetes Be Treated More Seriously Than Cancer?

Dr Andrew J.M. Boulton, DSc, FRCP

Disclosures

July 09, 2019

This transcript has been edited for clarity.

Hello, my name is Andrew Boulton, professor of medicine, University of Manchester, UK, and visiting professor, University of Miami, Florida.

I'm also incoming president of the International Diabetes Federation (IDF).

And I think that we need to remember the seriousness of diabetes. And across the world we need to raise the profile of diabetes, equal or even above that, for example of cancer, another chronic and feared disease.

The statistics for diabetes, as you all know, are horrendous.

Last November we marked 100 years since the end of the First World War. And it was estimated that about 4.5 million, or thereabouts, were killed each year during the first world war on the battlefield.

But if you look at statistics for diabetes, there are more than that number, dying each year from diabetes and its complications across the world.

So we really need to take diabetes seriously. We can no longer go on saying this is a touch of sugar, my grandmother had it. It'll be OK.

Data that we've published from my group in Manchester, looking at patients with diabetes with chronic renal failure, with end stage disease on dialysis, the outcome for these patients is that 50% will be dead within 2 years.

If they also have a foot problem, and for example have lost a toe or part of a foot, 3 out of 4 of these patients are dead within 2 years.

So we really need to take diabetes, seriously. Primary prevention, that is preventing those at high risk from going on to develop diabetes, screening of high-risk groups: certain ethnic groups, where there's obviously morbid obesity, there is inactivity, family history of diabetes, and so on. So we really need to be proactive in primary prevention.

In the UK in secondary prevention it has been shown that bringing in the mass screening for diabetic retinopathy with a retinal photograph taken each year has taken diabetes off the number one spot for the cause of blindness in young-aged adults.

So secondary is preventing those who have diabetes from getting late complications. We know how to do that, glycaemic control, etc.

And tertiary prevention, if you've got neuropathy for example, is preventing them going on to get a foot ulcer.

So we need to be proactive in prevention, raising the profile of diabetes as a serious and life-threatening disease in its late stages that needs to be taken as seriously as we take cancer.

And I think that's the message for governments across the world in the next 2 years, when I'll be looking after the IDF. Thank you.

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