World Diabetes Day is on 14th November. Diabetes, one of the four priority non-communicable diseases (NCDs) identified by the World Health Organisation (WHO), remains a misunderstood and neglected epidemic with numbers increasing alarmingly in every region of the world.
At first glance, Halle Berry, Larry King, former Pakistani cricketer Wasim Akram, five-time Olympic gold medalist Sir Steve Redgrave, Sharon Stone, Vanessa Williams and Winnie Mandela don’t seem to have anything in common, but one fact binds them together - they’re among the estimated 300 million people in the world who have diabetes.
The figures are frightening. In 1990 there were just 30 million people worldwide with diabetes and the figure’s increased 10-fold in 20 years. Every year, a further seven million people develop diabetes, with the International Diabetes Federation expecting the figure to rise to more than 438 million within 20 years. It’s rising at epidemic rates, in all countries, and for the first time, a non-infectious disease is seen as posing the same global threat as infectious diseases like HIV/Aids.
So what’s causing this dramatic increase in the number of people with diabetes?
As more and more people throughout the world start leading westernised lifestyles, so their eating habits change, and they exercise less - leading to a greater number of people being overweight, which in turn has led to increased incidences of diabetes and other diseases.
Although type 2 diabetes mostly affects people after the age of 40, the increased incidence of obesity in children and young adults means the number of people under the age of 40 with type 2 diabetes has also increased dramatically.
For the individual, having diabetes has serious health implications putting them at risk of other health problems, such as heart disease, stroke, kidney damage, amputations, blindness and premature death.
But that’s not where it ends. There are serious implications for the governments of countries around the world, as the burden on healthcare systems is overwhelming. Diabetes is one of the world’s most important causes of expenditure, mortality, disability and lost economic growth. The International Diabetes Federation estimates that the costs of diabetes complications account for 5-10% of total healthcare spending in the world.
The solution, of course, lies in education. People need to be made aware of the causes, consequences and prevention of diabetes – and within this, the importance of leading a healthier lifestyle and knowing how and when to access treatment early, cannot be emphasised enough.
There are many - but two of the most important issues are that of the link between obesity and diabetes and, consistent with the World Health Organisation’s focus on women’s and children’s health, the very real risk that Gestational Diabetes holds for the mother and baby.
Diabetes and obesity are inextricably interrelated epidemics which together threaten to engulf the world’s healthcare systems over the next two decades. "Diabesity" remains one of the most underreported and explosive medical stories of our time. If nobody was overweight or obese, the prevalence of Type 2 diabetes would be around 1%. In South Africa, the prevalence of diabetes in some population groups is almost 12%.
Understanding “diabesity” takes us to the front lines of the fight against this preventable but deadly disease: excess weight destroys the body’s ability to process glucose (sugar) properly - with life-threatening consequences. It shows what happens when the genes that evolved to protect us from famine collide with a sedentary lifestyle.
Gestational Diabetes (GDM) refers to diabetes in pregnancy and affects 2-5% of all pregnancies. It holds serious potential consequences for both the mother and baby.
GDM could result in macrosomia (newborn with excessive birth weight) - which in turn increases the risks of complications during birth. Babies could suffer from hypoglycaemia and jaundice, while macrosomic infants are at a higher risk for obesity - both in childhood and adulthood. GDM increases the risk of miscarriage, pre-eclampsia, premature birth and perinatal mortality. Women with GDM and their babies have a dramatically increased risk of developing type 2 diabetes later.
Where to from here?
Since diabetes affects everyone in some way, tackling the condition should be the business of individuals, communities, corporations and governments. Novo Nordisk, a pharmaceutical company at the forefront of diabetes research and development, lead with their support of the diabetic and are committed to various initiatives that aim to put diabetes on the agenda. In South Africa Novo Nordisk are supporting the following initiatives:
1) Kwaito star, Howza (Tshepo Mosese), who will this November launch a music video of his latest song “I choose to live” - about the impact of diabetes on the world and the importance of prevention. The song, written and performed with fellow artist Omen has been recorded in time for a World Diabetes Day release, thanks to a donation from Novo Nordisk, and also features the voices of another South African “great” - the renowned Soweto Gospel Choir.
2) The Changing Diabetes Bus, sponsored entirely by a grant from Novo Nordisk, has travelled the length and breadth of South Africa since its introduction in June 2007, testing thousands of people for diabetes. The bus is a mobile clinic where diabetes screenings are done free of charge. This year Novo Nordisk has invested further in equipment which includes a Fundus camera, a Nidek Laser, a Doppler and a Neurothesiometer which means people can now be screened free of charge for complications of diabetes.
The Changing Diabetes Bus will be in Bloemfontein during the week of 8-14 November with a “Diabetes village” on November 13 at the Pelonomi Hospital.
3) The Bongi Ngema-Zuma Foundation, formed in August 2010 aims to create awareness about diabetes. In the broader social context, the foundation seeks to drive the empowerment of women and children, rural development, education and health primarily central to diabetes and associated diseases. Novo Nordisk has decided to support this foundation as part of the company’s Changing Diabetes initiative.
- (World Diabetes Day Novo Nordisk press release)
(Sources: 1.International Diabetes Federation, www.idf.org; 2. Third World Network Info Service for Health Issues, www.twnside.org.sg; 3. DLife: The Diabetes Health Company, www.dlife.com; 4. American Diabetes Association, www.diabetes.org; 5. International Diabetes Federation, www.idf.org; 6. Society for Endocrinology, Metabolism and Diabetes of South Africa: www.semsda.org.za)
- (Health24, November 2010)