30. Diabetes: The Pandemic and Potential Solutions

Abstract

While diabetes affects persons of all ages and all races, it disproportionately afflicts people living in the developed world, where prevalence is higher. However, the number of 20– to 79–year–olds with diabetes is expected to jump 72 percent by 2025 most notably in the Middle East and North Africa, South Asia, and Sub–Saharan Africa.

Diabetes not only reduces a person's quality of life and life expectancy, it also imposes a significant economic burden on families and health care systems.

Complications of diabetes include microvascular diseases, such as blindness and kidney failure, and macrovascular diseases, such as coronary heart disease and stroke. More than 80 percent of disability–adjusted life years resulting from diabetes are lost in developing countries. As these countries westernize, individuals will have a higher risk of obesity and, consequently, type 2 diabetes, the most prevalent form of the disease.

A number of interventions are particularly appropriate for developing countries because the reduction in medical costs associated with short– and long–term complications of diabetes greatly exceeds the costs of interventions such as glycemic control, blood pressure control, and foot care. In addition, assuring adequate access to insulin and promoting patient education both relatively low–cost interventions should be top priorities for developing countries. Moreover, interventions that empower patients, such as reminders to make follow–up appointments, can be successful components of diabetes programs.