Although an estimated 30 million people had the disease in 1985, nowadays diabetes affects 194 million people worldwide. The International Diabetes Federation (IDF) predicts that numbers will increase well over a half to a massive 333 million by 2025. The World Health Organisation (WHO) warns, “a diabetes epidemic is underway.”

The WHO and the IDF are working together to raise awareness about diabetes worldwide. The 14th of November 2004 marked World Diabetes Day as part of their primary global diabetes awareness campaign. The WHO and the IDF have in the past focused on complications of diabetes such as a cardiovascular disease, eye disease and kidney disease, but this year are concentrating on obesity. The campaign slogan is ‘Fight Obesity Prevent Diabetes’.

What is diabetes?

Diabetes Melitus is a chronic and currently incurable condition in which too much glucose (sugar) is present in the blood. The term derives from the Greek word for siphon – to pass through. Melitius is the Latin for honeyed or sweet and refers to the major symptom of diabetes, that is, sugar in the urine.

Diabetes mellitus – inherited or acquired – occurs when the pancreas does not produce enough of the hormone insulin or when the body cannot effectively use the insulin it produces. People who have type 1 diabetes produce very little or no insulin and require daily injections of insulin to survive. People with type 2 diabetes cannot use insulin effectively. They can sometimes manage their condition with lifestyle measures alone, but oral drugs are often required and, less frequently insulin can be used to achieve good metabolic control.

Type 2 is much more common and accounts for around 90 per cent of all diabetes cases worldwide. It used to be known as non-insulin dependent diabetes or mature on-set diabetes. Though once associated with middle aged and older individuals, it is increasingly linked to younger persons.

Diabetes and obesity

“Overweight and obesity are increasingly affecting children and adolescents, resulting in more and more young people being diagnosed with type 2 diabetes. Tackling childhood obesity is now a highly effective way of preventing diabetes in the future,” explains Dr. Catherine Le Galès-Camus, WHO assistant Director-General for Noncommmunicable Diseases and Mental Health.

Globally an estimated 10 per cent of school-aged children between five and 17 years old are overweight or obese, and the situation is getting worse. In the United States, for example, the rate of obesity and overweight among children and adolescents aged six to 18 years increased to more than 25 per cent in the 1990s from 15 per cent in the 1970s.

Such increases are not restricted to developed countries. In China, the rate of overweight and obesity observed in a study of urban schoolchildren increased from almost 8 per cent in 1991 to more than 12 per cent six years later. In Brazil, the rate of overweight and obesity among children and adolescents 6 to 18 years old more than tripled from 4 per cent in the mid 1970s to over 13 per cent by 1997.

Obesity and type 2 currently threaten the health, well-being and economic welfare of virtually every country in the world, not just for young persons but also for adults alike.

Overall, obesity and overweight have affected an alarming 50 per cent to 60 per cent of populations not only in the USA, Europe and Australia, but also in lower to moderate-income countries such as Mexico, Egypt and the black population of South Africa. Even countries with significant rates of under-nutrition such as Ghana have started to see a growing prevalence of overweight and obesity in certain socio- economic groups.

The good news is that overweight and obesity are the main modifiable risk factors for type 2 diabetes.

Prevention

As part of global campaign, the WHO and IDF are stressing the following simple message: lifestyle changes such as eating a healthy diet and being physically active are effective in delaying and, in many cases, preventing the onset of type 2 diabetes, and reducing the risk of developing complications in people with diabetes. It is estimated that at least half of cases of type 2 diabetes could be prevented in adults if weight gain could be avoided.

And for children, some small changes could make real difference in reducing the risk of developing diabetes – for example: banning fizzy drinks in schools, increasing sport classes and teaching basic nutrition from an early age that can prevent weight gain.

Large population-based studies in China, Finland and the USA, for instance, have demonstrated the feasibility of preventing or delaying the onset of diabetes in overweight subjects with mild glucose intolerance. Studies in these countries suggest that even moderate reduction in weight and only half an hour of walking each day reduced the incidence of diabetes by more than one half.

Diabetes is a serious and costly disease which is becoming increasingly common. “The first step to an effective strategy on obesity and diabetes is to recognise the scale of the problem,” says Professor Rhys Williams, vice-president of IDF.

An incurable disease that is in our control to prevent is a strong message. Global recognition must combine with positive action between local, national and international health providers and educationalists to diffuse the diabetes time bomb.