World Diabetes Day, observed annually on November 14, is a powerful opportunity to highlight diabetes as a critical public health challenge. This year’s theme, “Breaking Barriers, Bridging Gaps,” emphasises the collective responsibility to improve the prevention, diagnosis, and management of diabetes worldwide. As the global incidence of diabetes grows, the need for accessible, equitable, and quality care has never been more urgent. Governments, health organisations, communities, and individuals are called to raise awareness, spread knowledge, and work together to improve the lives of millions impacted by diabetes.
Understanding Diabetes and Its Types
Diabetes is a chronic condition that affects how the body processes blood glucose (sugar). It results from either insufficient insulin production by the pancreas or the body’s inability to use insulin effectively. Insulin is essential for regulating blood glucose levels, and without proper insulin function, blood sugar can rise uncontrollably, leading to hyperglycemia. Over time, this condition can severely damage various systems within the body, especially the nerves and blood vessels.
Type 1 Diabetes
Type 1 diabetes, also known as insulin-dependent or juvenile diabetes, is characterised by the body’s inability to produce insulin. It is commonly diagnosed in children and young adults and requires lifelong insulin injections. Although it accounts for a smaller percentage of diabetes cases worldwide, type 1 diabetes presents unique challenges and a high burden, especially for those in low-income settings, where insulin availability may be limited.
Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes, making up over 95 per cent of cases globally. Unlike type 1, type 2 diabetes is often preventable and results from the body’s inability to use insulin properly. Risk factors include obesity, lack of physical activity, poor diet, and genetics. Type 2 diabetes can often be managed through lifestyle modifications and, in some cases, medication. However, left untreated, it can lead to serious complications affecting the heart, eyes, kidneys, and nerves.
Gestational Diabetes
Gestational diabetes develops during pregnancy and is associated with high blood glucose levels that may complicate delivery. It also increases the risk for type 2 diabetes later in life for both mother and child. Early diagnosis and lifestyle adjustments during pregnancy can mitigate the risks associated with gestational diabetes.
Impaired Glucose Tolerance (IGT) and Impaired Fasting Glycaemia (IFG)
IGT and IFG are intermediate conditions between normal glucose levels and diabetes. Individuals with these conditions are at a higher risk of progressing to type 2 diabetes. However, with lifestyle changes, progression to full diabetes can be delayed or prevented.
The Global Diabetes Crisis
Diabetes is a leading cause of blindness, kidney failure, heart attacks, strokes, and lower limb amputation. The prevalence of diabetes worldwide rose dramatically from 108 million in 1980 to 422 million in 2014, according to the World Health Organization (WHO). Notably, low- and middle-income countries have experienced a rapid rise in cases, largely due to increased obesity, urbanisation, and ageing populations.
In Europe alone, diabetes affects an estimated 64 million adults, with around 300,000 children and adolescents living with the condition. A 2019 report estimated that diabetes was responsible for 186,000 deaths in the region, a figure expected to double from 2005 to 2030. Type 1 diabetes is also most prevalent in Europe, adding to the region’s significant diabetes burden.
Similarly, the Indian Council of Medical Research (ICMR) released data in 2023 indicating that over 10.1 crore people in India are affected by diabetes. This reflects the urgent need for public health interventions to prevent and manage diabetes.
Symptoms of Diabetes
Diabetes symptoms can vary and may develop gradually in type 2 diabetes, making early diagnosis challenging. Common symptoms include increased thirst, frequent urination, blurred vision, fatigue, and unexplained weight loss. As diabetes progresses, it can lead to complications in vital organs, including the heart, kidneys, and nerves, increasing the risk of heart attacks, strokes, kidney failure, vision loss, and amputations.
Risk Factors and Prevention of Diabetes
Type 2 diabetes is largely preventable. Key risk factors include obesity, sedentary lifestyles, poor diet, and smoking. Governments and organisations worldwide are focusing on preventive measures to reduce diabetes incidence by promoting healthier lifestyles.
Preventive Strategies
1. Healthy Weight: Maintaining a healthy weight can significantly reduce the risk of developing type 2 diabetes.
2. Physical Activity: Regular exercise, including 30 minutes of moderate physical activity daily, can help control weight and reduce blood sugar levels.
3. Healthy Diet: Following a balanced diet low in added sugars and unhealthy fats is crucial for prevention.
4. Avoiding Tobacco: Smoking is a major risk factor for cardiovascular diseases, which are common complications of diabetes.
Global Efforts in Diabetes Prevention and Management
The World Health Organisation (WHO) is actively working to improve global diabetes prevention, care, and management, particularly in low- and middle-income countries. In 2021, WHO launched the Global Diabetes Compact, a comprehensive initiative focusing on diabetes prevention and treatment, especially in resource-limited settings. WHO’s guidelines promote awareness, early diagnosis, and access to affordable insulin and essential medicines. WHO’s five global diabetes treatment targets aim to improve care and outcomes by 2030.
Addressing India’s Diabetes Crisis: A holistic approach
India faces an urgent diabetes crisis, with over 74 million people diagnosed as of 2021, and projections suggesting this figure could exceed 124 million by 2045. Affecting around 11 per cent of the population, diabetes has become particularly prevalent in urban areas (16.4 per cent), though rural regions are also at significant risk (8.9 per cent). Alarmingly, a further 15.4 per cent of urban and 15.2 per cent of rural populations are classified as pre-diabetic, making them highly susceptible to developing diabetes in the future. With nearly 57 per cent of diabetes cases remaining undiagnosed, individuals are often subjected to delayed treatment, heightening the risk of serious complications like coronary heart disease, retinopathy, stroke, and nephropathy.
Given that more than 90 per cent of diabetes cases in India are type 2—often linked to lifestyle factors—the financial burden is also substantial. On average, diabetes management costs 14,000 rupees per year per person, with lifetime expenses potentially exceeding 350,000 rupees. Tackling this epidemic demands a comprehensive approach, one that unites healthcare infrastructure improvements, public health initiatives, and proactive preventive measures. Early detection, patient education, and accessible care options are critical to managing the diabetes crisis and reducing its societal and economic impact.
Diabetes Prevention and Management Initiatives in India
In India, the Government has implemented various diabetes prevention initiatives under the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), which is part of the National Health Mission (NHM). Key components of this initiative include:
Diabetes Clinics and Screening Centres: India has established over 6,000 Community Health Center (CHC) NCD Clinics and 743 District NCD Clinics for diabetes management and early diagnosis at the local level.
Population-Based Screening: People over 30 years of age are screened for common non-communicable diseases, including diabetes, at Ayushman Bharat – Health and Wellness Centers. These centres focus on prevention, early diagnosis, and promoting healthy lifestyle changes within communities.
Awareness and Education Programs: Observing national and international health days like World Diabetes Day, conducting community-based wellness programs, and using multiple media channels for public awareness are all part of India’s diabetes education efforts.
Accessible Medication and Treatment: Under the NP-NCD and Free Drugs Service Initiative, free or subsidised essential medicines, including insulin, are provided in government hospitals. Generic medicines are also made available at affordable prices under the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) program.
Promotion of Healthy Lifestyles: The Government actively promotes the Fit India and Khelo India initiatives to encourage physical activity among the population. Additionally, the Food Safety and Standards Authority of India (FSSAI) supports healthier food choices through initiatives like “Eat Right India.”
Addressing Health Inequities and Social Determinants
Diabetes disproportionately affects marginalised and low-income communities. Social, economic, and environmental factors can limit access to quality healthcare, resulting in delayed diagnosis and inadequate diabetes management. Health systems worldwide must consider these disparities when designing programs and policies, ensuring that people of all backgrounds have equitable access to diabetes care.
Complications of Diabetes: The Importance of Early Management
Without effective management, diabetes can lead to life-threatening complications
Cardiovascular Disease: People with diabetes are at a higher risk of heart attacks and strokes.
Kidney Disease: Diabetic nephropathy is a leading cause of kidney failure.
Eye Damage: Diabetic retinopathy can lead to permanent vision loss.
Nerve Damage and Foot Complications: Nerve damage and poor circulation in the feet can result in ulcers and amputation.
The Role of Education and Community Engagement
Education and awareness campaigns are essential in diabetes prevention and management. Programs that promote community involvement empower individuals to make healthier lifestyle choices and increase understanding of diabetes symptoms and risk factors. World Diabetes Day provides a global platform for these efforts, uniting people in a shared mission to combat diabetes.
Looking Ahead: The Future of Diabetes Care
The theme of World Diabetes Day 2024, “Breaking Barriers, Bridging Gaps,” emphasises the need for an inclusive approach to diabetes care, focusing on overcoming challenges and creating equitable access to treatment. Governments, health organisations, and communities worldwide are urged to collaborate, investing in early detection, quality treatment, and support systems for those living with diabetes. Innovations in diabetes care, such as advanced blood sugar monitoring technology, artificial pancreas systems, and improved insulin delivery devices, offer hope for enhanced patient care and quality of life.
World Diabetes Day serves as a reminder of the growing impact of diabetes on global health and the urgent need for a unified, inclusive approach to prevention and treatment. As diabetes prevalence continues to rise, efforts to close the gap in healthcare access, especially in low-income and marginalised communities, are essential. In 2024, the theme “Breaking Barriers, Bridging Gaps” underscores our shared responsibility to create a world where high-quality, affordable diabetes care is accessible to all, paving the way for a healthier future for everyone.
Through awareness, education, and access to resources, individuals and communities can take proactive steps to prevent and manage diabetes effectively. The commitment to reducing the diabetes burden calls for sustained action and collaboration on a global scale. With efforts focused on awareness, prevention, and equitable treatment, World Diabetes Day can catalyse meaningful, lasting change for millions affected by diabetes around the world.
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