World Health Organization Issues Staggering Global Report on Diabetes

By Melissa An and Varun Iyengar

On April 7, in honor of World Health Day 2016, the World Health Organization published its first-ever Global Report on Diabetes to increase awareness about the rise in the disease and to inspire actionable and affordable steps to tackle it. The document was simultaneously published alongside an analysis of trends in diabetes prevalence in a prominent medical journal, The Lancet. Together, the reports paint a compelling picture of the staggering burden and consequences of diabetes worldwide while issuing a global call to action.

What were the biggest global findings from the reports?

• The number of adults with diabetes has quadrupled in the past 25 years, from 108 million in 1980 to 422 million in 2014. This adds up to a global prevalence of 8.5% in 2014 vs. 4.7% in 1980. 90-95% of these individual have type 2 diabetes.

• The estimated annual cost of diabetes to the world is more than $827 billion. This doesn’t even count hours of loss productivity, reduced quality of life, etc.

• The report attributes the global rise in diabetes to the growing and aging world population, with increases in diabetes prevalence in all age groups.

The WHO’s estimates reinforce the severity of the diabetes pandemic raised in the IDF’s seventh edition of its Diabetes Atlas last November, which estimated that 415 million people globally have diabetes today and only 30 million had diabetes in 1980.

Potential bright spots: what's the latest on global trends in diabetes complications?

• Cardiovascular (heart disease) events: Adults with diabetes historically have a two or three-fold higher rate of cardiovascular disease than adults without diabetes. The incidence of cardiovascular events (heart attacks, stroke or death) has actually decreased over the past 20 years in people with diabetes, although the reduction has been less than that in people without diabetes. Fewer cardiovascular events are mostly attributed to reductions in smoking, better management of diabetes, and better management of risk factors (e.g., high blood pressure).

• Lower extremity amputations: Rates of amputation in populations with diagnosed diabetes are typically 10 to 20 times those of people without diabetes. Studies conducted in the US, UK, Sweden, Denmark, and Australia have shown a 40% to 60% reduction in amputation rates among adults with diabetes over 25 years, although no data exists for low- or middle-income countries.

• Loss of vision: In 2010, diabetic retinopathy was responsible for 1.9% of moderate or severe visual impairment globally and 2.6% of blindness. The prevalence of any retinopathy in people with diabetes is very high – 35%, more than one in three adults – while the prevalence of vision-threatening retinopathy is one in 15 (7%).

What regions have the highest rates of diabetes?

Half the diabetes cases in the world are in two regions: South East Asia (96 million, including India, Thailand, and Indonesia) and Western Pacific (131 million, including China, Australia, Japan, and New Zealand). While the drivers of these trends are complex, two contributing factors include rapid urbanization and genetic predispositions in certain East-Asian ethnic groups.

However, the WHO Eastern Mediterranean region (e.g., Egypt, Afghanistan, Pakistan) has experienced the greatest increase in diabetes prevalence over the past 25 years. This region also has the highest prevalence of inactivity in both adults and adolescents.

The WHO also highlights the link between obesity and diabetes, though the numbers also remind us that the correlation isn’t perfect. For instance, the prevalence of obesity was highest in the Americas (North America and South America) even though the same region was below average in diabetes prevalence. The lowest prevalence of obesity was seen in the South East Asian region, even though the region was the second highest in diabetes prevalence.

A Global Call to Action

The numbers represent the first WHO trend analyses published since the UN adopted a voluntary target to “halt the rise in diabetes and obesity” by 2025. The UN General Assembly adopted this target in 2011, encouraging member states to develop national plans to combat diabetes and obesity. Given these sobering trends, the WHO concludes that only a few regions – mostly in Western Europe – have even a chance of meeting the target to halt the rise in diabetes by 2025. Indeed, over the past three years, diabetes prevalence has either increased or remained the same in all countries and at all income levels.

This is unacceptable, and solutions will only come from our collective efforts. As the WHO report states:

There are no simple solutions for addressing diabetes, but coordinated, multicomponent intervention can make a significant difference. Everyone can play a role in reducing the impact of all forms of diabetes. Governments, health-care providers, people with diabetes, civil society, food producers and manufacturers and suppliers of medicines and technology are all stakeholders. Collectively, they can make a significant contribution to halt the rise in diabetes and improve the lives of those living with the disease.

To learn more about the WHO’s recommendations for combatting global diabetes, see its full report here.