The Diabetes Epidemic In India: A Vision Of The World's Future
India has the largest number of people with diabetes in the world. According to the International Diabetes Federation, the number of diabetics rose from its already high 1995 rate of 19 million to over 62 million in 2011. An estimated 11% to 20% of India's urban population has diabetes, and 3% to 5% of the adult rural population has the disease. Estimates from the World Health Organization say that the disease currently costs India about $250 billion per year, and that in the next ten years this figure will skyrocket to $335 billion. Clearly, India has a diabetes problem. But the real issue is that it's a predictor of a growing global problem. According to the International Journal of Diabetes in Developing Countries, the alarming increase in diabetes "has gone beyond epidemic form to a pandemic one." India is just the "canary in the coal mine," warning miners of dangers they cannot see. The rise of diabetes in India is being seen by health experts as a precursor of what we can expect to see happen all over the world in coming years. What are the causes of this diabetes pandemic? Because most of the newly-diagnosed cases in India are of Type 2 diabetes (formerly called non-insulin-diabetes), the root causes there are the same as they are in America – poor diet overloaded with fat, sugar, and calories, obesity, stress, and a sedentary lifestyle, in which people don't get enough exercise. These causal factors are amplified in India by genetics (in which many people seem to be prone to the disease because their parents and grandparents were) and cultural factors (what is considered "fat" in America is considered normal in India, and what America considers a normal weight is considered in India "too skinny"). It has also been triggered by the large-scale importation of a Continue reading >>
Is Prediabetes An Epidemic Or A Creation Of Drug Companies?
A lot has been made of the growth of the waistlines of Americans, but the facts continue to be alarming. A new report indicates that Americans on average now weigh 15 pounds more than 20 years ago–and we are not getting any taller. According to the Center for Disease Control (CDC), in 1996, no state on average had 20% of its population obese. Now EVERY state’s population has at least a 20% obesity rate and in three–West Virginia, Mississippi and Arkansas–more than 35% are obese. There is no sign of this trend slowing. The problem with the increasing American girth is not one of aesthetics, but rather the concomitant illnesses associated with such huge weight gains. Again, CDC data teach that, as obesity increases, so does type 2 diabetes, with the latter ultimately leading to heart disease, kidney disease and potential limb amputations. It’s no surprise that those same states with the highest obesity rates also have the highest rates of type 2 diabetes. Approximately 12% of the residents of West Virginia, Mississippi and Arkansas now have type 2 diabetes. The downstream costs for treating diabetic complications are enormous. Thus, it is crucial to identify patients early and try to modify their lifestyles as best possible to stem this rising disease epidemic. The CDC is trying to do just that and its website urges that those with “prediabetes” seek medical advice: “Having prediabetes means your blood glucose (sugar) levels are higher than normal–but not high enough to be diagnosed as diabetes. Prediabetes can lead to heart disease, stroke and type 2 diabetes, the most common form of diabetes. Prediabetes can often be reversed.” One would think that such a stance would be non-controversial. However, a recent commentary in the Chicago Tribune thinks th Continue reading >>
Cities Are The Front Line In The Global Diabetes Epidemic
Today, 437 million people worldwide have type 1 or type 2 diabetes. New estimates published this month show that three-quarters of a billion people could have the disease by 2045 — and cities are the front line of this challenge. As the growth fast becomes unmanageable for health systems, shortening the lives of millions of urban citizens and constraining economic growth, Novo Nordisk is working with a coalition of major cities to bend the curve on type 2 diabetes. We’re calling for local political and health leaders of all cities to ask what it will take to change the trajectory of the disease in their area and to put into practice the new models that we are forging. A rapidly urbanizing world is changing not just where we live but also how we live. As my predecessor at Novo Nordisk wrote, the way cities are designed, built, and run creates health benefits for citizens — but critically it also creates risks. Towns and cities, where half of the world’s population now lives, are home to two-thirds of people with diabetes. That’s why when we initiated the Cities Changing Diabetes program in 2014, we set out to put a spotlight on urban diabetes. This effort has grown into a global partnership of nine major cities, home to over 75 million people, and over 100 expert partners united in the fight against urban diabetes. Without concerted action, health systems around the world will reach a point in coming decades when they won’t be able to effectively treat patients sustainably. We conservatively estimate that the related costs of diabetes — including medication, supplies, hospital care, and the treatment of complications — will exceed $1 trillion a year by 2045. The catastrophic rise in diabetes won’t be stemmed by medicine alone. That’s why cities need t Continue reading >>
China Facing Largest Diabetes Epidemic In The World, Study Says
WASHINGTON – China is facing the largest diabetes epidemic in the world with around 11 percent of its population suffering from the metabolic illness, while nearly 36 percent are pre-diabetic, according to a U.S. study. The survey, which included 170,287 participants and was conducted in 2013, was analyzed with the assistance of Linhong Wang from the Chinese Center for Disease Control and Prevention and was published in the Journal of the American Medical Association (JAMA). Researchers measured levels of fasting plasma glucose of each participant. Those with levels of 126 milligrams per deciliter or higher were defined as diabetic while those with levels between 105 and 126 mg/dl were defined as pre-diabetic. Hyperglycemia is a result of two anomalies — a malfunction of the pancreas which creates insulin, or the resistance of the body to this hormone. Among the diabetic population in China, 36.5 percent were aware of their diagnosis and 32.2 percent were receiving treatment. Among those being treated, 49.2 percent had adequate glycemic control. Tibetan and Muslim Chinese had significantly lower prevalence of diabetes compared to the majority Han population (14.7 percent for Han, 4.3 percent for Tibetan, and 10.6 percent for Muslim). The adult diabetic rate in China of 10.9 percent is close to that of the United States of 9.3 percent according to 2014 figures recorded by the Centers for Disease Control and Prevention. The Chinese pre-diabetic rate of 35.7 percent was also close to the U.S. rate of 37 percent recorded in 2014. With approximately 1.09 billion adults in China, some 388.1 million were projected to be pre-diabetic (200.4 million men and 187.7 million women). Diabetes is a growing public health problem throughout the world. Some 422 million adults around Continue reading >>
Cost Of Global Diabetes Epidemic Soars To $850 Billion Per Year
The number of people living with diabetes has tripled since 2000, pushing the global cost of the disease to $850 billion a year, medical experts said on Tuesday. The vast majority of those affected have type 2 diabetes, which is linked to obesity and lack of exercise, and the epidemic is spreading particularly fast in poorer countries as people adopt Western diets and urban lifestyles. The latest estimates from the International Diabetes Federation mean that one in 11 adults worldwide have the condition, which occurs when the amount of sugar in the blood is too high. The total number of diabetics is now 451 million and is expected to reach 693 million by 2045 if current trends continue. The high price of dealing with the disease reflects not only the cost of medicines but also the management of a range of complications, such as limb amputations and eye problems. Continue reading >>
Prediabetes: The Epidemic That Never Was, And Shouldn't Be
(Nam Y. Huh / AP) This summer, your TV will begin alerting you to the dangers of high blood sugar. Your phone will buzz with automatic messages assessing the glycemic index of your breakfast bagel. And your Facebook feed will remind you to take the stairs, not the elevator. This is all the result of a recent initiative intended to increase awareness of a condition known as prediabetes. Marked by abnormal but not yet pathological blood sugar levels, prediabetes acts as a risk marker for Type 2 diabetes, a metabolic disease in which the body fails to properly process sugar. The idea is akin to cancer prevention: catch the tumor early (prediabetes) and avoid metastasis (diabetes). According to the most recent Centers for Disease Control and Prevention numbers, prediabetes is becoming a national emergency. In 2014, 86 million adult Americans were said to be prediabetic. This means that 1 in 3 American adults have prediabetes — a figure higher than the number of Americans who currently hold a bachelor's degree. Yet those claims may be scaring more people than they are helping. The United States has the lowest prediabetes cut-off points of high-income countries around the world, meaning that prediabetes gets diagnosed earlier and more frequently, leading to new patients and higher costs. In 2003, and then again in 2010, the American Diabetes Association shifted the prediabetes diagnostic threshold down, from 110 to 100 milligrams per deciliter for the finger-stick glucose test, and from 6.0 to 5.7 percent for the average blood sugar level (the HbA1C test). Other countries have pushed back. So has the World Health Organization, which has cautioned since 2006 that lower thresholds would needlessly double the prevalence of prediabetes and inadvertently implicate patients at mi Continue reading >>
Obesity Fueling Diabetes Epidemic In U.s.
It's easy to tell if your waistline is growing, but many Americans are missing signs of a more serious consequence of obesity: Type 2 diabetes. A new report from the Centers for Disease Control and Prevention reveals almost 1 in 10 Americans has the disease, but a quarter of them don't know it. Type 2 diabetes occurs when the body can't produce enough insulin or can't use the insulin it produces to process glucose. It's associated with being overweight and can be prevented or controlled with a healthy diet and exercise. But the symptoms can be subtle - feeling excessively tired, hungry and thirsty, urinating frequently, and possibly having blurred vision or tingling hands or feet. The number of Americans with Type 2 diabetes jumped by 3 million from 2010 to 2012, and it's expected to grow. More than 1 in 3 American adults currently have prediabetes, meaning their blood glucose levels are higher than normal, but not high enough to be classified as Type 2 diabetes. And minorities are disproportionately affected. Black, Latinos and American Indian adults are about twice as likely to have the disease as white adults. Here's a dive into the diabetes numbers: 29 million The number of Americans who have diabetes, which is 9.3 percent of the U.S. population. This is up from 26 million in 2010, according to the CDC report. 86 million The number of American adults with prediabetes. Without weight loss and exercise, 15 to 30 percent of these people will develop the disease within five years. 90-95% The percentage of diabetes cases that are Type 2. Unlike Type 1, Type 2 is closely linked with obesity and can be prevented or controlled with healthy diet and exercise habits, and sometimes insulin or other medication. 1 in 4 The ratio of Americans who have Type 2 diabetes who don't kn Continue reading >>
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Global Diabetes Epidemic
Photo: Diabetes screening © 2015 Uttam Kamati, Courtesy of K4Health Photoshare How Badly Are Developing Countries Hit? The World Health Organization (WHO)’s first global report on diabetes underscores how diabetes is no longer a disease of predominantly rich nations but is increasing in all regions, including in developing countries. In 2014, there were 422 million cases of diabetes, or 8.5 percent of the world’s population. In 2012 alone, 3.7 million people died from the disease, 1.5 million directly and 2.2 million indirectly. We ask: In which region is diabetes most prevalent? A. Africa B. Americas C. Eastern Mediterranean D. Europe E. South-East Asia Of the six WHO regions, Africa has the lowest prevalence, with 7.1 percent of its population suffering from diabetes. However, diabetes prevalence in Africa has more than doubled since 1980 and 25 million Africans now suffer from the disease, compared to only 4 million in 1980 and it looks like it will continue on a sharp upward direction. Sixty-two million people suffer from diabetes in the Americas, or 8.3 percent of the total population, which is a 344 percent increase since 1980. About one in twelve Americans today has diabetes, compared with one in twenty a generation ago. Nearly one in seven people in the Eastern Mediterranean, or 13.7 percent, suffer from diabetes. There has been an alarming increase in prevalence in this part of the world, which includes the Arabian Gulf countries, Afghanistan, Iran, and Pakistan. The number of sufferers has risen from 6 million in 1980 to 43 million today, a more than 700 percent increase. The Eastern Mediterranean also has the highest mortality rate from diabetes of all WHO regions, 139.6 per 100,000 people aged 20+. With 7.3 percent of its population suffering from diabe Continue reading >>
The Diabetes Epidemic Still Has A Disproportionate Impact On Some Americans
HuffPost joined The Forum at the Harvard T.H. Chan School of Public Health on World Diabetes Day to discuss the scope of the diabetes epidemic in the United States, including the disproportionate impact on communities of color, among pregnant women and in poor and underserved communities. Please follow along in the video below. Continue reading >>
1 Type 2 Diabetes: A 21st Century Epidemic
Around 415 million people around the world have diabetes (9% of adults), and the vast majority live in low- and middle-income countries. Over the next decade, this number is predicted to increase to 642 million people. Given that diabetes is a major cause of mortality, morbidity, and health care expenditures, addressing this chronic disease represents one of the greatest global health challenges of our time. The objectives of this article are three-fold: (1) to present data on the global burden of type 2 diabetes (which makes up 87–91% of the total diabetes burden), both in terms of prevalence and incidence; (2) to give an overview of the risk factors for type 2 diabetes, and to describe obesity and the developmental origins of disease risk in detail; and (3) to discuss the implications of the global burden and point out important research gaps. Continue reading >>
China's Looming Diabetes Epidemic
A diabetes patient shows diabetes specialist Doctor Tong Xiao Lin (2nd L) her tongue during a medical check-up at the Guanganmen Chinese medicine Hospital in Beijing. (David Gray/Reuters) These days we’ve been used to China being the land of “the first,” “the largest” and “the highest.” However, not all of these superlatives are worthy of praise. China now has the largest diabetic population in the world (114 million), according to a recent study published by the Journal of the American Medical Association (JAMA). Even more shocking is that China’s diabetes prevalence has increased from 1 percent in 1980 to 11.6 percent in 2010, which is even higher than the United States (11.3 percent). And the worst is yet to come. Indeed, 493 million people, or one in two adults, in China are thought to have prediabetes, or abnormally high blood sugar levels that presage the disease. According to Dr. Ji Linong, a leading Chinese expert on diabetics, each year, six to seven percent of those with prediabetes—amounting to approximately 30 million—will be added to the diabetes population estimate. If this true, China’s diabetes population already exceeds 130 million. (A 2010 article in the New England Journal of Medicine forecasted China would reach this benchmark by 2030.) The high diabetes prevalence in China reflects a combination of genetic and environmental influences. Other things being equal, Asians are more likely than Caucasians to develop diabetes even at a body weight considered “normal” by mainstream western standards. Also, more than half of the Chinese live in cities (as opposed to 20 percent in 1980); 9 percent of the population are aged over 65 (as opposed to 5 percent in 1982). In addition, Chinese are leading increasingly sedentary lives while Continue reading >>
How Diabetes Became An Epidemic
It is estimated that almost 8 percent of Americans have some form of diabetes. What's even more worrying is that the number of people with diabetes is on the rise not just in the United States, but all over the world. Scientists have been working to find out why more people are developing diabetes and looking for strategies to help reverse this trend. Diabetes in the United States In the United States, diabetes has become increasingly prevalent in recent years. In 1980, 5.8 million people were diagnosed with diabetes, compared with 17.9 million today. Diabetes is expected to rise significantly in the near future. It is estimated that one in three Americans living today will eventually develop diabetes, and that the number of cases will increase in this country by 165 percent by 2050. Researchers believe that the following factors play a role in the increase: The baby-boomer population is aging, and your chances of developing diabetes increases with age. The Hispanic population is one of the fastest-growing segments of the United States population, and Hispanics are at increased risk of developing diabetes. Americans are becoming increasingly overweight and physically inactive, both known risk factors for diabetes. The Worldwide Diabetes Epidemic Diabetes is now a problem that affects people everywhere. There is evidence that 246 million people worldwide have diabetes. If current trends continue, this number is projected to reach 380 million within the next 20 years. Diabetes affects developed and developing countries alike. In fact, the largest increases in diabetes prevalence in the years to come are projected to take place in developing countries. According to the International Diabetes Federation, India currently has the highest concentration of people with diabetes, Continue reading >>
The Great Diabetes Epidemic
In the past few months, there have been two deaths from Ebola in the United States, and half a dozen patients with the disease have been transferred from West Africa to specialized U.S. facilities for treatment. Americans are panicking about a U.S. Ebola epidemic, which has evoked a loud call for public health action — and generated efforts focused on prevention and vaccine development. Now compare that response to the lack of public outcry about the 281,400 deaths in 2010 from a different epidemic: Diabetes mellitus! That number is about the population of Toledo, Ohio, but the nation has not yet truly mobilized to address this very real threat. In 1994, the head of the Centers for Disease Control and Prevention’s (CDC) diabetes program declared that diabetes had reached epidemic proportions and should be considered as a major public health problem. Yet, in the last 20 years, we have failed to apply a dedicated and focused public health approach to diabetes; as a result, Type 2 Diabetes’ incidence has tripled, and deaths and serious complications have skyrocketed. As of 2012, almost 30 million people in the U.S. were thought to have Type 2 Diabetes — more than 9 percent of the population.1 Over one-quarter (27 percent) of those individuals have not been diagnosed and are not in treatment.2 An additional 86 million have pre-diabetes and are at-risk for developing diabetes (up from 79 million in 2010); of these, 90 percent are unaware of their condition, and 5 to 10 percent will progress to full diabetes annually.3 Diabetes occurs when the body either does not make enough insulin or cannot use it effectively. Type 2 Diabetes is the gateway to many serious complications, as the excess blood sugar (hyperglycemia) results in progressive damage to large and small bloo Continue reading >>
Diabetes: The Epidemic That Indians Created
Sharad Tripathi of Meerut developed diabetes five years ago, at 33, “no thanks to the stressful life of a sales person that involves a lot of travel, eating out and irregular meal times, and no time for exercise". Just when Tripathi learnt to manage his condition — with medication and lifestyle changes — his mother, in her mid-60s, developed diabetes. Tripathi found himself sharing the dos and don’ts of living with diabetes with his parents. The family’s predicament indicates how fast the disease is sweeping India, enveloping entire generations, ignoring age and setting new global records, as it trebled over the past two decades. (World Diabetes Day: 10 Healthy Snacks for People with Diabetes) In 1995, India had 19.4 million diabetics. Within 19 years, that number had more than tripled to 66.8 million in 2014, according to the International Diabetes Federation (IDF). That makes India, home to 17 percent of the world’s population, also home to 17 percent of the world’s diabetics. Another 77 million Indians are currently believed to be pre-diabetic, according to the Indian Council of Medical Research. In 2010, diabetes stood 18th in the list of diseases by years of life lost, up from 31 in 1990, as per the Global Burden of Disease Study 2010. Deaths attributable to diabetes grew 41 percent from 161,000 to 227,300 between 2000 and 2012, according to the World Health Organisation. That increase was enough to catapult diabetes into the top 10 of killer diseases in India. The IDF pegs annual deaths due to diabetes in India at more than one million, possibly because poorly controlled diabetes brings on other killer diseases. Diabetes in India now cuts across all age groups and geographies. Although it is more prevalent in urban areas, rural India will catch up as Continue reading >>
