The Global Epidemic of Diabetes - Essay Example

Diabetes: The Global Epidemic Every year, 3.3 million people die of diabetes-related illnesses. Along with a rapid increase in socio-economic development, standard of living, and age of populations in many societies, the incidence and prevalence of diabetes increases annually. A recent study estimates that 170 million people world-wide have diabetes; this figure is predicted to double by the year 2025. By this time, most diabetics in developed countries will be 65 or over, while in developing countries most will be in the 45-64 range. In terms of incidence rate and mortality, diabetes is one of the five most significant diseases in the world. Diabetes threatens not only the health of individuals, but has also become a significant public health concern. EASD1 suggests the spread of Type 2 diabetes is so rapid that it is approaching epidemic levels. To supply adequate care to those with diabetes, and educate populations about prevention of the disease, quantifying the presence of diabetes in different populations is crucial. Diabetes is a serious illness with multiple complications and premature mortality, accounting for at least 10% of total health care expenditure in many countries. Complex methods have been developed for estimating cause-specific mortality for some conditions (AIDS, tuberculosis) but not for diabetes. Based on routine statistics, recent WHO reports estimated mortality from diabetes in the world as 987,000 deaths for the year 2002, which was 1.7% of total world mortality. Mortality attributable to diabetes may actually be much higher, because individuals with diabetes most often die of cardiovascular and renal disease. The rapid increase of diabetes worldwide is primarily a consequence of population growth, population aging, urbanization, and the increasing prevalence of obesity and physical inactivity. Many efforts have been made to explain the causes of Type 2 diabetes. While the pathogenesis of this disease is still not completely understood, it is known that both genetic susceptibility and environmental influences play a role. Diabetes has become a major health problem in many developed countries, and in developing countries the prevalence of Type 2 diabetes has increased significantly in recent years. In China, the prevalence has almost tripled within the last 15 years, from 1% to about 3%. An urbanized, more sedentary lifestyle and unhealthy diet are thought to contribute greatly to the increase in diabetes and obesity in all ethnic groups. For example, around 90% of all Singaporeans live in high rise government or private apartments. An efficient public transportation system, as well as a policy of decentralizing schools, markets and services to local neighborhoods, means that people walk less and climb fewer steps. The government has made it a point to provide exercise facilities in every neighborhood, but 54.7% of respondents in the National Health Survey of 1998 reported no exercise participation. (Lee) The WHO estimates that the prevalence of diabetes for all age groups world-wide will increase from 2.8% to 4.4% by 2030. Currently, more men suffer from diabetes than do women, however by 2030 this trend is predicted to reverse. It is also thought that urban populations in developing countries will experience an increased rate of prevalence compared to rural populations. Urbanization is used as a measure of increased risk factors which are assumed to be more prevalent in urban areas compared to urban areas. These factors are diet, obesity, decreased physical activity, and secondary factors such as stress. The most important predicted demographic change is the increase in prevalence among those under 65 years of age. The global burden of diabetes will more than double over the next 25 years, to reach a total of 366 million by 2030. Most of this increase will occur as a result of a 150% rise in developing countries. Projections of the number of people with diabetes in 2030 take into account the fact that there will be more people in the world and that there will be more elderly people. They also take into account trends in urbanization – the fact that people are moving from rural areas to cities, particularly in developing countries. This affects the number of people who are likely to have diabetes, because people living in cities in developing countries tend to be less physically active and have higher levels of overweight and obesity than people in rural areas. In developing countries, most diabetics are aged 45-64. In these countries three-quarters of all people with diabetes are under 65 years old and 25 % of all adults with diabetes are younger than 44. In developed countries, more than half of all people with diabetes are older than 65, and only 8% of adults with diabetes are younger than 44. By 2030, it is estimated that the number of people with diabetes ≥ 64 years of age will be more than 82 million in developing countries and more than 48 million in developed countries. A WHO estimate of excess deaths due to diabetes and the percentage of total mortality in each region are presented in Table 2. Global excess mortality attributable to diabetes is estimated at 2.9 million deaths (1 million in developed countries and 1.9 million in developing countries), which is equivalent to 5.2% of mortality in the year 2000. Overall, 7.5 million people with diabetes are estimated to have died in the year 2000. This includes 4.6 million people with diabetes assumed to have died from causes other than diabetes, plus the excess 2.9 million that died because of diabetes. In individuals with diabetes younger than 35 years, 75% of all deaths were attribute to diabetes; in individuals with diabetes aged 35-64 years, 59% of deaths were attribute to diabetes; while in individuals with diabetes and older than 64 years, 29% of all deaths were attributable to diabetes. In the U.S., the prevalence of diabetes in adults aged 17-49 has increased rapidly since 1998. In 2003, the number of diabetes patients was 13.8 million – an increase of 41% over 1997 figures. The latest estimate is that there are over 18 million diabetics in the U.S. The causes of this rapid increase include an aging population, reduced diagnosis standards, and changes in consciousness of health prevention. The most important problem is the rapid increase of obesity and overweight in America. In a survey carried out in American states, the incidence rate of obesity and overweight was estimated at 20-25%. Around 20% of obese people are also diabetics. This chronic disease has become a huge economic burden in America – in 2002 the total health cost of diabetes was 131.6 billion dollars. In contrast, diabetes scientific research investment from the National Institute of Health and ADA is 790 million dollars and 140 million dollars respectively – less than 10% of the total health cost of diabetes. By 2030 the estimated cost of diabetes in America will top 250 billion dollars annually, and just 2.5 billion will be spent on diabetes research each year. Both developed and developing countries lack effective prevention strategies for this incurable disease. This may prove to be an even bigger problem in developing countries, which also lack the resources to provide adequate care for the growing number of patients. Prevalence of diabetes in the WHO Western Pacific Region Country 2000 2030 Australia 941,000 1,673,000 Brunei Darussalam 18,000 49,000 Cambodia 110,000 317,000 China 20,757,000 42,321,000 Cook Islands 700 1,300 Fiji 37,000 72,000 Japan 6,765,000 8,914,000 Kiribati 4,000 7,000 Lao Peoples Dem. Rep. 46,000 128,000 Malaysia 942,000 2,479,000 Marshall Islands 2,000 4,000 Federated States of Micronesia 5,000 13,000 Mongolia 34,000 81,000 Nauru 2,000 4,000 New Zealand 179,000 307,000 Niue Read More