News & Commentary

WHO: Diabetes No Longer A Rich-Country Problem


Eating more doesn’t mean you eat better, might be one lesson taken from a study by the World Health Organization that tracks a dramatic worldwide rise in diabetes. That goes hand-in-hand with this shocker: The number of people living in extreme poverty (less than the equivalent of $1.90 a day) dipped to 10% last year for the first time in human history, according to the World Bank. And—get this—poverty might actually end by 2030.

Yet every silver lining has its cloud, and the quarter-century march that just might end world hunger not only spreads the wealth but also ill health, in this case in the form of problems that come from eating more poorly.

Diabetes, a once-near exclusive first world problem, now disproportionately affects poorer parts of the planet, according to WHO in its Global Report on Diabetes published in April. That this is the organization’s first such study of the problem can be taken as an indicator of just how much diabetes has grown as a worldwide problem.

The unrelenting march of diabetes

% prevalence and number of adults with diabetes by WHO region in 1980 and 2014*

* Millions of people and % of total regional population

Source: World Health Organization, Global Report on Diabetes, April 2016

Map of world with countries, multicolor, by FreeVectorMaps.com

Prevalence of the disease nearly doubled since 1980, from 4.7% to 8.5% of the world’s adult population. “The percentage of deaths attributable to high blood glucose or diabetes that occurs prior to age 70 is higher in low- and middle-income countries than in high-income countries,” the WHO report states.

WHO estimates that most of the 422 million adults with diabetes now live in low-income countries. Prevalence rose from just over 5% to about 7% in high-income countries. Rates in low-income countries rose from just over 3% to more than 7%, a rate of growth that overtook high-income countries for the first time.

The WHO report says that diabetes has become a problem in poor countries because of the growing number of people who are overweight and obese. Around the world, children are getting heavier, so type 2 diabetes, once exclusively an adult disease, is affecting children, noted WHO.

That diabetes caused 1.5 million deaths in 2012 tells only part of the story, because diabetes is a causal factor in heart disease, stroke, and kidney disease. In WHO’s reckoning, higher-than-optimal blood glucose was culpable in an additional 2.2 million deaths.

So, who you gonna call? Well, WHO wants those at risk to depend on primary care physicians and their basic diagnostic tools, such as blood glucose tests. Good luck with that. “In general, primary health care practitioners in low-income countries do not have access to the basic technologies to help people with diabetes properly manage their disease,” the report states. In addition, low-income countries face a lack of access to insulin and oral hypoglycemics because they are priced too high for their budgets.

Preventing diabetes often comes down to lifestyle, and the WHO urges countries to do all they can to help prevent people from becoming overweight or obese by making healthy foods available.

Margaret Chan, the WHO’s director general, said the findings show an urgent need to address unhealthy diets and lifestyles around the world.

“If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active, and avoid excessive weight gain,” Chan said in a prepared statement. “Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes.”