The global challenge of diabetes

Key demographic, economic, social and cultural changes across the world are influencing the growing number of people with diabetes, particularly in low- and middle-income settings. Overcoming diabetes is a many sided and complex challenge for individuals, populations and health systems.

To plan and evaluate effective public health intervention strategies for diabetes we need to know some key data:

• How many people have diabetes in our population at present?
• What are the rates of the complications caused by the disease?

A recent report from the Lancet commission clearly highlights the challenges health systems face from lack of data:

“Most countries do not have data or data collection systems that are sufficiently reliable to enable mounting of a commensurate health-system response. To plan such a response requires high-quality, population-representative data on both current burdens and associated demographic factors and that systems for longitudinal data collection be put in place.”
(Zhou et al. 2016)

Worldwide prevalence trends of diabetes have been estimated from a range of carefully selected population based studies. Considerable research needs to be undertaken to understand the complex interactions between obesity, socioeconomic status and type 2 diabetes.

For example, to understand the high prevalence of diabetes in low and middle income countries research has been undertaken to understand the impact of the “thrifty phenotype” which describes obesity related health problems that occur later in life amongst people who have experienced poor nutrition during foetal and early life.

Scarcity of high quality data further limits our ability to reliably appreciate trends over time and consider the burden of complications from diabetes. Responsive health systems need to identify and manage diabetes earlier.

As you watch this video, consider why it is important to have information on magnitude and trends in diabetes. How can we use it to influence patient care?