Globally, an estimated 422 million adults were living with diabetes in 2014, compared to 108 million in 1980. The global prevalence of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population. This reflects an increase in associated risk factors such as being overweight or obese. Over the past decade, diabetes prevalence has risen faster in low and middle-income countries than in high-income countries.
Diabetes is a major cause of blindness, kidney failure, heart attack, stroke and lower limb amputation. Healthy diet, physical activity and avoiding tobacco use can prevent or delay type 2 diabetes. In addition diabetes can be treated and its consequences avoided or delayed with medication, regular screening and treatment for complications.
In 2007 General Assembly adopted resolution 61/225 designating 14 November as World Diabetes Day. The document recognized “the urgent need to pursue multilateral efforts to promote and improve human health, and provide access to treatment and health-care education.”
The resolution also encouraged Member States to develop national policies for the prevention, treatment and care of diabetes in line with the sustainable development of their health-care systems.
The theme for World Diabetes Day 2021-23 is access to diabetes care.
100 years after the discovery of insulin, millions of people with diabetes around the world cannot access the care they need. People with diabetes require ongoing care and support to manage their condition and avoid complications.
The centenary of the discovery of insulin presents a unique opportunity to bring about meaningful change for the more than 460 million people living with diabetes and the millions more at risk. United, the global diabetes community has the numbers, the influence and the determination to bring about meaningful change. We need to take on the challenge.
Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose in the blood (hyperglycaemia).
Type 1 diabetes (previously known as insulin-dependent or childhood-onset diabetes) is characterized by a lack of insulin production.
Type 2 diabetes (formerly called non-insulin-dependent or adult-onset diabetes) is caused by the body’s ineffective use of insulin. It often results from excess body weight and physical inactivity.
Gestational diabetes is hyperglycaemia that is first recognized during pregnancy.
Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves.
Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes (2).
Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation.
Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. Close to 1 million people are blind due to diabetes (3).
Diabetes is among the leading causes of kidney failure (4).
People with diabetes are more likely to have poor outcomes for several infectious diseases, including COVID-19.
Lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:
achieve and maintain a healthy body weight;
be physically active – doing at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control;
eat a healthy diet, avoiding sugar and saturated fats; and
avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease.
Early diagnosis can be accomplished through relatively inexpensive testing of blood glucose.
Treatment of diabetes involves diet and physical activity along with lowering of blood glucose and the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications.
Interventions that are both cost-saving and feasible in low- and middle-income countries include:
blood glucose control, particularly in type 1 diabetes. People with type 1 diabetes require insulin, people with type 2 diabetes can be treated with oral medication, but may also require insulin;
blood pressure control; and
foot care (patient self-care by maintaining foot hygiene; wearing appropriate footwear; seeking professional care for ulcer management; and regular examination of feet by health professionals).
Other cost saving interventions include:
screening and treatment for retinopathy (which causes blindness);
blood lipid control (to regulate cholesterol levels);
screening for early signs of diabetes-related kidney disease and treatment.
WHO aims to stimulate and support the adoption of effective measures for the surveillance, prevention and control of diabetes and its complications, particularly in low- and middle-income countries. To this end, WHO:
provides scientific guidelines for the prevention of major noncommunicable diseases including diabetes;
develops norms and standards for diabetes diagnosis and care;
builds awareness on the global epidemic of diabetes, marking World Diabetes Day (14 November); and
conducts surveillance of diabetes and its risk factors.
The WHO Global report on diabetes provides an overview of the diabetes burden, interventions available to prevent and manage diabetes, and recommendations for governments, individuals, the civil society and the private sector.
The WHO module on diagnosis and management of type 2 diabetes brings together guidance on diagnosis, classification and management of type 2 diabetes in one document.
In April 2021 WHO launched the Global Diabetes Compact, a global initiative aiming for sustained improvements in diabetes prevention and care, with a particular focus on supporting low- and middle-income countries. The Compact is bringing together all stakeholders to work on a shared vision of reducing the risk of diabetes and ensuring that all people who are diagnosed with diabetes have access to equitable, comprehensive, affordable and quality treatment and care.
In May 2021, the World Health Assembly agreed a Resolution on strengthening prevention and control of diabetes. It recommends action in areas including increasing access to insulin; promoting convergence and harmonization of regulatory requirements for insulin and other medicines and health products for the treatment of diabetes. In May 2022 the World Health Assembly endorsed five global diabetes coverage and treatment targets to be achieved by 2030.