In 2018, Nam Han Cho, then-President of the International Diabetes Federation (IDF), referred to the epidemic of this disease as “World War III,” comparing the one and a half million deaths a year to the casualties of a war. The exaggeration shows the desperation of some experts at the inexorable progression of the disease and the difficulty in making society aware of its extent. Today, the medical journal The Lancet is publishing a series of articles reiterating the threat posed by diabetes, which it believes is not being addressed with the right tools.
According to estimates published in the journal, around 1.3 billion people worldwide will be living with diabetes by 2050, more than double the 529 million affected today. 90% will be people with type 2 diabetes, a disease associated with obesity, diet, alcohol or tobacco use, and lack of physical activity, and closely related to poverty. In the US, diabetes is 1.5 times more common among minorities such as blacks or Native Americans, a problem that the authors of The Lancet articles attribute in part to structural racism.
In an editorial also published today, the journal warns of the wrong way many people approach diabetes. Despite the success of new drugs against the disease, which also help reduce obesity, “the solution to unhealthy and unfair societies lies not in more pills, but in re-evaluating and re-thinking our lives to create opportunity, racism and justice and to respond to the social factors of the disease,” they affirm, citing doctor Rupa Marya and economist Raj Patel. The diabetes drug market is projected to grow to $100 billion in the next decade, by some estimates, and could reach 10 times that number by 2045. However, as with many other diseases, these are more treatable with timely adoption of healthy habits than medication, when it is almost too late efforts to prevent diabetes are not given the attention they deserve. In 2018, European Union countries spent an average of 2.8% of their healthcare spending on prevention.
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For some time, experts have been emphasizing the need to include poverty as a fundamental factor to be addressed in order to improve health. The Lancet’s wake-up call estimates that by 2045, up to three in four adults with diabetes worldwide will be living in low- and middle-income countries. Today, only about 10% of people suffering from this disease receive adequate treatment. However, the growing burden of diabetes is not unique to countries with fewer resources. In the US, the prevalence of the disease has almost doubled among young people, who are increasingly exposed to all types of foods that increase the risk of obesity and a sedentary lifestyle. As with all diseases in every part of the world, the poor, most of whom are Black or Native American, are the ones who suffer from the rise of world power.
Given current trends, no country is expected to reduce its proportion of diabetics, and there will be regions such as North Africa or the Middle East where rates will reach 20%. “Diabetes remains one of the greatest public health threats of our time and will increase rapidly in all countries, regardless of age or gender, over the next three decades and pose a major challenge to health systems around the world,” says Shivani Agarwal of from the Albert Einstein School of Medicine in New York (USA). Agarwal, who directed this series of articles, states that “focusing on understanding inequalities in diabetes is critical to achieving the UN Sustainable Development Goals, which seek to reduce noncommunicable diseases.” [como el cáncer o la diabetes] by 30% in less than seven years, reducing the growing negative impact on the health of marginalized populations and on the strength of economies for decades to come,” he adds.
The series cites success stories of helping communities with fewer resources, such as in some sub-Saharan African countries, where collaboration between governments, industry and patient groups has made it possible to increase access to insulin and other healthcare products with measurable reductions in impact illness.
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