Preview
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar levels. Hyperglycemia, also called high blood sugar or high blood sugar, is a common effect of uncontrolled diabetes and, over time, leads to serious damage to many body systems, especially nerves and blood vessels.
In 2014, 8.5% of adults aged 18 and older had diabetes. In 2019, diabetes was the direct cause of 1.5 million deaths and 48% of all diabetes deaths occurred before the age of 70. Another 460,000 deaths from kidney disease were caused by diabetes, and increased blood sugar is responsible for about 20% of cardiovascular deaths. (1).
Between 2000 and 2019, age-standardized diabetes-related mortality rates increased by 3%. In lower-middle-income countries, the mortality rate from diabetes increased by 13%.
In contrast, the probability of dying from one of the four main noncommunicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases or diabetes) between the ages of 30 and 70 decreased by 22% globally between 2000 and 2019.
Symptoms
Symptoms of diabetes can appear suddenly. In type 2 diabetes, symptoms may be mild and take several years to appear.
Symptoms of diabetes include:
- to be very thirsty
- needing to urinate more often than usual
- Blurred vision
- Feeling tired
- lose weight unintentionally
Over time, diabetes can damage blood vessels in the heart, eyes, kidneys and nerves.
People with diabetes are at higher risk of health problems, including heart attack, stroke and kidney failure.
Diabetes can cause permanent vision loss by damaging the blood vessels in the eyes.
Many people with diabetes develop foot problems due to nerve damage and poor blood circulation. This can cause foot ulcers and lead to amputation.
Type 1 diabetes
Type 1 diabetes (formerly called insulin-dependent, juvenile or infantile) is characterized by deficient insulin production and requires daily insulin administration. In 2017, 9 million people suffered from type 1 diabetes; the majority of them live in high-income countries. Neither its cause nor the means to prevent it are known.
Type 2 diabetes
Type 2 diabetes affects how your body uses sugar (glucose) for energy. It prevents the body from using insulin properly, which can lead to high blood sugar levels if left untreated.
Over time, type 2 diabetes can cause serious damage to the body, including nerves and blood vessels.
Type 2 diabetes is often preventable. Factors that contribute to the development of type 2 diabetes include being overweight, lack of exercise and genetics.
Early diagnosis is important to prevent the worst effects of type 2 diabetes. The best way to detect diabetes early is to have regular checkups and blood tests with a healthcare professional.
Symptoms of type 2 diabetes may be mild. It may take several years to notice them. Symptoms may resemble those of type 1 diabetes but are often less severe. As a result, the disease can be diagnosed several years after its onset, when complications have already appeared.
More than 95% of people with diabetes have type 2 diabetes. Type 2 diabetes was formerly called non-insulin-dependent diabetes or adult-onset diabetes. Until recently, this type of diabetes was only seen in adults, but now it is becoming more and more common in children.
Gestational Diabetes
Gestational diabetes is hyperglycemia characterized by blood glucose values above normal but below those diagnostic of diabetes. Gestational diabetes occurs during pregnancy.
Women with gestational diabetes are at increased risk of complications during pregnancy and childbirth. These women and possibly their children are also at increased risk of type 2 diabetes in the future.
Gestational diabetes is diagnosed through prenatal screening rather than reported symptoms.
Impaired glucose tolerance and impaired fasting blood sugar
Impaired glucose tolerance (IGT) and impaired fasting blood glucose (IFG) are intermediate conditions in the transition from normality to diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.
Prevention
Lifestyle changes are the best way to prevent or delay the onset of type 2 diabetes.
To help prevent type 2 diabetes and its complications, people should:
- achieve and maintain a healthy weight
- stay physically active with at least 30 minutes of moderate exercise each day
- eat healthily and avoid sugar and saturated fats
- do not smoke tobacco.
Diagnosis and treatment
Early diagnosis can be made with relatively inexpensive blood sugar tests. People with type 1 diabetes need insulin injections to survive.
One of the most important ways to treat diabetes is to maintain a healthy lifestyle.
Some people with type 2 diabetes will need to take medication to help them manage their blood sugar levels. These may include insulin injections or other medications. Here are some examples :
- metformin
- sulfonylureas
- sodium-glucose cotransporter 2 (SGLT-2) inhibitors.
In addition to medications to lower blood sugar, people with diabetes often need medications to lower their blood pressure and statins to reduce the risk of complications.
Additional medical care may be needed to treat the effects of diabetes:
- foot care to treat ulcers
- kidney disease screening and treatment
- eye exams to check for retinopathy (which causes blindness).
WHO response
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. For this purpose, WHO:
- provides scientific guidelines for the prevention of major noncommunicable diseases, including diabetes;
- develops norms and standards for the diagnosis and care of diabetes;
- raises awareness of the global diabetes epidemic, on World Diabetes Day (November 14); And
- monitors diabetes and its risk factors.
In April 2021, WHO launched the Global Diabetes Compact, a global initiative to sustainably improve diabetes prevention and care, with a particular focus on supporting low- and middle-income countries.
In May 2021, the World Health Assembly adopted a resolution on strengthening diabetes prevention and control. In May 2022, the World Health Assembly approved five global targets for diabetes coverage and treatment to be achieved by 2030.
The references
1. Global Collaborative Network on Burden of Disease. Global Burden of Disease Study 2019. Results. Institute for Health Metrics and Evaluation. 2020 (https://vizhub.healthdata.org/gbd-results/).
2. Diabetes mellitus, fasting blood glucose and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Collaboration on emerging risk factors. Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio et al. Lancet. 2010; 26; 375:2215-2222.
3. Causes of blindness and visual impairment in 2020 and 30-year trends, and prevalence of avoidable blindness compared to VISION 2020: The right to sight: an analysis for the GBD 2019 Global Burden of Disease Study Contributors on blindness and visual impairment* on behalf of the Global Burden of Disease Study Vision Loss Expert Group† Lancet Global Health 2021;9:e141-e160.
4. USRDS 2014 Annual Data Report: Epidemiology of Kidney Disease in the United States.
United States Renal Data System. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2014: 188-210.
