Diabetes

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Diabetics in Senegal are using mobile technology to manage their condition and improve their health through the Be He@lthy, Be Mobile initiative. Photo: Government of Senegal
Treating diabetes takes more than insulin: Senegal mobile phone project promoting public health
Diabetes

    Overview

    Infectious diseases, HIV/AIDS and poverty have traditionally dominated the African Region but diabetes has become a new priority. Diabetes occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.

    The main symptoms of diabetes include increased thirst, needing to urinate more often than usual, and increased hunger. There are three different types of diabetes called type 1, type 2 and gestational diabetes. Surveys carried out recently in the African Region indicate that up to 15% of adults aged 25 to 64 have diabetes. Diabetes is often a silent condition and a significant number of people are unaware that they have the disease.

    Diabetic patients often lack access to proper treatment and diabetic medications, especially insulin, resulting in avoidable complications. Complications include neurological, vascular or visual disorders, heart disease, stroke, lower limb amputation, kidney failure and many other chronic conditions.

    Diabetes in the Region is a serious, chronic and costly disease that is estimated to rise to 23.9 million cases by 2030. Diabetes risk factors include physical inactivity, overweight and obesity, tobacco use and consuming foodstuffs that are high in bad fats and calories.

    Related Health Topics

    World Diabetes Day

    Each year on November 14, the World Health Organization Regional Office for Africa joins the international community in commemorating World Diabetes Day. This is a day to re-commit ourselves to strengthening the prevention and control of diabetes in our region. This year the day is commemorated under the theme “Women and diabetes - our right to a healthy future”.

    Globally, 205 million women – live with diabetes. In the African region, in 2014, it was estimated that 22.9% of men and 38.6% of women above the age of 18 were obese. Overweight and obesity are risk factors for cardiovascular disease, diabetes and some cancers in later life. During pregnancy some women may experience a temporary rise in blood glucose above normal but still below those diagnostic of diabetes. This condition is commonly referred to as gestational diabetes. Overweight or obesity or excess weight-gain during pregnancy increases the risk of gestational diabetes or diabetes in pregnancy. Diabetes in pregnancy and gestational diabetes increase the risk of future obesity and type 2 diabetes, as well as complications during pregnancy, labour and delivery including stillbirth.

    Healthy diet, physical activity and avoiding tobacco use can prevent or delay type 2 diabetes.

    The World Diabetes Day 2017 campaign promotes affordable and equitable access for all women with diabetes or at risk of diabetes to the essential medicines and technologies, self-management education and information they require to achieve optimal diabetes outcomes and strengthen their capacity to prevent type 2 diabetes.

    Message of the WHO Regional Director for Africa Dr Matshidiso Moeti on World Diabetes Day, 14 November 2017

    Related Links

    More on diabetes 

    Factsheet on diabetes

    Diabetes country profiles 2016

    Factsheet

    Key Facts

    • The number of people with diabetes has risen from 108 million in 1980 to 422 million in 20141.
    • The global prevalence of diabetes* among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 20141.
    • Diabetes prevalence has been rising more rapidly in middle- and low-income countries1.
    • Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation1.
    • In 2012, an estimated 1.5 million deaths were directly caused by diabetes and another 2.2 million deaths were attributable to high blood glucose**1.
    • Almost half of all deaths attributable to high blood glucose occur before the age of 70 years1. WHO projects that diabetes will be the 7th leading cause of death in 2030 2.
    • Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes1.
    • Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications1.
    What is diabetes?

    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 3. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels 3.

    In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2012 diabetes was the direct cause of 1.5 million deaths and high blood glucose was the cause of another 2.2 million deaths1.

    Type 1 diabetes

    Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin 3. The cause of type 1 diabetes is not known and it is not preventable with current knowledge.

    Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes and fatigue. These symptoms may occur suddenly.

    Type 2 diabetes

    Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body’s ineffective use of insulin 3. Type 2 diabetes comprises the majority of people with diabetes around the world 3, and is largely the result of excess body weight and physical inactivity.

    Symptoms may be similar to those of Type 1 diabetes, but are often less marked. As a result, the disease may be diagnosed several years after onset, once complications have already arisen.

    Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.

    Gestational diabetes

    Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes, occurring during pregnancy 4. Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. They and their children are also at increased risk of type 2 diabetes in the future.

    Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.

    Impaired glucose tolerance and impaired fasting glycaemia

    Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes 3. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.

    What are common consequences of diabetes?

    Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves:

    • Adults with diabetes have a 2-3-fold increased risk of heart attacks and strokes 5.
    • 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. 2.6% of global blindness can be attributed to diabetes 6.
    • Diabetes is among the leading causes of kidney failure 7.
    How can the burden of diabetes be reduced?

    Prevention

    Simple 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 healthy body weight;
    • be physically active – 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 intake; and
    • avoid tobacco use – smoking increases the risk of diabetes and cardiovascular diseases.
    Diagnosis and treatment

    Early diagnosis can be accomplished through relatively inexpensive testing of blood sugar.

    Treatment of diabetes involves diet and physical activity along with lowering 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 developing countries include 8:

    • 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.

    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 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. To this end, WHO:

    • provides scientific guidelines for the prevention of major NCDs 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);
    • conducts surveillance of diabetes and its risk factors.

    The “WHO Global report on diabetes” provides an overview of the diabetes burden, the interventions available to prevent and manage diabetes, and recommendations for governments, individuals, the civil society and the private sector.

    The WHO “Global strategy on diet, physical activity and health” complements WHO's diabetes work by focusing on population-wide approaches to promote healthy diet and regular physical activity, thereby reducing the growing global problem of overweight people and obesity.


    * Defined as fasting blood glucose equal to or higher than 7 mmol/L, or on medication for raised blood glucose, or with a history of diagnosis of diabetes.

    ** High blood glucose is defined as a distribution of fasting plasma glucose in a population that is higher than the theoretical distribution that would minimize risks to health (derived from epidemiological studies). High blood glucose is a statistical concept, not a clinical or diagnostic category.

    Multimedia

    World Health Day 2016: Beat diabetes
    World Health Day 2016: Beat diabetes