The World Health Organization (WHO) has recently updated its fact sheet on diabetes.

Background Information:

Insulin is a hormone that regulates blood sugar.

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.

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.

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

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

Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes, occurring during pregnancy. Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.

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

Key Messages:

The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.

The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014.

Diabetes prevalence has been rising more rapidly in middle- and low-income countries.

Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

In 2016, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.

Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. WHO estimates that diabetes was the seventh leading cause of death in 2016.

Clinical Features:

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

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:

• 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.

Consequences:

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.
• 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.
• Diabetes is among the leading causes of kidney failure

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 diabetes.

Prevention:

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.

The consequences of diabetes can avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.

Useful Links:

Link to the updated WHO fact sheet:

http://www.who.int/news-room/fact-sheets/detail/diabetes

Link to WHO infographic on diabetes (English) [PDF]:

Click to access WHD2016_Diabetes_Infographic_v2.pdf