‘IDF predicts that the number of people with diabetes will rise to 552 million by 2030’

By On Nov 15, 2012

India is the uncrowned ‘Diabetes capital of the world’ and this silent killer is one of the major healthcare on the country’s horizon. Hence, International Diabetes Federation (IDF) has chosen India as the focal country for its activities on this World Diabetes Day that falls on November 14. Professor Jean Claude Mbanya, President, IDF talks to Lakshmipriya Nair about the IDF’s focus this year, the various activities planned and the steps that can be implemented to curb diabetes in India.

IDF’s focus for this World Diabetes Day is “Diabetes education and prevention’. So what’s in store on this front for this year?

This year’s World Diabetes Day campaign is a global call to action for protecting the health of our future generations. It aims to convey the urgency with which the diabetes epidemic must be approached and focus on the changes in our behaviour, from the individual to the multinational-corporation level, that will help to protect the future of individuals and communities. In order to reduce the impact of diabetes, basic knowledge on the prevention and optimal management of the disease much reach the hands of people with diabetes, those at risk and our healthcare providers. Policy makers must also be made aware of the socio-economic benefits of our messages, and spurred into action by an informed general public.

Young people are the driving force behind our activities to promote and disseminate our education and prevention messages this year, which address three issues of concern for the diabetes community: the importance of the right diabetes education for all; how the way we live is putting our health at risk; and the stigma and discrimination that many people with diabetes around the world still face. With children and adolescents at the centre of the campaign slogan – Diabetes: protect our future – IDF has widened its scope to engage individuals and organisations outside of the diabetes community that are active in promoting healthy living. We want diabetes to be included on everyone’s wellness and nutrition agenda.

New this year is our “Pin a Personality” campaign which aims to get the blue circle – the global symbol for diabetes awareness – more widely recognised outside the diabetes community. The concept is simple: we encourage anyone and everyone to take a picture of a well-known person wearing a blue circle pin. Launched in April, the campaign has proved very popular among the IDF network with over 200 personalities from around the world currently featured in our online gallery. This initiative complements our on-going and ever popular Blue Monument Challenge and other activities aimed at getting everyone to ‘Go Blue for Diabetes’.

Tell us about the activities that are planned specifically for India, seeing that it is the focal country for this year’s campaigning?

IDF is partnering with local associations on a nationwide campaign that will have its main events in three cities: Chennai, New Delhi and Mumbai. A month-long series of activities targeting health professionals and the general public – including surveys, screening drives, and walkathons – will be highlighted by the showcase event ‘Diabetes Blue Fortnight’. This is the country’s largest awareness campaign that will bring together the government, medical fraternity, associations and organisations working around diabetes, media, corporate organisations and the general public on a single platform to facilitate exchange and growth of knowledge. The event hopes to highlight solidarity towards the cause of reducing the diabetes burden in India. Activities include:

Doctors 4 Diabetes Care, an opportunity for doctors and medical professionals to pledge their commitment to spread diabetes awareness, inform people about preventive and management measures and encourage family members of people with diabetes to go for regular and frequent screening
A diabetes screening drive in several cities across India, at hospitals and clinics, government and corporate offices, community centres and other venues, to promote the importance of early detection and treatment of diabetes.
The lighting in blue over 30 landmark Indian monuments which include the Swaminarayan Akshardham Temple, Old Fort; Qutub Minar and Humayun Tomb in Delhi; Sidhuvinayak Temple in Mumbai; Victoria Memorial Hall in Kolkata and Shaniwada Fort in Pune.

Tell us more about the ‘Go Blue’ campaign of IDF.

Blue became the colour for diabetes awareness following the passage of United Nations Resolution 61/225 in December 2006, which recognised World Diabetes Day as an official UN day. Blue is colour of the blue circle, the symbol of World Diabetes Day and of the global fight to curb the global epidemic and improve the lives of people with diabetes. The aim of IDF is to see coordinated global celebrations for World Diabetes Day with the colour blue used to rally the diabetes community around an easily recognisable and impactful theme and display unity for a common cause. Activities around the colour blue include the Blue Monument Lighting Challenge and Blue Fridays, where everyone is encouraged to wear blue in their home, school or workplace to raise diabetes awareness.

It is said that Indians are more vulnerable to Type II diabetes? Why is it so? How can it be brought under control?

Diabetes can be found in every country in the world and without effective prevention and management programmes the burden will continue to increase globally.

Type 2 diabetes makes up about 85 to 95 per cent of all diabetes in high-income countries and may account for an even higher percentage in low- and middle-income countries such as India. Type 2 diabetes is now a common and serious global health problem, which, for most countries, has developed together with rapid cultural and social changes, ageing populations, increasing urbanisation, dietary changes, reduced physical activity, and other unhealthy behaviours

Since obesity and diabetes represent one of the biggest public health challenges of the 21st century, IDF has adopted the following position, in line with the recommendations of the World Health Assembly of May 2004:

All-embracing strategies focusing on prevention and education at every level must be designed
Healthy dietary patterns need to be encouraged at an early age
Physical activity should form a central part of both childhood and adult lifestyles
Clear food labeling and a reduction in portion size are crucial factors in encouraging a healthy diet
Children should be protected from advertising, which promotes inappropriate (and unnecessary) consumption of energy dense (high calorie) food and drink
To prevent Type 2 diabetes, IDF promotes the regular screening of people who are overweight or have a first degree relative with Type 2 diabetes and ethnic high-risk groups as well as everyone over 65 years. IDF also advocates taking the following practical steps to prevent the development of diabetes and obesity from childhood:
Creation of suitable footpaths, designed tracks and road schemes that allow safe walking, cycling and the use of play areas around the home and school
Change in school curriculum to encourage children to participate in sports and physical activity
Implement policies to control access to energy dense food and drinks, whether at home, on the way to school or at school itself
A ban on all forms of marketing of foods and drinks directed at children at school and on radio, TV and other avenues
Simple and understandable displays of the composition and energy density in all eating establishments
Monitoring food consumption patterns and the prevalence of diabetes in the population

IDF encourages those with responsibility for the provision of healthcare services to guarantee that all steps are taken to ensure that these measures are met. Governments can make a significant contribution by encouraging lifestyle changes and investing in health programmes. However, a comprehensive approach is needed to tackle the global epidemic of diabetes and obesity successfully. IDF therefore promotes the active collaboration of member associations, public health authorities, the pharma industry and the food and drinks industry to achieve the best possible results in tackling the dual, overlapping problems of diabetes and obesity.

Kindly elucidate on the co-relation between obesity and diabetes?

Obesity and diabetes currently threaten the health, well-being and economic welfare of virtually every country in the world. According to recent estimates of the International Obesity Task Force, up to 1.7 billion people of the world’s population are at heightened risk of weight-related, NCDs such as Type 2 diabetes. IDF predicts that the number of people with diabetes will rise to 552 million by 2030. Type 2 diabetes accounts for up to 95 per cent of diabetes cases, and the rise in Type 2 diabetes appears to be mainly related to the increasing prevalence of overweight and obesity worldwide. Furthermore, the rising level of childhood obesity worldwide and the subsequent onset of Type 2 diabetes have profound implications for the future.

What are the causes for Indian children being more vulnerable to Type-1 diabetes? How can it be brought under control?

At present, Type 1 diabetes cannot be prevented and we do not know the exact causes. The environmental triggers that are thought to generate the process which results in the destruction of the body’s insulin-producing cells are still under investigation.

Today, there is no cure for diabetes, but effective treatment exists. If you have access to the appropriate medication, quality of care and good medical advice, you should be able to lead an active and healthy life and reduce the risk of developing complications.

Good diabetes control means keeping your blood sugar levels as close to normal as possible. This can be achieved by a combination of the following:

Physical activity: A goal of at least 30 minutes of moderate physical activity per day (e.g. brisk walking, swimming, cycling, dancing) on most days of the week.
Body weight: Weight loss improves insulin resistance, blood glucose and high lipid levels in the short term, and reduces blood pressure. It is important to reach and maintain a healthy weight.
Healthy eating: Avoiding foods high in sugars and saturated fats, and limiting alcohol consumption.
Avoid tobacco: Tobacco use is associated with more complications in people with diabetes.
Monitoring for complications: Monitoring and early detection of complications is an essential part of good diabetes care. This includes regular foot and eye checks, controlling blood pressure and blood glucose, and assessing risks for cardiovascular and kidney disease.

How can the patients themselves take charge and prevent a debilitating disease like diabetes from taking control of their lives?

A good diabetes education is key and also the points mentioned above.

A recent study by WHO established that people suffering from diabetes are more susceptible to TB. Can you elaborate on this situation is likely to aggravate India’s disease burden?

People with diabetes are at higher risk of developing tuberculosis (TB) than those without diabetes. Tuberculosis, an infectious disease of the lungs, affects 9.4 million people and kills 1.7 million worldwide every year. 1

TB is a major public health problem in many low- and middle-income countries, where the number of people with diabetes is also rising rapidly. Regions, such as India who are most heavily affected by tuberculosis are also those that have some of the highest numbers of people with diabetes and will experience the biggest increases by 2030.

Not only does diabetes contribute to a person’s risk of developing tuberculosis, but it also makes it more difficult to treat those who have both diseases. A review looking at the impact of diabetes on tuberculosis treatment found that people with diabetes are more likely to fail treatment and more likely to die during treatment compared to those without diabetes.

The link between tuberculosis and diabetes requires interventions that address both diseases. For example, screening for tuberculosis in people with diabetes and screening for diabetes in people with tuberculosis could offer opportunities to increase detection and prevent diabetes or tuberculosis-related complications.

A recent review showed that when people with diabetes were checked for tuberculosis, more people were found to have previously undiagnosed TB than in the general population. This was also true of people who had tuberculosis, and were checked for diabetes, in which many more were found to have previously undiagnosed diabetes than in the general population.

People with diabetes who have good glucose control are less likely to develop tuberculosis. In addition, tuberculosis treatment leads to decreasing blood glucose levels suggesting that integrated management of tuberculosis in people with high blood glucose could lead to better diabetes control.

Effective management of both diseases requires the same elements including early detection, providing guided standard treatment, and having an effective drug supply. The same principles can be applied to both diseases and help many people affected by tuberculosis and diabetes. Setting standards on these simple priorities could lead to effective detection and treatment for diabetes as has been seen in global tuberculosis control.

What are the major obstacles that hinder the initiatives to bring diabetes under control?

Each country faces its own particular challenges. In India, a lack of resources and government investment in NCDs often hinders initiatives to bring diabetes under control. In a lot of cases, diabetes research cannot be translated into low income/low resource settings. Diabetes awareness is low and at the same time stigma attached to the disease is high! Without a substantial people’s movement, pressing for change on all levels, it will be very difficult to inspire any kind of change.

What are the immediate steps that India should implement to curb the growing threat of diabetes?

India needs to implement the following steps:

All-embracing strategies focussing on prevention and education at every level must be designed
Healthy dietary patterns need to be encouraged at an early age
Physical activity should form a central part of both childhood and adult lifestyles
Clear food labelling and a reduction in portion size are crucial factors in encouraging a healthy diet
Children should be protected from advertising, which promotes inappropriate (and unnecessary) consumption of energy dense (high calorie) food and drink.

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