It is a bittersweet pleasure to be presiding over the International Diabetes Federation upon the launch of this sixth edition of the IDF Diabetes Atlas. The evidence published herein on the millions of people swept up by the diabetes pandemic vindicates the Federation’s relentless efforts to promote solutions to this worldwide health crisis. Previous editions of the Atlas were a crucial tool in the successful campaign for a UN Resolution on diabetes and our figures informed the subsequent political declaration on non-communicable diseases. We have achieved much: diabetes is now firmly on the highest of decision-making agendas. But the figures in this edition are a harsh reminder of how far we still have to go.
Today, there are 382 million people living with diabetes. A further 316 million with impaired glucose tolerance are at high risk from the disease – an alarming number that is set to reach 471 million by 2035. Diabetes is on the rise all over the world and countries are struggling to keep pace. The misconception that diabetes is ‘a disease of the wealthy’ is still held by some – to the detriment of desperately needed funding to combat the pandemic. But the evidence published in the IDF Diabetes Atlas disproves that delusion: a staggering 80% of people with diabetes live in low- and middle-income countries, and the socially disadvantaged in any country are the most vulnerable to the disease.
Today’s emerging diabetes hotspots include countries in the Middle East, Western Pacific, sub-Saharan Africa and South-East Asia where economic development has transformed lifestyles. These rapid transitions are bringing previously unheard of rates of obesity and diabetes; developing countries are facing a firestorm of ill health with inadequate resources to protect their population.
By the end of 2013, diabetes will have caused 5.1 million deaths and cost USD 548 billion in healthcare spending. Without concerted action to prevent diabetes, in less than 25 years’ time there will be 592 million people living with the disease. Most of those cases would be preventable. However, without a multi-sectoral, all-of-society approach, the disturbing projections in this edition of the IDF Diabetes Atlas will be realised.
Despite the grim picture painted by the new figures, we already have the knowledge and expertise to begin creating a brighter future for generations to come. We must increase awareness of the importance of a healthful diet and physical activity, especially for children and adolescents. Crucially though, environments have to be created that lay the foundations for healthy living. These measures are most pressing in low- and middle-income countries, precisely those which are least prepared to confront this huge-scale pandemic, and whose very development will be thwarted in its aftermath. It is essential that health professionals – particularly the primary care practitioners – receive adequate and appropriate training to be able to perform effectively on the front line against diabetes.
In the last two years, progress has been made toward driving political change for diabetes. Building on the momentum of the 2011 UN Political Declaration on non-communicable diseases (NCDs), the 66th World Health Assembly in May 2013 saw the unanimous adoption by Member States of a voluntary Global Action Plan for the prevention and control of NCDs. Diabetes is now prominent on the global health agenda, with specific targets for access to essential medicines and for halting the growth of obesity and diabetes. Still, we must not miss this opportunity. Governments and policy-makers, health professionals and those affected by the disease must remain engaged in the fight so that IDF may achieve its vision of living in a world without diabetes.
Sir Michael Hirst
International Diabetes Federation