Diabetes treatment > Access and supply

The World Diabetes Day campaign is led by the International Diabetes Federation and its member associations. It is a multiple-stakeholder partnership that includes diabetes organizations and their members around the world and Official World Diabetes Day Partners. Each campaign is centred on a theme that is established by the IDF Executive Board and approved by the World Health Organization. This year sees the second half of a 24-month campaign focussing on diabetes in children and adolescents. The main campaign slogan is ‘Know the warning signs’.

Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality worldwide, representing 60% of all deaths. Contrary to common perception, 80% of chronic disease deaths occur in low- and middle-income countries. This invisible epidemic is an underestimated cause of poverty and hinders the economic development of many countries. Sub-Saharan Africa carries the highest burden of disease in the world, the bulk of which still consists of the communicable diseases HIV/AIDS, tuberculosis and malaria.

It is estimated that over 3 million deaths each year are directly related to diabetes. Of greatest concern is that diabetes prevalence appears to be highest in the low- and middle-income countries. Managing diabetes, a complex task in ideal circumstances, can be made extremely difficult in emergency situations. Millions of people around the world live under constant threat from armed conflict or natural disasters, such as floods, hurricanes and earthquakes. The difficulties faced by poor and underserved people in accessing diabetes care are exacerbated in times of catastrophe.

Kyrgyzstan is a landlocked, largely mountainous country, bordering Kazakhstan, China, Tajikistan and Uzbekistan, and is therefore sometimes referred to as ‘the Switzerland of Central Asia’. But the dramatic beauty of its snow-capped mountains and Alpine gorges hides a terrible potential for destruction: heavy winter snow often leads to spring floods, provoking serious damage in valleys and lowlands.

In people with diabetes, optimal management of their condition, regular examinations, the use of adequate footwear, and education are the best strategies to prevent diabetes-related foot problems, such as ulceration. If foot problems cannot be prevented, these should be treated as early as possible. However, in many cases, some degree of amputation of lower limbs cannot be avoided. In people who undergo a major amputation, artificial limbs are required to enable them to continue normal daily life.

Editorial of the Editor-in-chief

Average temperatures are rising due primarily to the release of increased amounts of carbon dioxide and other greenhouse gases through the burning of fossil fuels. This is provoking other changes, including rising sea levels and changes in rainfall. These changes appear to be increasing the frequency and intensity of extreme weather events – floods, droughts, heat waves, hurricanes, and tornados – which have the potential to provoke large-scale human crises.

Diabetes is a life-long chronic condition. Herein lies one of the major challenges to addressing global inequalities in diabetes care. The costs of insulin and monitoring are often beyond the resources of people with diabetes or their country’s healthcare system. While it is easier to secure temporary price reductions or short-term financial support in the form of donations or grants than it is to find long-term ongoing support, diabetes needs in most countries are not temporary.