Diabetes in Society

DREAM Trust is a non-government organization and registered charity in Nagpur, central India. In this region and indeed throughout the Indian sub-continent and the developing world, covering the medication needs of a child with diabetes requires many families to commit a quarter of their monthly income. The principal objective of DREAM Trust is to respond to these needs by providing insulin, accessories and healthcare free of charge to poor children with type 1 diabetes.

At 7.59 am local time on 26 December 2004, a mighty earthquake rocked the floor of the Indian Ocean just northwest of Sumatra, triggering a series of large and powerful tsunamis that killed nearly a quarter of a million people – 168 000 in Indonesia alone. The tsunami decimated towns and cities from Indonesia, Thailand and the north-western coast of Malaysia to Bangladesh, India, Sri Lanka and the Maldives, thousands of kilometres away, and as far as Somalia, Kenya and Tanzania in East Africa.

I am a forty-seven year old white male living in Ypsilanti, Michigan, USA. For most of my life, I have lived in either southeast Michigan or northwest Ohio. I hold a Masters Degree and Bachelors Degree in Geology. For the last 17 years I have been employed in some form or another in the environmental resources divisions of major US car manufacturers. But neither my studies nor my employment record prepared me for the difficulties I have faced and the adversity I continue to endure in attempting to manage my diabetes.

Diabetes is one of the most common chronic conditions in school-age children. In the USA, about 154 400 young people aged 20 years or younger have diabetes – about one in very 400 to 500. Type 1 diabetes accounts for about 80% of cases. In certain ethnic groups, however, the proportion of type 2 diabetes in young people is much higher. With the epidemic of overweight and obesity, healthcare professionals are finding increasing numbers of young people with risk factors for type 2 diabetes.

When the author began her career as a paediatric endocrinologist in Los Angeles, USA, 30 years ago, childhood obesity was rare and type 2 diabetes in young people was almost unheard of. Nowadays, however, one in three children in that city is overweight or obese, and a quarter of the children diagnosed with diabetes at her centre have type 2 diabetes. This situation mirrors developments in paediatric health throughout the world; obesity and type 2 diabetes in young people are now regarded as related global epidemics.

For some time now, international agencies have been warning about the rapid increases in the rates of diabetes and other chronic disease in Asian countries. Asia already accounts for a sizeable proportion of the world’s population with diabetes and the prevalence of diabetes in the region looks set to rise dramatically in the coming years. In addition, the age of onset of type 2 diabetes is moving downward. While the condition was historically diagnosed in people over age 65 years, nowadays type 2 diabetes in young adults is not unusual.

The number of children with diabetes is growing. Some countries, particularly in the developed world, are seeing a significant increase in the incidence of type 1 diabetes; type 2 diabetes in children and adolescents is an emerging problem worldwide. Premature deaths as a result of undiagnosed diabetes are a large and hidden global problem. Moreover, children with diabetes risk developing disabling and life-threatening complications at an early age, placing a significant human and economic burden on families and societies.

Diabetes is finally emerging from the shadows thanks largely to the recent adoption by the UN General Assembly of a landmark Resolution on diabetes. This Resolution, which recognizes the severity of diabetes and encourages Member States to develop national policies for the prevention, treatment and care of diabetes, is closely linked to the UN Millennium Development Goals. One of the UN’s targets for 2015, Millennium Goal number 4, is to reduce child mortality worldwide.

In many countries, young people work effectively as advocates for a range of causes, from inner-city regeneration to anti-bullying and smoking cessation. An IDF initiative aimed to engage Youth Ambassadors in diabetes advocacy worldwide and specifically to participate at as many levels as possible in IDF’s global awareness campaign ’Unite For Diabetes’. In this article, representatives from the group describe the principles and objectives of the IDF Youth Ambassadors programme and make a call for increased involvement of young people in diabetes advocacy.