Issue: April 2017 - Advancing the urgency for action
Section: Diabetes views
Urgent need for better interventions
At present there is cause for grave concern. There is an urgency for greater action to improve diabetes outcomes and reduce the global burden of diabetes now affecting more than 415 million lives worldwide. Diabetes, most predominantly type 2, is a leading cause and contributor to premature mortality and morbidity in developing and developed nations alike, and directly linked to the dramatic rise in obesity.
Overall, people with diabetes are at twice the risk for premature death due to microvascular and macrovascular complications; diabetes is the leading cause of blindness due to retinopathy, a major cause of chronic renal failure and the leading cause of end-stage renal failure requiring dialysis. Macrovascular complications of diabetes include stroke and heart failure, as well as other major morbid conditions including lower limb amputation. Diabetes, if ignored or inadequately treated, destroys lives.
What will it take for governments to recognize the urgency to take action?
Timely and appropriate interventions for both diabetes prevention and care are vital to the public health of every country worldwide. Based on firm evidence, IDF and its partners developed the four pillars of the Early Action in Diabetes initiative (2015) to establish targets and drive meaningful policies. The four pillars are: Prevention, Early Detection, Early Control and Early Access to the Right Interventions. The original initiative was followed by a forum composed of diabetes experts and political leaders from 11 countries resulting in the Berlin Declaration, written in 2016. This international proclamation represents the extreme urgency for global diabetes action today, and is discussed in greater detail in this issue (The Berlin Declaration: Strengthening Early Action for Diabetes Prevention and Care).
By making lifestyle changes, such as improving diet and exercise, the risk of developing diabetes can be reduced. Type 2 diabetes starts long before symptoms present. However, once diabetes has developed, identifying and treating the disease early and appropriately may reduce serious and costly complications. Ammar Ibrahim, one of the expert authors of IDF’s new Clinical Practice Recommendation on the Diabetic Foot, writes about the new guide for healthcare professionals in this issue. IDF’s Recommendation is a much needed intervention developed to help HCPs better manage diabetic foot disease thereby eliminating the threat of amputation. Of the one million amputations per year, experts believe about 85% are preventable.
Collectively, IDF, diabetes stakeholders, and policy makers can make a significant contribution in reducing the destructive impact of diabetes, stopping the rise in diabetes and improving the lives of those living with the disease. People living with diabetes are also valuable advocates whose voices are essential to improving access and care and ending discrimination. IDF’s Blue Circle Voices (BCV) initiative is a virtual network drawing on the experiences of people living with diabetes from IDF Members and is introduced in this issue. BCV members will participate in specific surveys and consultations covering topics from discrimination to access making a more transparent, solid call-to-action for improvements in care and greater understanding of people with diabetes everywhere.
Gaps in diabetes awareness and education exist everywhere but information and care are weakest in developing countries where type 1 diabetes is misunderstood or not recognized at all. Oren Lieberman, CNN correspondent for Israel, developed type 1 diabetes in 2014 while travelling in Nepal. He’s written a memoir about his experience in The Insulin Express and we are grateful for his interview.
Our April issue of Diabetes Voice presents information specific to the IDF Congress 2017 where thousands of the world’s experts in diabetes, faculty and researchers will gather in Abu Dhabi from the 4th to the 8th December, 2017. IDF’s Congress, the most significant global diabetes event worldwide, will share the latest achievements in diabetes research as well as explore new developments and technologies in care. It will be there that we will report not just on advances in treatment or focus on data, but also on progress for Early Action in diabetes.
Douglas Villarroel is Editor-in-Chief of Diabetes Voice