At present, type 1 diabetes cannot be prevented. The environmental triggers that are thought to generate the process that results in the destruction of the body’s insulin-producing cells are still under investigation. Type 2 diabetes, however, can be prevented in many cases by maintaining a healthy weight and being physically active. Studies in China, Finland and the United States have confirmed this.
Putting aside arguments over the quality of the data and methodologies employed, the last thirty years have seen a rapid increase in type 2 diabetes. In 1985, an estimated 30 million people worldwide had diabetes. A little over a decade later, the figure had risen to over 150 million. Today, according to IDF figures, it exceeds 285 million. Unless action is taken to implement effective prevention and control programmes, IDF predicts that the total number of people with diabetes will reach 435 million by 2030. It is increasingly apparent that the explosion in diabetes will overwhelm healthcare systems everywhere and subvert the gains of economic development. It is important for the diabetes world to communicate a consistent message that investment in diabetes education and diabetes prevention programmes will save money in the long term and deliver significant returns in quality of life for people with diabetes and people at high risk of diabetes.
The World Diabetes Day campaign’s approach to primary prevention is informed by the IDF Consensus on Type 2 Diabetes Prevention (2007). The consensus proposes a simple three step plan for the prevention of type 2 diabetes in those at increased risk.
IDF recommends that all people at high risk of developing type 2 diabetes be identified through opportunistic and self-screening. People at high risk can be easily identified through a simple questionnaire to assess risk factors such as age, waist circumference, family history, cardiovascular history and gestational history.
Once identified, people at high risk of diabetes should have their plasma glucose levels measured by a health professional to detect Impaired Fasting Glucose or Impaired Glucose Tolerance, both of which indicate an increased risk of type 2 diabetes. Prevention efforts should target those at risk in order to delay or avoid the onset of type 2 diabetes.
There is substantial evidence that achieving a healthy body weight and moderate physical activity can help prevent the development of type 2 diabetes. In primary prevention there is an important role for the diabetes educator to help people understand the risks and set realistic goals to improve health. IDF recommends a goal of at least 30 minutes of daily exercise, such as brisk walking, swimming, cycling or dancing. Regular walking for at least 30 minutes per day, for example, has been shown to reduce the risk of type 2 diabetes by 35-40%.
World Diabetes Day will promote greater awareness of the risk factors for diabetes and encourage best-practice sharing in diabetes prevention. The campaign will ask diabetes stakeholders to call on UN Member States to follow through on the promise of the UN Resolution on diabetes and develop national policies for the prevention, treatment and care of diabetes in line with the sustainable development of their healthcare systems.