Healthcare professionals who have long battled AIDS, malaria, and other diseases in developing countries are now facing an epidemic typically associated with the developed world: type 2 diabetes. In 2015, according to the World Health Organization (WHO), more people died worldwide from diabetes than from HIV/AIDS, malaria, and tuberculosis combined.
WHO reports that more than 420 million people worldwide are affected by type 2 diabetes, and developing countries are reporting the fastest rates of increase in the disease. Because type 2 diabetes is a chronic disease, patients need long-term care and medical supervision that is often difficult to find in developing countries. The 2016 WHO Global Report on Diabetes released statistics quantifying the epidemic:
- In 1980, about 108 million people around the world lived with diabetes. In 2014, WHO estimated that number to be about 422 million.
- Diabetes caused 1.5 million deaths in 2012, and another 2.2 million deaths that year were attributed to high blood glucose. WHO estimates that 43 percent of the total 3.7 million people who died were younger than 70.
- WHO predicts that by the year 2040, the number of people in Africa who live with diabetes will increase by 140 percent.
In his paper “Globalization of Diabetes,” which the American Diabetes Association published on its website, Harvard School of Public Health Professor Frank B. Hu described type 2 diabetes as a “a global public health crisis that threatens the economies of all nations, particularly developing countries.”
What is type 2 diabetes?
According to JDRF, a global diabetes research foundation, diabetes is a group of metabolic diseases where the body either does not produce insulin or does not respond correctly to the insulin produced. Type 2 diabetes causes the patient’s pancreas to decrease its insulin production so that the body either doesn’t have enough insulin or can’t efficiently use the insulin present. This phenomenon results in sustained high blood sugar levels that can cause many health issues for patients. Left untreated, type 2 diabetes can cause blindness, stroke, high blood pressure, kidney failure, and foot amputation.
Patients typically develop type 2 diabetes after the age of 40, but doctors have begun to see more young people with the disease.
How do you get type 2 diabetes?
Researchers have not pinpointed a cause for diabetes, but they have discovered possible genetic links in some cases. They also have determined that environmental factors contribute to patients developing diabetes. Obesity and sedentary lifestyles are responsible for more than 90% of cases of diabetes in the United States, according to the Centers for Disease Control (CDC)
In developing countries, researchers have attributed the surge in cases of type 2 diabetes in part to increased urbanization. As people move to cities looking for a better life, they leave behind rural lifestyles that include daily walking or bike riding, regular socialization with neighbors, and healthy, simple food. Urban lifestyles tend to be more sedentary, and in poorer countries, city dwellers can have a difficult time accessing affordable fruits and vegetables. In addition, people in developing countries are increasingly adopting the typical Western diet, which is high in unhealthy fats and refined sugars.
Further, the changing economy now features more jobs that are sedentary in nature driven by technology versus operational that requires physical labor.
“What’s happening in the low and the middle-income countries quite quickly is very rapid urbanization,” Etienne Krug of WHO recently told Newsweek. Instead of working in fields, people are working behind desks or in factories for much of the day. People living in cities tend to eat more Western junk food and have fewer safe places to exercise, which can increase rates of obesity and type 2 diabetes.
How can developing countries combat type 2 diabetes?
In many cases, type 2 diabetes can be managed with a healthy lifestyle that includes nutritious food and exercise. Strategies to reduce the rate of type 2 diabetes in developing countries include:
- Fighting crime: While crime isn’t directly related to type 2 diabetes, when urban streets are dangerous, people cannot walk and exercise outside. With crime under control, city residents can travel freely on the streets and sidewalks and will naturally engage in more activity.
- Food security: If grocers and vendors are able to sell fruits and vegetables in a city, the food often is expensive and unaffordable for residents who are poor. Governments that focus on protecting farmers and creating supply chains that bring fresh fruits and vegetables into city markets will promote healthier eating and access to nutritious food.
- Health education: Children and adults in developing countries can benefit from education about the connections between healthy living and chronic diseases such as diabetes. Children who learn early about the dangers of eating too much sugar and junk food may make healthier eating choices and ward off an onset of type 2 diabetes. Education can be especially important for pregnant women who have diabetes, because they need to control their blood sugar during their pregnancy to curb health issues they may encounter during and after birth impacting their own health and that of their newborn.
- Basic diabetes care: WHO suggests a list of guidelines for basic diabetes care for clinics in developing countries, where healthcare staff can be scarce. Suggestions include teaching patients how to monitor their blood sugar at home, offering foot care to avoid amputations, and providing annual eye screenings to type 2 diabetes patients at risk for blindness.
Many of these strategies and solutions have been successfully implemented in developing countries, but funding for programs, clinics, and treatment remains a challenge. Healthcare officials say with sustained interest, financial backing, and a focus on type 2 diabetes prevention and early diagnosis, they can make progress in reducing cases of this chronic disease in developing countries.