Governments Must Act On Biggest Epidemic In Human History - New IDF Consensus On Prevention Of Diabetes Is Launched

Main Category: Diabetes
Article Date: 11 May 2007 - 12:00 PDT

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The diabetes pandemic is threatening to overwhelm global healthcare services. Today, the International Diabetes Federation (IDF) launched a new consensus statement on diabetes prevention, to be published in the May issue of Diabetic Medicine, hot on the heels of a December 2006 United Nations General Assembly Resolution calling for concerted international action.

"The UN Resolution is a huge win in the fight against the biggest disease epidemic in human history. Diabetes is responsible for close to 4 million deaths every year. With 246 million people with diabetes now and 380 million people with diabetes by 2025, diabetes is set to bankrupt national economies1" said Professor Paul Zimmet, Director, International Diabetes Institute and co-author of the consensus. "Type 2 diabetes can be prevented, but it will take enormous political will on the part of governments to make this a reality. They can achieve this by creating the environment that allows individuals to make lifestyle changes. That is why we are calling on all countries to endorse the UN Resolution and to target entire populations through the development and implementation of National Diabetes Prevention Plans."

The new IDF consensus recommends that all individuals at high risk of developing type 2 diabetes be identified through opportunistic screening by doctors, nurses, pharmacists and through self-screening.

Professor Sir George Alberti, Past President of IDF and co-author of the new IDF consensus said: "There is overwhelming evidence from studies in the USA, Finland, China, India and Japan that lifestyle changes (achieving a healthy body weight and moderate physical activity) can help prevent the development of type 2 diabetes in those at high risk.2-6 The new IDF consensus advocates that this should be the initial intervention for all people at risk of developing type 2 diabetes, as well as the focus of population health approaches."

In addition to the need for individual lifestyle change, IDF recognizes that there are powerful environmental forces that influence the behavioural, eating and exercise patterns of the community.

"Inadvertently, our own government authorities may have contributed to this epidemic by allowing developers to create urban social problems,' said Professor Avi Friedman, Professor of Architecture at McGill University, Montreal. "Urban sprawls are part and parcel of new developments without proper attention to building design, sidewalks, bike paths, public transport corridors, playing fields and friendly exercise areas that are essential and need to be accessible to people who want to maintain a healthy lifestyle."

National Diabetes Prevention Plans will therefore require coordinated policy and legislative changes across all sectors including health, education, sports and agriculture, as well as the formation of strategic relationships. They must be culturally sensitive and targeted to mobilize all sectors of the community.

"Diabetes is already a massive social cost, and it is up to politicians to decide whether they will spend more and more money on acute care and drugs, or invest in prevention by supporting lifestyle change among the entire population," said Professor Alberti.

"A Kyoto-like agreement on diabetes prevention and management is needed among governments worldwide if we are to prevent this problem from becoming catastrophic," concluded Professor Zimmet.

The International Diabetes Federation (IDF) is the global advocate for more than 240 million people with diabetes worldwide. It represents 200 diabetes associations in more than 150 countries. The mission of IDF is to promote diabetes care, prevention and a cure worldwide. IDF is a non-governmental organisation in official relations with the World Health Organisation and in association with the Department of Public Information of the United Nations.

www.idf.org

About Diabetes

Each year 7 million people develop diabetes and the most dramatic increases in type 2 diabetes have occurred in populations where there have been rapid and major changes in lifestyle, demonstrating the important role played by lifestyle factors and the potential for reversing the global epidemic. A person with type 2 diabetes is 2 - 4 times more likely to get cardiovascular disease (CVD), and 80% of people with diabetes will die from it. Premature mortality caused by diabetes results in an estimated 12 to 14 years of life lost. A person with diabetes incurs medical costs that are two to five times higher than those of a person without diabetes, and the World Health Organization (WHO) estimates that up to to 15% of annual health budgets are spent on diabetes-related illnesses.

There is conclusive evidence that good control of blood glucose levels and management of high blood pressure and aspects of the lipid profile (blood fats) can slow the progression to or of type 2 diabetes, and substantially reduce the risk of developing complications (such as cardiovascular, eye and kidney disease) in people with diabetes.

Acknowledgement

The IDF consensus on diabetes prevention was supported by an educational grant from AstraZeneca Pharmaceuticals.

References

1. Diabetes Atlas, third edition, International Diabetes Federation, 2006
2. Pan X, Li g, Hu Y, Wang J, Yang W, An Z. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997; 20: 537-544
3. Tuomilehto J. Lindström J, Eriksson J, Valle T, Hamalainen H. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343-1350
4. Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar A, Vijay V. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 2006; 49 (2): 289-297
5. Knowler W, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403
6. Kosaka K, Noda M, Kuzuya T. Diab Res Clin Pract 2005; 67: 152-162