Diabetes has become a leading cause of death and disability in the Region of the Americas, and if current trends continue, the burden of the disease will increase substantially over the next two decades, according to experts at the Pan American Health Organization/World Health Organization (PAHO/WHO).
On November 14, PAHO/WHO celebrated World Diabetes Day to raise awareness of the impact of diabetes and encourage improvements in prevention and care for the disease. "Diabetes has reached epidemic proportions in the Americas," said Dr. James Hospedales, PAHO/WHO senior advisor on chronic diseases. "Latin America and especially the Caribbean now have among the highest diabetes rates in the world, and if we don't take action now - especially to slow rising rates of obesity - the trend will only get worse."
PAHO/WHO estimates that some 62.8 million people in the Americas suffer from diabetes (2011 data). If current trends continue, this number is expected to increase to 91.1 million by 2030. In Latin America, the number of people with diabetes is projected to increase from 25 million to 40 million by 2030, and in North America and the English-speaking Caribbean, the number will increase from 38 million to 51 million during the same period, according to PAHO/WHO estimates.
Worldwide, WHO estimates that more than 346 million people have diabetes, with the number expected to more than double by 2030 if current trends continue.
Diabetes is strongly linked to overweight and obesity, which are also on the upswing in the Americas and worldwide. Survey data from countries in the Americas show that rates of obesity (Body Mass Index ≥ 30) in adults range from 15% in Canada to 30% or more in Belize, Mexico, and the United States.
Surveys also show that obesity and overweight are increasing in all age groups: 7% to 12% of children under 5 and one in five adolescents in the Americas are obese, and among adults, rates of overweight and obesity approach 60%.
If left uncontrolled, diabetes can cause damage to the eyes (potentially leading to blindness), kidneys (leading to renal failure), and nerves (leading to impotence and foot disorders, many requiring amputation). Diabetes also increases the risk of heart disease, stroke, and insufficient blood flow to legs. Studies have shown that good metabolic control prevents or delays such complications. Good foot care, regular eye exams, and control of blood pressure are also essential, especially to prevent amputations and blindness.
Diabetes poses a major and growing challenge for health systems, experts say. People with diabetes need comprehensive, coordinated, and evidence-based care that promotes a central role for patients and their families.
"Patient education and involvement is absolutely key to promote better self-management of diabetes," says Hospedales. "This includes self-monitoring of blood glucose levels and being alert to the signs of possible complications."
Equally important is prevention. To help prevent type 2 diabetes and its complications, people should:
- Achieve and maintain a healthy body weight.
- Be physically active, with at least 30 minutes of moderate-intensity activity on most days and more for weight control.
- Eat a healthy diet, including three to five servings of fruit and vegetables per day and reduced intake of sugar and saturated fats.
- Avoid tobacco use, which increases the risk of cardiovascular diseases.
- Drink less alcohol.
World Diabetes Day 2012 campaign materials include posters featuring the warning signs of diabetes (frequent urination, weight loss, lack of energy, and excessive thirst), risk factors (family history, lack of exercise, unhealthy diets, and excess body weight), and physical activities that can help prevent the disease (brisk walking, dancing, swimming, and cycling). The prevention poster notes that 30 minutes of exercise per day can reduce a person's risk of developing type 2 diabetes by 40%.
Facts on diabetes in the Americas
- In the Americas, diabetes prevalence in adults is highest in the countries of the English-speaking Caribbean, followed by populations living on both sides of the U.S.-Mexico border.
- The highest prevalence of type 2 diabetes is found among the Pima Indians of Arizona, among whom almost all adults develop diabetes.
- In Mexico and in the majority of the countries of Central and South America and the Spanish-speaking Caribbean, diabetes prevalence has been reported between 8% and 10%.
- The lowest reported prevalence of diabetes in the Americas was in Tegucigalpa, Honduras (6.1%).
- In North America, African- and Mexican-Americans show greater risk for diabetes than Caucasian Americans, due to both heredity and environmental factors, such as poor nutrition and lack of exercise.
- Survey data show that the percentage of people with diabetes whose blood sugar is not controlled is as high as 66% in Chile (2009), 70% in Veracruz, Mexico (2005), 63% on the Mexican side of the U.S. border and 58% among Latinos on the U.S. side (2001-2002), and 54% in Costa Rica (2010).