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How to turn the tide on the growing problem of diabetes

7 Apr, 2016

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With Ebola and Zika grabbing so many headlines these days, it may come as a surprise that the biggest global health crisis affecting developing nations is not caused by yet another rare virus we had never heard of, or an exotic tropical parasite, but rather something far too familiar to us all – diabetes. 

The condition is the focus of this year‘s World Health Day – a campaign that aims to increase awareness about the rise of diabetes and the staggering burden it places on health systems, as well as triggering a set of actions to tackle it. Wellcome Trust Strategic Partnerships Manager Marta Tufet takes us through the recent research that has revealed the true scale of the crisis…

Once a disease affecting mainly richer nations, type 2 diabetes has risen exponentially in the past two decades in parallel to the obesity epidemic, with more than 80% of diabetes deaths now occurring in low and middle income countries. This dramatic increase of diabetes in the developing world is happening as these countries are struggling to tackle existing and emerging infectious diseases such as HIV/AIDS, malaria, Ebola and Zika. Needless to say that this double burden of disease imposes a huge economic strain on health systems, individuals and their families. It also threatens to compromise many of the significant national and international efforts made in the past few decades to reduce the infectious disease burden in these regions.

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Changes in diabetes prevalence for men aged 18+ between 1980 and 2014

A new study published in The Lancet, supported by Wellcome and led by Professor Majid Ezzati of Imperial College London, has estimated that the cost of diabetes worldwide is $825 billion a year, with half of all cases coming from China, India, Brazil, Indonesia and USA. Published in The Lancet, this research follows a previous study from the team looking at the global change in BMI trends. The global diabetes epidemic seems to be driven largely by a combination of social and economic factors such as rapid urbanisation, greater consumption of fatty foods and increasingly sedentary lifestyles.

Obesity is the greatest risk factor for diabetes, and the obesity epidemic too is soaring out of control. A recent report from the same Imperial research group showed that more people in the world now overweight than underweight. That study also found that between 1975 and 2014, the global population’s BMI increased at a rate which correlates with every person becoming on average 1.5kg heavier each decade.

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The number of women aged 18+ with diabetes has risen to over 200 million in 2014, equivalent to 7.9% of the global population

Research is increasingly demonstrating that diabetes can largely be prevented through healthier lifestyles and diet. However, translating this evidence into policy and practice is not an easy feat and will require significant reform of public health policies, health systems, and changes to the food and built environment.

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Community gyms in Brazil. Credit: Thomas Slater

Wellcome has supported a number of efforts towards increasing this evidence base and to translate it into policy and practice:

  • In Brazil, Wellcome Trust Investigator Dr Pedro Hallal is investigating links between physical exercise and lifelong health. His research is directly helping to drive government policy in Brazil, with the introduction of community ’health gyms’ which are already demonstrating impact.
  • In the UK, the Centre for Diet and Activity Research led by Professor Nick Wareham and supported by Wellcome through the UK Clinical Research Collaboration is contributing evidence on the wider factors that influence diet and physical activity related behaviours, developing and evaluating interventions and helping shape practice and policy around these.  
  • In China, with support from multiple funders, including Wellcome and the Chinese Ministry of Science and Technology, the Kadoorie Biobank led by Professor Zhengming Chen is collecting health data on half a million healthy adults in a prospective cohort study to investigate genetic and environmental causes of chronic diseases developed later in life, including diabetes.

Other Wellcome Trust initiatives such as Our Planet our Health, the Joint Health Systems Research Initiative and the Joint Global Health Trials Initiative, provide regular funding opportunities for researchers to address such matters.

All of these schemes have a strong emphasis on collaboration. If we are to beat diabetes, in line with calls from the WHO and others, researchers and funders must work together with governments, civil society, private sector, the public and media to develop new ways of preventing, diagnosing, treating and caring for people with diabetes.

Map and graph courtesy of NCD-RisC. For all data visualizations from the obesity and diabetes study please visit their website

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