The global prevalence of diabetes
Common health risks, associated symptoms, and impact on healthcare costs
Diabetes, a disease affecting blood glucose control, is a growing issue worldwide. From 1980 to 2014, the number of people affected by diabetes almost quadrupled from 108 million to 422 million worldwide, or a growth in diabetes prevalence of 4.7% to 8.5%.1
This growth trend is not estimated to stop or slow in the future, according to the IDF Diabetes Atlas, by 2040 the number of worldwide diabetics are expected to grow to 642 million, representing a potential future healthcare crisis for patients and providers alike.2
The healthcare costs are also expected to balloon. In the years between 2007 and 2012, the total healthcare costs associated with diabetes rose from $174 billion to $245 billion, or 41% in just a 5-year period.3
The majority of diabetes cases occur in developing countries, representing a high proportion of the disease’s economic burden. Prevalence of diabetes in Asian countries is particularly high and expected to increase.4
In fact, 60% of the world’s diabetic population are concentrated in Asian countries, with socio-economic growth, industrialization, and urbanization being three of the most common factors associated with increased prevalence of the disease.4
Diabetes is also growing in potentially epidemic proportions in India where over 62 million people are affected.5,6 Genetic factors, improved living standards, and rising levels of obesity are some of the many reasons associated diabetes is growing in this geographic region.7
Diabetes: health effects
The short- and long-term health effects associated with diabetes are many, and each of these health effects worsen with poor glycemic control. Managing diabetes appropriately with prescribed therapies, diet, and lifestyle changes are crucial for reducing the progression of associated symptoms.
Short-term health effects
- Hypoglycemia: Is when a patient has low blood sugar levels. In diabetes, this may result if blood glucose is poorly managed either by using too much insulin or missing a meal, and can also be affected by behavior such as alcohol consumption and exercise. Hypoglycemia can occur in some patients who have yet to be diagnosed. Symptoms include confusion, raised heart rate, anxiety, headache, lethargy and potentially a loss of consciousness.
- Ketoacidosis: If the body has little insulin to draw glucose from the bloodstream and refuel cells, it will metabolize fat into ketones, which are acidic. If this is allowed to continue, levels of ketones will become too high and causes ketoacidosis, while the liver will produce glucose to try and combat the problem leading to high levels of glucose in the bloodstream. Symptoms include high thirst, increased urination, vomiting, and comas. Generally, this condition is seen in type 1 diabetes patients or patients with type 2 diabetes who produce only small amounts of insulin.
- Hyperosmolar hyperglycemic state (HHS): Often caused by illness or ineffective diabetes medication hyperosmolar hyperglycemic states are characterized with a blood glucose level over 40 mmol/l. This high blood sugar level in turn causes severe dehydration and requires fluids to treat. Symptoms include increased thirst and urination, nausea, disorientation, a high risk of complications and coma.
Long-term health effects
- Diabetic retinopathy: Poorly managed type 2 diabetes, can result in prolonged high blood glucose, which can damage the small blood vessels in the retina of the eye, causing diabetic retinopathy. If left untreated, this disorder can lead to blindness. Once retinopathy has set in, the treatments are currently generally limited to intraocular laser photocoagulation therapy and anti-VEGF injections into the eye, therefore proper management of diabetes is the best course of action as a preventative measure.
- Cardiovascular disease: People with diabetes are at an increased risk for developing cardiovascular disease (CVD) due to inflammation, oxidative stress, HbA1c, and a multitude of other associative factors.8 Chronic hyperglycemia (high blood sugar) triggers inflammation and oxidation, contributing to the pathogenesis of endothelial dysfunction. This is one reason why managing diabetes is crucial for reducing future morbidity and mortality.
- Nephropathy: Kidney disease, also known as nephropathy, is a common long-term complication of diabetes. Hyperglycemia can cause the filtering of too much blood through the kidneys, which can contribute to filter damage. These filters can start to leak small amounts of protein into urine, which is called microalbuminuria. If blood sugar remains high, larger amounts of blood sugar will leak into the blood stream, called macroalbuminuria. In its later stages, end-stage renal disease may result. Symptoms of nephropathy include fluid buildup, insomnia, upset stomach, fatigue, and difficulty concentrating.9
- Neuropathy: Affecting the nerves, neuropathy is a long-term complication also associated with chronic and uncontrolled diabetes. Hyperglycemia can cause damage to small blood vessels supplying the nerves, precluding delivery of essential nutrients. Three types of neuropathy exist: sensory, autonomic, and motor.10
People with diabetes can take measures to reduce their blood sugar and prevent the progression of short- and long-term health effects. Exercise is one method for improving cells’ sensitivity to insulin in type 2 diabetes and enhances a well-rounded treatment protocol consisting of a healthy diet and pharmacological (insulin therapy) support.11
Regular analytic measurements with a glucose analyzer can help monitor effect of therapy, assessing the most appropriate strategy depending upon a patient’s individual needs.
One key method of reducing diabetes incidence globally is with early detection and preventative measures, especially at the prediabetes stage of the disorder.
Point-of-Care-Testing (POCT) devices for diabetes have quickly become one of the most important tools for detecting diabetes. These devices can analyze blood glucose levels, lactate, and even glycated hemoglobin (HbA1c), a marker for diabetes as well as a prognostic risk marker for heart disease.
In addition to glucose and HbA1c analyzers, Glycated Serum Protein (GSP) assays, like the GSP LiquiColor® Assay offered by EKF Diagnostics, can help detect markers for diabetes. This GSP assay provides a description of average blood glucose over a 2-3 week period.
In patients deemed ineligible for HbA1c testing, like pregnant women and patients with pancreatic disease, a GSP assay can be an accurate form of measurement and prediction of diabetes status.
- Global report on diabetes. World Health Organization. http://www.who.int/diabetes/global-report/en/.
- Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, Cavan D, Shaw JE, Makaroff LE. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017 Jun;128:40-50. doi: 10.1016/j.diabres.2017.03.024.
- The Cost of Diabetes. American Diabetes Association. http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html.
- Ramachandran A, Snehalatha C, Shetty AS, Nanditha A. Trends in prevalence of diabetes in Asian countries. World J Diabetes. 2012;3(6):110-117.
- Kumar A, Goel MK, Jain RB, Khanna P, Chaudhary V. India towards diabetes control: Key issues. Australas Med J. 2013;6(10):524-531.
- Joshi SR, Parikh RM. India--diabetes capital of the world: now heading towards hypertension. J Assoc Physicians India. 2007;55:323-324.
- Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J. 2014;7(1):45-48.
- Mannucci E, Dicembrini I, Lauria A, Pozzilli P. Is glucose control important for prevention of cardiovascular disease in diabetes? Diabetes Care. 2013;36 Suppl 2:S259-263.
- Kidney Disease (Nephropathy). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html.
- Nerves (neuropathy). Diabetes UK. https://www.diabetes.org.uk/Guide-to-diabetes/Complications/Nerves_Neuropathy/.
- Dubé JJ, Allison KF, Rousson V, Goodpaster BH, Amati F. Exercise dose and insulin sensitivity: relevance for diabetes prevention. Med Sci Sports Exerc. 2012;44(5):793-799.