HomeENGLISH MAGAZINEDiabetemic: the umpteenth experts' cryin' out beside the current COVID

Diabetemic: the umpteenth experts’ cryin’ out beside the current COVID

Almost two years have passed since the last experts’ appeal on the severity of the diabetes pandemic and its global health and economic impact, that a new report just published is becoming insistent. Because COVID-19 is only the latest pandemic to come after others with many more victims behind it.

Nearly half a billion people on the planet have diabetes, but most of them are not receiving the kind of care that could make their lives healthier, longer and more productive, according to a new global study. Many don’t even know they have the condition. According to findings published in Lancet Healthy Longevity, only 1 in 10 people with diabetes in the 55 low- and middle-income countries studied receive the kind of comprehensive care that has been shown to reduce diabetes-related problems. That complete package of care: low-cost drugs to reduce blood sugar, blood pressure and cholesterol levels; and counseling on diet, exercise and weight – can help reduce the health risks of under-treated diabetes. These risks include future heart attacks, strokes, nerve damage, blindness, amputations, and other disabling or fatal conditions. The new study, led by physicians at the University of Michigan and Brigham and Women’s Hospital with a global team of partners, draws on data from standardized home studies to enable shoulder-to-shoulder comparisons across countries and regions.

The authors analyzed data from surveys, exams and tests of more than 680,000 people between the ages of 25 and 64 conducted around the world in recent years. More than 37,000 of them had diabetes; more than half of them had not yet been formally diagnosed, but had a key biomarker of high blood sugar. The researchers provided their findings to WHO, which is developing efforts to increase the provision of evidence-based diabetes care globally as part of an initiative known as the Global Diabetes Compact. The diabetes-related forms of care used in the study are all included in the WHO’s 2020 package of essential noncommunicable disease interventions. Diabetes continues to explode everywhere, in every country, and 80% of people with it live in these low- and middle-income countries, with a high risk of complications. In addition to the main finding that 90% of the people with diabetes studied did not have access to all six components of effective diabetes care, the study also notes important gaps in specific care.

For example, while about half of all people with diabetes were taking a blood glucose-lowering drug and 41% were taking a blood pressure-lowering drug, only 6.3% were taking cholesterol-lowering drugs. show the need to scale-up proven treatment not only to lower glucose but also to address cardiovascular disease risk factors, such as hypertension and high cholesterol, in people with diabetes. Less than a third have had access to diet and exercise counseling, which can help people with diabetes adopt habits that can further control health risks. Even when the authors focused on people who had already received a formal diagnosis of diabetes, they found that 85% were taking a blood sugar lowering drug, 57% were taking a blood pressure drug, but only 9% were taking something to control their cholesterol. Nearly 74% had received diet-related counseling and just under 66% had received exercise and weight counseling.

Overall, fewer than one in five people with previously diagnosed diabetes received the full package of evidence-based care. Overall, the study finds that people were less likely to get evidence-based diabetes care, where the median income of the country or region they lived was lower. It is based on a model that the authors created using economic and demographic data on the countries included in the study. Nations in the Pacific Oceania region had the highest prevalence of diabetes – both diagnosed and undiagnosed – but the lowest rates of diabetes-related care. But there were exceptions where low-income countries had higher than expected rates of good diabetes care, scientists say, citing the example of Costa Rica and the Latin American and Caribbean region overall. It was second only to Oceania in the prevalence of diabetes, but had much higher levels of care. Focusing on what countries with outstanding achievements in diabetes care are doing well, could provide valuable information for improving care elsewhere.

This also includes information assistance in high-income countries like the United States, which do not consistently provide evidence-based care to people with diabetes. The study also highlighted the variation between countries and regions in the percentage of diabetes cases that have been diagnosed. Improving reliable access to diabetes diagnostic technologies is important in driving more people to get preventative care and counseling. Women, people with higher education levels and greater personal wealth, and older people or people with a high BMI were more likely to receive evidence-based diabetes care. Diabetes in people with “normal” BMI is not uncommon in low- and middle-income countries, suggesting a greater need to focus on these individuals, the authors say. The fact that diabetes-related drugs are available at very low cost and that people can reduce risk through lifestyle changes means that cost shouldn’t be a major barrier.

In fact, studies have shown that the drugs are affordable, which means that the cost of their early and consistent use is offset by the savings on other types of subsequent care.

  • edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Basu S et al. Lancet Glob Health. 2021; 9(11):e1539-e1552.

Myhre PL et al. J Am Heart Assoc. 2021 May 17:e020447.

Roth GA et al. J Am Coll Cardiol. 2020; 76(25):2982-3021.

Flood D et al. PLoS Med. 2020 Nov 12; 17(11):e1003434.

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Dott. Gianfrancesco Cormaci

Medico Chirurgo, Specialista; PhD. a CoFood s.r.l.
- Laurea in Medicina e Chirurgia nel 1998 (MD Degree in 1998) - Specialista in Biochimica Clinica nel 2002 (Clinical Biochemistry residency in 2002) - Dottorato in Neurobiologia nel 2006 (Neurobiology PhD in 2006) - Ha soggiornato negli Stati Uniti, Baltimora (MD) come ricercatore alle dipendenze del National Institute on Drug Abuse (NIDA/NIH) e poi alla Johns Hopkins University, dal 2004 al 2008. - Dal 2009 si occupa di Medicina personalizzata. - Guardia medica presso strutture private dal 2010 - Detentore di due brevetti sulla preparazione di prodotti gluten-free a partire da regolare farina di frumento enzimaticamente neutralizzata (owner of patents concerning the production of bakery gluten-free products, starting from regular wheat flour). - Responsabile del reparto Ricerca e Sviluppo per la società CoFood s.r.l. (Leader of the R&D for the partnership CoFood s.r.l.) - Autore di articoli su informazione medica e salute sul sito www.medicomunicare.it (Medical/health information on website) - Autore di corsi ECM FAD pubblicizzati sul sito www.salutesicilia.it
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