Diabetes: No Longer Solely a “Rich Country” Problem
Within the United States, it is common to hear about diabetes as a leading public health issue. What may come as a surprise is the fact the diabetes is becoming more and more significant throughout low income countries. According to World Health Organization, in Africa the prevalence of diabetes in adults has increased more than six times since 1980, going from 4 million to 25 million in 2014.
So what is contributing to this increase in diabetes? Similar to the United States a main factor is lifestyle. In countries where sugar represents wealth and access to processed foods is more prevalent, people on both ends of the wealth spectrum are influenced by pressures of living an unhealthy life style. At the root of this issue lies necessity of education. Efforts are being made to improve this in some countries. For example, the International Diabetes Federation (IDF) is working on standardizing education in Tanzania, Cameroon, Mozambique, Kenya, Uganda, Senegal, Zimbabwe, and Zambia. Further, in Nigeria, where there were more than 1.56 million cases of diabetes in 2015, dietary management education and physical activity promotions exist, but implementation of them is limited.
Another difficulty is considering where diabetes initiatives fit into countries where communicable diseases of HIV, tuberculosis, and malaria are primary concerns. It is common that there is lack of government funding and shortage of medicines for diabetes. In Nigeria the government provides minimal funding for diabetes and medication is not very affordable. The cost is care of the disease is frequently out of pocket, resulting in insulin costing 29% of an average monthly minimum wage income. As a result, many people are not able to properly care for the disease.
Perhaps the most pressuring issue with the increase in diabetes in low income countries is the concerns of further chronic diseases that it can result in. These diseases includes hypertension, seizures, strokes, kidney failure, and blindness.
Diabetes has been referred to as the world’s most threatening epidemic. There is not one simple way to reduce the significance of diabetes, but if further progress is not made globally to increase prevention, diagnosis, and management, it is estimated that the amount of people living with diabetes will increase from 415 to 642 million adults in 2040.