The diabetes burden

Published
8

WHILE the pandemic might have heightened peoples’ awareness of communicable and infectious diseases, the grave risks posed by non-communicable diseases (NCDs) remain as potent as ever. This threat is further aggravated in lower- and middle-income and developing countries, where living and working conditions remain less than ideal for a plethora of reasons.

As the saying goes, health is wealth: it is only natural, and logical, that countries with robust economies would have healthier populations mostly on account of effective healthcare systems in place. The physical and mental health of any individual is key in ascertaining their productivity and longevity. In fact, the World Bank suggests that better health conditions in developed countries can make them up to 50 per cent more fiscally productive than developing economies that usually have weaker healthcare systems.

Though infectious diseases pose grave challenges to the global economic order, as proved by Covid-19, it is NCDs— which often remain undetected — which still comprise the major portion of the total disease burden of the world, especially in low- or middle-income countries where more than half the world’s population resides. In this regard, Asia remains one of the top contributors to the world’s GDP with prospects of driving as much as 60pc of global growth by 2030. Yet the region, especially South Asia, bears one of the highest socioeconomic costs of the non-communicable disease burden. Around 8.5 million people die each year in South Asia from NCDs. According to the World Health Organisation, NCDs are a key threat to South Asian economies.

One of the diseases that affects a large fraction of the South Asian population is type 2 diabetes, or diabetes mellitus, where the body’s response to the blood-sugar-regulating hormone — insulin — is compromised. The country most affected by and at risk from diabetes in South Asia is Pakistan, where according to a recent study published in The Lancet, 33m people suffer from type 2 diabetes — the third-highest diabetes prevalence in the world — while 11m more have impaired glucose tolerance. In addition to this, it is estimated that between 8.9m cases remain undiagnosed in the country.

The country most at risk from diabetes in South Asia is Pakistan.

Diabetes mellitus is the most common form of diabetes across the world. More than 95pc of worldwide diabetes cases are said to be of type 2 variant, states WHO. Under it, the body becomes resistant to insulin and is, therefore, unable to self-regulate blood sugar levels. Its major risk factors include physical inactivity, poor eating habits, stress, and obesity among others, very common in urban populations across Pakistan and the rest of South Asia. This is not all; diabetes mellitus increases the body’s susceptibility to other serious illnesses, including renal failure, heart disease, and increased susceptibility to outside infections such as Covid-19. Over time, if not managed, diabetes often becomes debilitating as it acts as a force multiplier for other chronic illnesses.

World Diabetes Day is observed today (Nov 14) every year to spread awareness and educate people about this disease and arrest its spread in growing populations. The theme for 2021-23 is “access to diabetes care”, a slogan that emphasises the need for making policies more conducive toward diabetes management. To keep more people from developing it, it is essential that predisposition towards diabetes is caught early and managed by lifestyle alternations. In Pakistan, the government should allow every citizen to get tested at least once a year according to their individual risk factors (any one of the three internationally-recognised biochemical tests), to ascertain their de­­gree of glucose im­­p­airment and pre­­­v­ent future com­­­plications. Simul­t­­­aneously, the government would also do well to adopt policies more conducive for a healthier lifestyle, such as increasing the tax on tobacco products, soft drinks and other sugar-based products consumed widely and across socioeconomic divides.

It should be stressed, however, that diabetes mellitus is to an extent preventable, and if diagnosed, largely manageable by improving physical activity, eating a balanced diet and reducing stress. With more than half the population living below the poverty line, our government needs to prioritise sustainable measures for improving food security and nutritional inadequacy in millions of households across the country. The government should also create more green spaces in urban areas where people can be physically active, de-stress and participate in recreational activities. Focusing on people’s well-being would go a long way in enabling a stronger economy.

The writer is editor of Scientific Investigation and Global Network of Scientists.

Published in Dawn, November 14th, 2022

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