Diabetes: Global Perspective

Not so long ago, diabetes was rare and something that happened to one’s grandparents as they aged. Now, the world is grappling with a major epidemic of type 2 diabetes as well as an increase in type 1 diabetes. Once called “adult-onset” diabetes, type 2 diabetes can even impact children due to increase in obesity, maternal obesity, and glucose level during pregnancy. Diabetes continues to cause symptoms and is a leading cause of heart disease, blindness, kidney disease, non-traumatic amputation, and other neurologic complications.

Facts from the World Health Organization:

  • The global prevalence of diabetes among adults is 9% in 2014.
  • Approximately 1.5 million deaths were directly caused by diabetes in 2012 (note, this does not include the contribution of diabetes to the cause of death from infection, heart disease, kidney failure, etc.)
  • Diabetes is projected to be the 7th leading cause of death in 2030.
  • We can prevent or delay the onset of type 2 diabetes! This can be achieved by maintaining ideal weight, eating a healthy diet, engaging in regular physical activity, and avoiding tobacco use.

In 2014, the International Diabetes Federation listed countries starting with those that had the highest percentage of people with diabetes. For those of us in the United States, the results may be surprising as we are not number one on the list. In fact, the United States is listed at number 57.

Rank Country Value Year
1 Kiribati 26.43 2014
2 Saudi Arabia 23.90 2014
3 Vanuatu 23.71 2014
4 Kuwait 23.13 2014
5 Bahrain 21.87 2014
6 Mauritius 21.15 2014
7 New Caledonia 20.06 2014
8 Qatar 19.78 2014
9 United Arab Emirates 19.02 2014
10 Palau 18.46 2014

(http://www.indexmundi.com/facts/indicators/SH.STA.DIAB.ZS/rankings)

 

Susan Renda
Susan Renda, DNP, Assistant Professor, Johns Hopkins School of Nursing

Low and middle income people can have problems with diabetes due to lack of access to care, prevention, and early detection. Wealthier societies may have more health care, but can have problems due to less availability of fruits, vegetables, grains, and more reliance on processed foods. Note that five of the top ten countries with the highest percentage of people with diabetes are in the Middle East where historically people were active for their livelihood. With the income from oil, people in these countries have adopted more sedentary behaviors.

World Health Day 2016 called for us to “halt the rise” and “beat diabetes”. So how do we halt the rise and beat diabetes? The amazing thing about type 2 diabetes is that it can be prevented or delayed and responds really well to improved lifestyle– no expensive medication, no painful treatment, just healthier habits.   That’s where nursing has a huge opportunity to help stem the tide of diabetes and improve life for people in all settings across the world.

So if you are a nurse, here are a few things you can do to help.

  • Every moment with a patient and family can be a teaching moment, so start by learning as much as you can about diabetes self-management education. The American Diabetes Association and the International Diabetes Federation have lots of information and education materials.
  • Learn about the culture of the people you are with such as customs, foods, and health beliefs.
  • Meal-planning can be especially challenging for people, so be ready to have a non-judgmental attitude, keep it simple, reward small changes, and utilize dietitians when available.
  • Encourage more physical activity! It is equal in importance to food choices, but often forgotten. Involve the family and community. Ideally, people with diabetes should get 30 minutes of aerobic activity daily. Start slow and remember any increase in activity is a good start.
  • Then, there are medications including insulin. Medications can be expensive and for some people, difficult to obtain. Certain cultures discourage use of medication with concern the medication causes the complications, not the poorly controlled diabetes. In some areas of the world, insulin is not available.   Fortunately, groups such as the International Diabetes Federation and Eli Lilly, an insulin manufacturer, are working to make insulin accessible. Know the beliefs and the resources in your area.

The rise in diabetes is a challenge for the world, but nurses can play a major role in preventing type 2 diabetes and preventing complications.

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