Background 

Dr. Fredrick Banting, a Canadian Physician, who invented Insulin and got the Nobel prize for it along with John Macleod in 1923, was born on November 14, 1891. In his honor, his birthday is celebrated as World Diabetes Day (WDD. Launched in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO), WDD aims to promote the importance of coordinated and concerted action to confront diabetes as a critical global health issue. The event unites a global audience of more than one billion people across more than 160 countries to raise awareness of the need for better care, education, and resources to support people living with diabetes and help delay or prevent the condition in those at risk.

The challenge of diabetes is many fold more since half of the 537 million cases globally and 8.7 million of nearly 37 million cases in the USA are not even aware that they have diabetes. Diabetes is not just a disease of medical importance. It is devastating quite often, and the person affected will be affected mentally, physically and also socially. So, the theme for the year is “Diabetes and Wellbeing.” On this theme the International Diabetes Foundation and World Health Organization along with all of us will focus for the next three years 2024 to 2026. 

What is diabetes? 

Diabetes is a chronic condition that occurs when the pancreas can no longer make insulin, or the body cannot effectively use insulin.

Insulin is a hormone made by the pancreas that acts like a key to let glucose from the food we eat pass from the bloodstream into the cells in the body to produce energy. The body breaks down all carbohydrate foods into glucose in the blood, and insulin helps glucose move into the cells.

When the body cannot produce or use insulin effectively, this leads to high blood glucose levels, called hyperglycemia. Over the long-term high glucose levels are associated with damage to the body and failure of various organs and tissues.

Diabetes: How common is it? Where is it prevalent maximum?

Diabetes is currently the fastest growing disease. As per the latest World Atlas of Diabetes, it is estimated that 537 million people have diabetes globally. This means the number of people with diabetes in the world is more than the total number of people staying in the USA, Canada and Mexico combined! On the World Diabetes Day this year, the World Atlas of Diabetes 2024 will bring new statistics for diabetes. 6.7 million people died in 2021 due to diabetes and that comes to nearly 765 deaths every day, 12 every minute, death every five seconds! The new estimate of diabetes, which is most likely to go upwards, will soon be declared on this world diabetes day.

China, India, Pakistan, the USA, and Indonesia are the top five countries with the highest number of diabetes patients currently and will continue to remain so for the next 20 years (See figure 1). Barring the USA, all other countries are in Asia and thus Asia is the major continent contributing to the global burden of Diabetes.

BMI 23: Asians are at high risk for diabetes and at lower body weight as compared to Europeans and white population. Therefore, for screening purposes, it is recommended that Asians be screened at Body Mass Index (BMI) of 23 and above unlike other populations where screening is recommended for BMI of 25 and above. New recommendation proposes to screen every Asian and most insurances are covering diabetes screening for every Asian and not just those who are above BMI 23.

Diabetes in Arizona:  Approximately 631,251 people in Arizona, or 11% of the adult population, have diagnosed diabetes. An additional 164,000 people in Arizona have diabetes but don’t know it, greatly increasing their health risk. One in three are in the prediabetes phase with much higher risk to develop diabetes (See the Figure 2). 6.8 billion dollars is the diabetes related cost in Arizona.

Diabetes and Well Being

The theme for World Diabetes Day 2024-26 is diabetes and well being

Millions of people with diabetes face daily challenges managing their condition at home, work, and school. They must be resilient, organized, and responsible, impacting both their physical and mental well-being. Diabetes care often focuses only on blood sugar, leaving many overwhelmed. This World Diabetes Day, 14 November, let’s put well-being at the heart of diabetes care and start the change for a better diabetes life. 

In 2024, the campaign focuses on the importance of diabetes and wellbeing. Research suggests that 36% of known diabetes patients experience diabetes distress, 63% of these patients say that they experience fear of diabetes complications and so they don’t feel well, 28% of diabetes patients find it hard to remain positive with diabetes. This fact is disturbing since we know that diabetes if diagnosed early and attended properly keeps life completely normal.  It is thus important to attend to diabetes patients’ health needs physically and mentally and understand the effect of diabetes on the life of a patient and not see it just as a metabolic disease linked to blood sugar. 

The World Health Organization sets up the following targets by 2030 for all the countries and regions of the world.

1. 80% of people living with diabetes are diagnosed.
2. 80% of people with diagnosed diabetes have good   control of glycaemia.
3. 80% of people with diagnosed diabetes have good control of blood pressure.
4. 60% of people with diabetes of 40 years or older receive statins.
5. 100% of people with type 1 diabetes have access to affordable insulin and blood glucose self-monitoring.

Governments need to commit themselves with manpower, material and other resources and modify the policy in favor of diabetes control more seriously. 

What can we do to help reduce and prevent diabetes for us and our families?

The focus and slogan for this year’s diabetes day theme answers this question. “Diabetes and wellbeing””. At an individual level we can contribute by taking preventive measures to ensure that we do not develop diabetes or if we have it, it remains under control and does not disturb our mental and physical health, and no complications occur. These steps include following risk factors and preventive measures. 

Acceptance:

If diabetes is diagnosed, it is a disease if managed correctly, allows one to have a completely normal life and does not disturb our routine life in any way. However, it has to be managed correctly and the guidelines for management provided by treating physicians strictly adhered to. That very disease, if not managed correctly, will affect almost every organ of our body and has a long list of possible complications. So following preventive measures if we do not have diabetes and therapeutic measures if we have diabetes are essential. 

Weight:

The heavier we are, the greater the risk. Being overweight increases the risk for diabetes, as well as other heart related conditions. Even the children who are overweight are at risk for diabetes. Preventing overweight and obesity and if overweight, reducing and controlling weight will help in preventing diabetes and many other diseases.

Exercise:

Exercise can greatly help prevent diabetes, and also helps diabetic patients have better control of their disease state and reduce the chances for further complications. 30 minutes of moderate-strenuous exercise like brisk walking for 5 days a week can be greatly beneficial. 

Diet: 

Modification of diet towards less processed food, more fruits and vegetables and food with less glycemic index helps to control diabetes. Total portion consumed needs to be checked with our daily requirement and excess food consumption be avoided. 

Smoking:

Smoking increases insulin resistance which causes increased levels of blood sugar. This can lead to kidney, heart, and blood vessel related complications in diabetic patients. Quitting smoking is very important. 

Regular medical checkups:

Get yourself examined for diabetes every year since diabetes is a silent disease and a large proportion of them are not diagnosed yet. We should get ourselves and our family members screened once a year at least for diabetes. 

Asian Pacific Community in Action and National Kidney Foundation are ‘not for profit’ organizations in Phoenix that help to get yourself screened free of cost for diabetes and guide for non-medical and lifestyle intervention to prevent complications and refer you for medical treatment.