Mohammad Hanief About 830 million people worldwide have diabetes, the majority living in low-and middle-income countries. More than half of people living with diabetes are not receiving treatment. Both the number of people with diabetes and the number of people with untreated diabetes have been steadily increasing over the past decades. In the past three decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025. Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn’t make enough insulin. The starting point for living well with diabetes is an early diagnosis – the longer a person lives with undiagnosed and untreated diabetes, the worse their health outcomes are likely to be. Easy access to basic diagnostics, such as blood glucose testing, should therefore be available in primary health care settings. Patients will need periodic specialist assessment or treatment for complications. A series of cost-effective interventions can improve patient outcomes, regardless of what type of diabetes they may have. These interventions include blood glucose control through a combination of diet, physical activity and, if necessary, medication; control of blood pressure and lipids to reduce cardiovascular risk and other complications; and regular screening for damage to the eyes, kidneys and feet to facilitate early treatment. The World Health Organization (WHO) has already issued a medical product alert on falsified semaglutides, the type of medicines that are used for treatment of type 2 diabetes and obesity in some countries. The alert addresses 3 falsified batches of product of semaglutide class of medicines (of specific brand Ozempic), which have been detected in Brazil in October 2023, the United Kingdom of Great Britain and Northern Ireland in October 2023, and the United States of America in December 2023. WHO Global Surveillance and Monitoring System (GSMS) has been observing increased reports on falsified semaglutide products in all geographical regions since 2022. This is the first official notice issued by WHO after confirmation of some of the reports. The number of adults living with diabetes worldwide has surpassed 800 million, more than quadrupling since 1990, according to new data released in The Lancet on World Diabetes Day. The analysis, conducted by the NCD Risk Factor Collaboration (NCD-RisC) with support from the World Health Organization (WHO), highlights the scale of the diabetes epidemic and an urgent need for stronger global action to address both rising disease rates and widening treatment gaps, particularly in low- and middle-income countries (LMICs). The study released recently was conducted by the NCD Risk Factor Collaboration (NCD-RisC), a worldwide network of over 1500 researchers and practitioners, in collaboration with WHO. It is the first global analysis of trends in both diabetes rates and treatment coverage that is based on data from over 140 million people aged 18 years or older that were included in more than 1000 studies covering populations in all countries. The study used an updated methodology of measuring diabetes prevalence in populations from previous studies to provide a more accurate overview of the global diabetes epidemic. “We have seen an alarming rise in diabetes over the past three decades, which reflects the increase in obesity, compounded by the impacts of the marketing of unhealthy food, a lack of physical activity and economic hardship,” WHO Director-General DrTedrosAdhanom Ghebreyesus has said in a WHO press release and added that “To bring the global diabetes epidemic under control, countries must urgently take action. This starts with enacting policies that support healthy diets and physical activity, and, most importantly, health systems that provide prevention, early detection and treatment.” The study reports that global diabetes prevalence in adults rose from 7% to 14% between 1990 and 2022. LMICs experienced the largest increases, where diabetes rates have soared while treatment access remains persistently low. This trend has led to stark global inequalities: in 2022, almost 450 million adults aged 30 and older – about 59% of all adults with diabetes – remained untreated, marking a 3.5-fold increase in untreated people since 1990. Ninety per cent of these untreated adults are living in LMICs. The study further reveals substantial global differences in diabetes rates, with the prevalence of diabetes among adults aged 18 and older around 20% in the WHO South-East Asia and the Eastern Mediterranean Regions. These two regions, together with the African Region, have the lowest rates of diabetes treatment coverage, with fewer than 4 in 10 adults with diabetes taking glucose-lowering medication for their diabetes. Addressing the soaring diabetes burden, WHO is also launching a new global monitoring framework on diabetes. This product represents a crucial step in the global response, providing comprehensive guidance to countries in measuring and evaluating diabetes prevention, care, outcomes and impacts. By tracking key indicators such as glycaemic control, hypertension and access to essential medicines, countries can improve targeted interventions and policy initiatives. This standardized approach empowers countries to prioritize resources effectively, driving significant improvements in diabetes prevention and care. WHO’s Global Diabetes Compact, launched in 2021, includes the vision of reducing the risk of diabetes, and ensuring that all people who are diagnosed with diabetes have access to equitable, comprehensive, affordable and quality treatment and care. The work undertaken as part of the Compact will also support the prevention of type 2 diabetes from obesity, unhealthy diet and physical inactivity. In addition, the same year, a diabetes resolution was endorsed at the World Health Assembly urging Member States to raise the priority given to the prevention, diagnosis and control of diabetes as well as prevention and management of risk factors such as obesity. In 2022, WHO established five global diabetes coverage targets to be achieved by 2030. One of these targets is to ensure that 80% of people with diagnosed diabetes achieve good glycemic control. Today’s release underlines the scale and urgency of action needed to advance efforts to close the gap. The upcoming year 2025 presents a significant opportunity to catalyse action against the alarming rise in diabetes worldwide with the Fourth High-level Meeting of the United Nations General Assembly on the prevention and control of non-communicable diseases (NCDs) to take place in September. This meeting brings heads of states and governments together to set a powerful vision for preventing and controlling NCDs, including diabetes, through a collective commitment to address root causes and improve access to detection and treatment. By aligning efforts towards the 2030 and 2050 goals, this high-level meeting is a pivotal moment for strengthening global health systems, including primary health care and halting the rise in the diabetes epidemic.
