Call for international action on biggest epidemic in human history —
4 May 2007
Barcelona, Spain. The International Diabetes Federation
(IDF) has launched a new consensus statement on diabetes prevention, to be
published in the May issue of Diabetic Medicine. It is calling for urgent
action to counter the diabetes pandemic, which is threatening to overwhelm
global healthcare services.
It also follows a December 2006 United Nations General Assembly
resolution calling for concerted international action. "The UN resolution is
a huge win in the fight against the biggest disease epidemic in human
history. Diabetes is responsible for close to 4 million deaths every year.
With 246 million people with diabetes now and 380 million people with
diabetes by 2025, diabetes is set to bankrupt national economies(1)" said
Professor Paul Zimmet, Director, International Diabetes Institute and
co-author of the consensus.
"Type 2 diabetes can be prevented, but it will take enormous political
will on the part of governments to make this a reality. They can achieve
this by creating the environment that allows individuals to make lifestyle
changes. That is why we are calling on all countries to endorse the UN
resolution and to target entire populations through the development and
implementation of National Diabetes Prevention Plans."
The new IDF
consensus recommends that all individuals at high risk of developing type 2
diabetes be identified through opportunistic screening by doctors, nurses,
pharmacists and through self-screening.
Professor Sir George Alberti, Past
President of IDF and co-author of the new IDF consensus said: "There is
overwhelming evidence from studies in the USA, Finland, China, India and
Japan that lifestyle changes (achieving a healthy body weight and moderate
physical activity) can help prevent the development of type 2 diabetes in
those at high risk (2-6) The new IDF consensus advocates that this should be
the initial intervention for all people at risk of developing type 2
diabetes, as well as the focus of population health approaches."
addition to the need for individual lifestyle change, IDF recognizes that
there are powerful environmental forces that influence the behavioural,
eating and exercise patterns of the community.
"Inadvertently, our own
government authorities may have contributed to this epidemic by allowing
developers to create urban social problems,' said Professor Avi Friedman,
Professor of Architecture at McGill University, Montreal. "Urban sprawls are
part and parcel of new developments without proper attention to building
design, sidewalks, bike paths, public transport corridors, playing fields
and friendly exercise areas that are essential and need to be accessible to
people who want to maintain a healthy lifestyle."
Prevention Plans will therefore require coordinated policy and legislative
changes across all sectors including health, education, sports and
agriculture, as well as the formation of strategic relationships. They must
be culturally sensitive and targeted to mobilize all sectors of the
"Diabetes is already a massive social cost, and it is up to
politicians to decide whether they will spend more and more money on acute
care and drugs, or invest in prevention by supporting lifestyle change among
the entire population," said Professor Alberti.
"A Kyoto-like agreement on diabetes prevention and management is needed
among governments worldwide if we are to prevent this problem from becoming
catastrophic," concluded Professor Zimmet.
Each year 7 million people develop diabetes and the most dramatic increases
in type 2 diabetes have occurred in populations where there have been rapid
and major changes in lifestyle, demonstrating the important role played by
lifestyle factors and the potential for reversing the global epidemic.
A person with type 2 diabetes is 2 - 4 times more likely to get
cardiovascular disease (CVD), and 80% of people with diabetes will die from
it. Premature mortality caused by diabetes results in an estimated 12 to 14
years of life lost.
A person with diabetes incurs medical costs that are two to five times
higher than those of a person without diabetes, and the World Health
Organization (WHO) estimates that up to 15% of annual health budgets are
spent on diabetes-related illnesses .
There is conclusive evidence that good control of blood glucose levels and
management of high blood pressure and aspects of the lipid profile (blood
fats) can slow the progression to or of type 2 diabetes, and substantially
reduce the risk of developing complications (such as cardiovascular, eye and
kidney disease) in people with diabetes.
The International Diabetes
Federation (IDF) is the global advocate for more than 240 million people
with diabetes worldwide. It represents 200 diabetes associations in more
than 150 countries. The mission of IDF is to promote diabetes care,
prevention and a cure worldwide. IDF is a non-governmental organisation in
official relations with the World Health Organisation. For further
information see: www.idf.org
(1) Diabetes Atlas, third edition, International
Diabetes Federation, 2006.
(2) Pan X, Li g, Hu Y, Wang J, Yang W, An Z.
Effects of diet and exercise in preventing NIDDM in people with impaired
glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997;
(3)Tuomilehto J. Lindstrom J, Eriksson J, Valle T, Hamalainen
H. Prevention of type 2 diabetes mellitus by changes in lifestyle among
subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343-1350.
(4) Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar A, Vijay V. The
Indian Diabetes Prevention Programme shows that lifestyle modification and
metformin prevent type 2 diabetes in Asian Indian subjects with impaired
glucose tolerance (IDPP-1). Diabetologia 2006; 49 (2): 289-297.
Knowler W, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM. Reduction in
the incidence of type 2 diabetes with lifestyle intervention or metformin. N
Engl J Med 2002; 346: 393-403.
(6) Kosaka K, Noda M, Kuzuya T. Diab Res
Clin Pract 2005; 67: 152-162.
Source: International Diabetes Federation
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