What is Diabetes and How Does it Occur?
Overview
Diabetes is a chronic condition that arises either when the
pancreas fails to produce sufficient insulin or when the body becomes incapable
of effectively using the insulin it generates. Insulin is a critical hormone
responsible for regulating blood sugar (glucose) levels. Uncontrolled diabetes
often results in hyperglycemia, or elevated blood glucose levels, which over
time can inflict serious damage on various body systems, particularly the
nerves and blood vessels.
Global Statistics
and Trends
In 2014, 8.5% of adults aged 18 and older were living with
diabetes. By 2019, the disease directly caused 1.5 million deaths, with 48% of
these fatalities occurring in individuals under the age of 70. Additionally,
diabetes was responsible for around 460,000 deaths linked to kidney disease and
contributed to approximately 20% of cardiovascular deaths.
From 2000 to 2019, there was a 3% rise in age-standardized
mortality rates due to diabetes. The impact was more pronounced in
lower-middle-income countries, where mortality increased by 13%. In contrast,
global mortality rates from the four major noncommunicable diseases
(cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes)
decreased by 22% during this same period for individuals aged 30 to 70 years.
Symptoms of Diabetes
Symptoms of diabetes can manifest suddenly or develop
gradually over time. In the case of type 2 diabetes, symptoms may be mild and
can go unnoticed for years. Common symptoms include:
- Intense thirst
- Frequent urination
- Blurred vision
- Fatigue
- Unintentional weight loss
If left untreated, diabetes can damage the blood vessels of
critical organs such as the heart, kidneys, eyes, and nerves. Individuals with
diabetes are also at a higher risk of experiencing heart attacks, strokes, and
kidney failure. The disease can lead to permanent vision loss by damaging the
blood vessels in the eyes and cause severe foot problems, including ulcers,
which can necessitate amputation.
Types of Diabetes
1. Type
1 Diabetes - Type 1 diabetes, previously known as insulin-dependent or juvenile
diabetes, is characterized by insufficient insulin production and requires
daily insulin injections. In 2017, around 9 million individuals worldwide were
living with type 1 diabetes, with the majority residing in high-income
countries. The exact cause of type 1 diabetes remains unknown, and there are no
known measures to prevent it.
2. Type
2 Diabetes - Type 2 diabetes affects how the body metabolizes glucose for
energy, leading to insulin resistance or the inability to use insulin
effectively. Over time, this can result in high blood sugar levels, which may
cause significant damage to nerves and blood vessels. Type 2 diabetes is
largely preventable through lifestyle changes, including maintaining a healthy
weight, regular physical activity, and balanced nutrition. This form of
diabetes accounts for over 95% of all cases globally and is increasingly affecting
children as well as adults.
Early detection through routine check-ups and
blood glucose testing is essential in preventing the severe complications
associated with type 2 diabetes.
3. Gestational
Diabetes - Gestational diabetes occurs during pregnancy and is characterized by
blood glucose levels that are higher than normal but below the diagnostic
threshold for diabetes. Women with gestational diabetes are at an increased
risk of complications during pregnancy and delivery, as well as a heightened
likelihood of developing type 2 diabetes later in life.
4. Impaired
Glucose Tolerance (IGT) and Impaired Fasting Glycaemia (IFG) - IGT and IFG are
intermediate states between normal blood glucose levels and diabetes.
Individuals with these conditions are at a higher risk of developing type 2
diabetes, although it is not inevitable.
Prevention and Management
Lifestyle modifications are the most effective means of
preventing or delaying the onset of type 2 diabetes. Key preventative measures
include:
- Achieving and maintaining a healthy body weight
- Engaging in at least 30 minutes of moderate exercise daily
- Following a nutritious diet low in sugar and saturated
fats
- Avoiding tobacco use
Early diagnosis is critical and can be achieved through
inexpensive blood glucose tests. While individuals with type 1 diabetes require
insulin injections to survive, people with type 2 diabetes may need medications
to manage their blood sugar levels, such as:
- Metformin
- Sulfonylureas
- Sodium-glucose co-transporter type 2 (SGLT-2) inhibitors
Additionally, treatments to manage blood pressure, reduce
cholesterol levels, and address complications such as foot ulcers, kidney
disease, and retinopathy are often necessary.
WHO's Global Response
The World Health Organization (WHO) plays a vital role in
promoting the prevention, diagnosis, and treatment of diabetes, particularly in
low- and middle-income countries. WHO’s efforts include:
- Providing scientific guidelines for the prevention of
diabetes and other noncommunicable diseases
- Developing norms and standards for diabetes care
- Raising awareness of the global diabetes epidemic,
especially on World Diabetes Day (14 November)
- Conducting global surveillance of diabetes and its
associated risk factors
In April 2021, WHO launched the Global Diabetes Compact, a
global initiative aimed at improving diabetes prevention and care, with a
particular focus on low- and middle-income nations. In May 2021, the World
Health Assembly adopted a resolution to strengthen the global response to
diabetes, and in May 2022, the Assembly endorsed five global diabetes targets
to be achieved by 2030.
For more detailed information, visit the [WHO Diabetes
webpage](https://www.who.int/health-topics/diabetes).
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