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The economic cost of diabetes


Yemurai Machirori Correspondent
For so long the world turned a blind eye to diabetes, a condition that has been labelled as the “silent killer”.

In world health matters, it has been something between a millstone and a ticking time bomb.

In fact, the burden is now being acutely felt not just on the Zimbabwean economy, but also the world as a whole and the effects cascade down to social and economic sectors/environments.

In the health sector, diabetes has become one of the largest global health emergencies of the 21st century as research and statistics show that each year more and more people live with this condition, which can result in life-changing complications.

The International Diabetes Federation (IDF) in its latest Atlas (7th edition) indicates that in addition to the 415 million adults who are already estimated to currently have diabetes, there are 318 million adults with impaired glucose tolerance, which puts them at a high risk of developing the condition in the future.

What is even more worrying though is the fact that diabetes may have overtaken other chronic and infectious diseases over the years, with statistics from the IDF revealing that an estimated five million people died from diabetes and its related complications in 2015 alone, whereas the statistics from the World Health Organisation Global Health Observatory Data Repository (2013) revealed that an estimated 1,5 million people died from HIV/AIDS, another 1,5 million from tuberculosis and just 600 000 deaths were caused by malaria.

Social and financial cost of diabetes

According to the 7th edition of the Diabetes Atlas, diabetes has become more than a silent killer as it is starting to dominate our communities and slowly becoming an epidemic to our economies.

This is mainly due to the fact that diabetes and its complications are major causes of death in most countries.

Type 2 diabetes is the most prevalent form of diabetes and has increased alongside cultural and societal changes.

In high-income countries up to 91 percent of adults with the disease have type 2 diabetes.

The International Diabetes Federation estimates that 193 million people with diabetes are undiagnosed and are therefore more at risk of developing complications.

Furthermore, one in 15 adults is estimated to have impaired glucose tolerance, and one in seven births is affected by gestational diabetes. Both of these conditions are associated with an increased risk of developing type 2 diabetes in later life.

In addition to placing a large financial burden on individuals and their families due to the cost of insulin and other essential medicines, diabetes also has a substantial economic impact on countries and national health systems.

This is because of an increased use of health services, loss of productivity and the long term support needed to overcome diabetes related complications, such as kidney failure, blindness or cardiac problems.

The majority of countries spend between 5 percent and 20 percent of their total health expenditure on diabetes.

With such a high cost, the disease is a significant challenge for healthcare systems and an obstacle to sustainable economic development.

Despite these huge figures it is worrying that many countries are still unaware of the social and economic impact of diabetes.

This lack of understanding is the biggest barrier to effective prevention strategies that could help halt the inexorable rise of type 2 diabetes.

However, given the statistics provided above indicating the effects of diabetes on health, society and the economy, the question thus becomes: why are policy makers sitting on such facts and figures and not acting on them?

A holistic and well thought out strategy is therefore required to deal with this global phenomena.

Halting the rise in diabetes

Greater education is needed to improve the diagnosis and management of all types of diabetes and to embed lifestyle changes that will slow the rise in type 2 diabetes.

While educational programmes can help improve the management of people with diabetes, public health education is needed at the population level to encourage behaviour change to prevent type 2 diabetes.

Early diagnosis can prevent or delay the long term health complications of people who are undiagnosed with type 2 diabetes.

However, besides the governments and health workers looking out for type 2 diabetes, it is also important for the public to take measures which will help them in the prevention of type two diabetes.

Some tips that can be gradually adopted by people may include the following:

Exercise: Sedentary habits, especially watching television, are associated with significantly higher risks for obesity and type 2 diabetes. Regular exercise, even of moderate intensity (such as brisk walking), improves insulin sensitivity and may play a significant role in preventing type 2 diabetes – regardless of weight loss.

Weight Management: Being overweight is the number one risk factor for type 2 diabetes. Even modest weight loss can help prevent type 2 diabetes from developing. It can also help control or even stop progression of type 2 diabetes in people with the condition and reduce risk factors for heart disease.

Reduce portions and eat healthier: Even though there is an increase in fast food outlets, which also seem to be cheaper, it is important for people to choose healthier food choices. Reducing portions and limiting added fat and sugar is considered a step towards eating healthy. Instead of eating fast foods, people should try to choose more whole grains, vegetables, and lean meats and dairy products. A terrific rule to follow is: everything in moderation. Reduced portion sizes and a limit in the intake of alcohol can also help in the reduction of type 2 diabetes in adults. It is therefore important to eat small, well-balanced meals spread throughout the day as larger meals can make it more difficult to keep blood glucose levels in a healthy range.

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