Diabetes 2016 update: 382 million diabetics worldwide and 13 million California adults have prediabetes, which is a preventable precursor to diabetes.
Diabetes is a global health problem. To address the many issues surrounding diabetes, experts worldwide have come together to offer recommendations on optimizing global diabetes care, which may help tackle the diabetes epidemic. The recommendations were published in the special issue of the Annals of Global Health.
Issue editor Jeffrey I. Mechanick explained, “The multi-faceted nature of diabetes requires an assessment of lifestyle, behavior, genetics and epigenetics, and the intrauterine environment. The problems of one country are not only relevant for that country; information gleaned from a portfolio of countries may generate emergent ideas to solve the complex diabetes problem globally.”
“Not surprisingly, diabetes prevalence rates are increasing the most in rural and low-middle income areas. Cultural differences also have an influence. The lack of guidelines for different target populations and also the interaction of acculturation to Westernized lifestyle with a genetic susceptibility, especially in aboriginal populations, is of concern. Clearly, understanding the effects of one culture in one country can assist diabetes care for patients of the same culture but in another country,” added Dr. Mechanick.
Although each paper reveals their own unique take on diabetes based on culture and socioeconomics, there are some key similarities seen across the board. Here are some of them:
-Diabetes is associated with a high economic burden.
-There is insufficient funding in low- to middle-income countries.
-More governmental policies and interventions need to be implemented to increase awareness and improve care.
There is a need to create local or transculturalized foreign evidence-based guidelines and then implement on a national scale.
The main findings have been synthesized into core conclusions that may inform further actions.
Knowledge base: Each nation needs to assess the region-specific epidemiology and scientific evidence base to identify high-risk patients and develop diagnosis guidelines and therapeutic intervention.
Public health: Each nation establishes a public health imperative to acquire the necessary tools (diagnostics, drugs, supplies, etc.) and funding to successfully implement culturally-sensitive guidelines, as well as developing metrics to evaluate and improve these guidelines.
Durability: Each nation must commit to education and research and continue to interact on a multi-national scale to improve optimization.
Dr. Mechanick concluded, “These three recommendations serve as a starting point to address the complex nature of global diabetes care – to treat populations and individuals, to recognize similarities and differences, and to move more quickly than ever, as the diabetes epidemic has thus far been deaf to our calls for action.”
Thirteen million California adults have prediabetes, which is a precursor to diabetes, but the good news is, prediabetes is not a life sentence and can be reversed in order to prevent type 2 diabetes. Prediabetes rates generally increase with age, but it has been found that many young adults are developing prediabetes, too. More specifically, one-third of those aged 18 to 39 have prediabetes. Furthermore, the rates of prediabetes in younger adults are found to be higher among those individuals of color. Policies should be implemented to reduce the burden of prediabetes. Further support for prevention and treatment of prediabetes is needed.
Some recommendations offered in order to prevent prediabetes from transitioning into type 2 diabetes – along with preventing prediabetes altogether – include the following:
-Support diabetes prevention methods by offering screening and greater insurance coverage.
-Promote community and workplace environments that support healthy eating.
-Promote built environments that promote regular physical activity, such as safe parks and other areas for recreation.
-Support adequate access to quality primary and secondary care by increasing insurance coverage.
-Increase access to lifestyle modifications to prevent diabetes.
If these recommendations are followed, Californians can have better success in controlling diabetes and preventing prediabetes from developing into diabetes.
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