Improving access to diabetes medicines and care
Currently, there are more than 420 million people living with diabetes worldwide. Deaths related to diabetes have increased by 70% globally between 2000 and 2019. In the Eastern Mediterranean Region, diabetes is a major public health challenge, affecting nearly 14% of people living in this region. It causes premature death and health consequences like heart attacks, stroke, blindness, kidney failure and amputation. By 2045, more than 100 million people in the Eastern Mediterranean Region may experience the heavy burden of diabetes.
World Diabetes Day aims to raise awareness of diabetes as a public health issue and what needs to be done, collectively and individually, for better prevention, diagnosis and management of the condition. This year’s theme is “improving access to diabetes medicines and care”. This year also marks the 100th anniversary of the discovery of insulin, an essential diabetic medication.
World Diabetes Day and the 100th anniversary of the discovery of insulin are both opportunities for WHO and partners to:
highlight the huge gap between the people who need access to insulin to control their diabetes, as well as essential technologies such as blood glucose meters and test strips, and those who actually have access.
raise the priority given to diabetes prevention, diagnosis and management of risk factors like obesity, physical inactivity, unhealthy diet and tobacco use through implementation of strategic and cost-effective interventions in the regional framework for action on diabetes prevention and control, endorsed by countries in this year’s Regional Committee for the Eastern Mediterranean, with the aim of halting the rise in diabetes and reducing premature deaths from noncommunicable diseases by 2030.
World Diabetes Day also comes at a time when the world continues to live through the COVID-19 pandemic, which has not only resulted in a high proportion of people with diabetes among hospitalized patients with severe manifestations of COVID-19 and among those who have succumbed to the virus, but has also led to severe disruption of diabetes services. So on this day and beyond, let us transform our commitments into actions during and post-COVID-19 to build healthier communities with better access to diabetes medicines and care.
International Diabetes Federation: World Diabetes Day 2021
WHO headquarters: World Diabetes Day 2021
Webinar on Improving access to diabetes medicines and care in the Region
Webinar on Improving access to diabetes medicines and care in the Region
Statement from the Regional Director
Regional framework for action on diabetes prevention and control
The Eastern Mediterranean Region has the highest rates of diabetes worldwide. Diabetes affects nearly 14% of people living in this region. Six out of the 10 countries with the highest rates of diabetes worldwide are in the Region.
Diabetes causes premature death and health consequences like heart attacks, stroke, blindness, kidney failure and amputation. By 2045, more than 100 million people in the Eastern Mediterranean Region may experience the heavy burden of diabetes.
Steps have been taken in this year’s Regional Committee for the Eastern Mediterranean where countries endorsed a framework for action to address diabetes as a public health challenge, with the aim of halting the rise in diabetes and reducing premature deaths from noncommunicable diseases by 2030.
Regional framework for action on diabetes prevention and control
Addressing diabetes as a public health challenge in the Eastern Mediterranean Region
WHO Global Diabetes Compact: an opportunity for lasting change
On World Diabetes Day 2020, WHO announced the Global Diabetes Compact, which was later launched in April 2021. The WHO Global Diabetes Compact is a comprehensive and inclusive approach to support countries in implementing effective programmes for the prevention and management of diabetes. The Compact brings together in one package all WHO materials available for the prevention and management of diabetes, both existing and new.
The WHO Global Diabetes Compact has 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. Key to the success of the Compact will be alignment and united action across all sectors ̶ public, private and philanthropic.
The Lancet Commission on diabetes: using data to transform diabetes care and patient lives
Over 460 million people worldwide have diabetes, with around 80% of them living in low-income and middle-income countries. Despite high-level commitments to accelerate global action against noncommunicable diseases (NCDs), the world is not on-track to reach Sustainable Development Goal 3.4 to reduce premature mortality from major NCDs by 30% between 2015 and 2030. Ahead of World Diabetes Day 2020, this Lancet Commission on diabetes provided a blueprint for closing gaps in diabetes prevention, care, professional knowledge and data that could save millions of lives. Modelling done by the Commission shows that use of a data-driven, multicomponent, integrated strategy could avert up to 800 000 premature deaths in the top 10 low- and middle-income countries with the highest populations of people with diabetes. Implementing this Commission’s recommendations will require a whole-of-society approach to transform ecosystems and care environments.
Diabetes
What is diabetes?
Diabetes is a chronic illness that raises sugar (glucose) levels in the blood. If not controlled, raised blood glucose levels can lead to serious complications.
Type 1 diabetes
Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. In 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries. Neither its cause nor the means to prevent it are known. Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes and fatigue. These symptoms may occur suddenly.
Type 2 diabetes
Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body’s ineffective use of insulin. More than 95% of people with diabetes have type 2 diabetes. This type of diabetes is largely the result of excess body weight and physical inactivity. Symptoms may be similar to those of type 1 diabetes but are often less marked. As a result, the disease may be diagnosed several years after onset, after complications have already arisen. Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.
Gestational diabetes
Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes. Gestational diabetes occurs during pregnancy. Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. These women and possibly their children are also at increased risk of type 2 diabetes in the future. Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.
Impaired glucose tolerance and impaired fasting glycaemia
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.
Check for diabetes
What are the complications?
Heart attacks
Stroke
Blindness
Lower limb amputation
Kidney failure
What are the risk factors?
40 years of age and older
Overweight/obesity
Physical inactivity
Unhealthy diet
Tobacco use
Family history of diabetes
History of abnormal glucose during pregnancy
What are the symptoms?
Constant thirst
Constant hunger
Excessive urination
Weight loss
Blurred vision
Fatigue
Living with diabetes
You can live a long, healthy and productive life despite having diabetes, provided it is diagnosed early and managed effectively.
Adopt a healthy lifestyle
Eat healthy
Eat more fruit and vegetables
Reduce sugar and fat intake
Be active
Engage in 30 minutes of regular, moderate-intensity activity on most days
Do not use tobacco
Follow medical advice
Control blood glucose
Control blood pressure
Get regular check-ups
Adhere to medication
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The Global Diabetes Compact: Unite
Let us all unite, including people living with diabetes to set clear goals and targets to help better prevent and control diabetes. We know what works. Effective treatment and care, and preventing risk factors like obesity, physical inactivity, unhealthy diet and tobacco use. Let us all unite and take action in our specific areas of expertise.
The Global Diabetes Compact: Integrate
Diabetes is a serious public health issue in the Eastern Mediterranean. The Region has the highest prevalence of diabetes worldwide. In many countries, services for the prevention, diagnosis and treatment of diabetes, including screening for complications, do not exist at the primary care level or cannot be accessed free of charge. In addition, diabetes medicines are not included in health insurance schemes or cannot be purchased without financial hardship. We know what works. Let us all unite to integrate affordable diabetes management into primary health care and universal health coverage.
The Global Diabetes Compact: Innovate
Diabetes causes premature death and health problems such as heart attacks, stroke, blindness, kidney failure and amputation. At present, 55 million people are living with diabetes in the Region, and by 2045, this figure is expected to rise to 108 million people. We know what works. Let us all unite to promote innovation, development and evaluation of low-cost technologies and digital solutions for diabetes care.
The Global Diabetes Compact: Treat
Many children, adolescents and adults struggle to access affordable diabetes medicines and technologies. Improving access requires leadership from governments, as well as engagement from the pharmaceutical, health technology product and related private sector industries. Let us work together to identify ways for these industries to help resolve these issues, such as increasing transparency, guaranteeing uninterrupted supplies of human insulin for lower income countries and humanitarian settings, participating in future procurement mechanisms, and engaging in WHO’s prequalification programme for insulin.
The Global Diabetes Compact: Track
WHO aims to support countries in integrating diabetes medicines and care into primary health care services and the universal health coverage agenda. WHO Member States in the Eastern Mediterranean Region recently took a major step forward on this by endorsing a new framework for action to address diabetes as a public health challenge. Setting targets can galvanize action to improve access to care for people living with diabetes. We know what works. Let us all invest in action on diabetes to ensure that access to diabetes medicines and care is cost-effective and equitable.
The Global Diabetes Compact: Fund
Several million people who live with diabetes are estimated to have been displaced by protracted complex emergencies and natural disasters. WHO’s Eastern Mediterranean Region is host to some of the world’s biggest emergencies and protracted crises. At the end of 2018, of the 70.8 million people forcibly displaced worldwide – including refugees and internally displaced persons – 32.1 million (45.3%) originated from the Region, while 25.4 million continued to reside in the Region. People who live with diabetes in humanitarian emergencies face unique challenges. For them, access to essential medicines and diagnostics is often insufficient. Let us all prioritize the development and adoption of context-specific and evidence-based interventions in collaboration with humanitarian partners to improve diabetes care for those living through humanitarian emergencies.
The Global Diabetes Compact: Educate
World Diabetes Day is an opportunity for us to raise awareness about diabetes, and how it can be prevented and controlled. It is important for us to learn and understand the signs and symptoms of diabetes, and what interventions are available. We should also educate ourselves on how to prevent diabetes-related risk factors like obesity, physical inactivity, unhealthy diet and tobacco use. We know what works. Let us all unite on improving our understanding of diabetes, and how it can be prevented and treated.
The Global Diabetes Compact: Power ahead
Without immediate action, diabetes threatens the livelihoods of families, the resiliency of national health systems, and growth and development. The COVID-19 pandemic is an additional pressure on these threats, and will have long-lasting impacts on health, and the health systems vital for rehabilitation and care. Recovery from COVID-19 needs to go hand-in-hand with action to address diabetes. For these reasons, the Global Diabetes Compact is not just important but urgently needed. Together, let us transform our commitments into actions during and post-COVID-19. We know what works. Let us all unite to build back healthier communities with better access to diabetes medicines and care, and to ensure health for all by all.
