Diabetes cases jump 16% in 2 years and situation alarms specialists

​​The incidence of diabetes worldwide has increased by about 16% since 2019. Today, 537 million adults between the ages of 20 and 79 have the disease, or 1 in 10, compared to 463 million two years ago.

The global situation is considered alarming, and by 2030, the number of diabetics may reach 643 million adults, or 1 in 8. The estimate for 2045 is 784 million.

The disease also claimed 6.7 million lives in 2021, or 1 every 5 seconds – not counting the deaths resulting from complications from other illnesses that had an aggravated effect by diabetes, such as Covid-19 itself.

The data are from the 10th Edition of the Atlas Diabetes 2021, produced by the International Diabetes Federation (IDF). The full report will be published on December 6th – preliminary results were released last Friday (5).

In the previous survey, Brazil had 16.8 million adults living with diabetes, leaving the country in fifth position in the world ranking, behind China (116.4 million), India (77 million), the United States (31 million) and Pakistan (19.4 million).

Like most chronic non-communicable diseases (NCDs), diabetes is unevenly distributed: about 81% of carriers are in low- and middle-income countries. And the higher incidence in developing countries brings another aggravating factor: the cost that this and other chronic diseases impose on health systems.

According to the IDF estimate, the global health cost caused by diabetes is US$966 billion (or about R$5.36 trillion).

For Ricardo Cohen, coordinator of the Specialized Center on Obesity and Diabetes at Hospital Alemão Oswaldo Cruz, it is necessary to recognize that for some decades we have been experiencing a pandemic of “diabesity”: the combination of diabetes and obesity.

“The Covid pandemic should be a warning for us to take this other NCD pandemic much more seriously, since the main causes of mortality in non-elderly adults were precisely diabetes, obesity and hypertension,” he says.

According to the doctor, in addition to the nearly 7 million deaths from diabetes worldwide, it is necessary to add up a considerable portion of Covid’s deaths as a result of diabetes. “Probably 40%, 50% of deaths were in patients with this NCD, which only reinforces how these diseases should be taken seriously”, he says.​

For him, the leap in new cases most likely also results from an increase in diagnoses. The strategies that have been shown to work to control and expand knowledge of NCDs, according to the WHO (World Health Organization), are prevention and treatment.

“Prevention for NCDs should come mainly from awareness campaigns about, firstly, what the disease is, because it is important to recognize it and, secondly, to talk to a doctor to find out what is the most appropriate treatment for every patient,” says Cohen.

When talking about diabetes prevention, however, the focus should be on type 2 of the disease, which today corresponds to between 95% and 97% of cases in the world, explains the doctor.

Type 1 diabetes, whose origin is genetic, is not directly associated with other diseases of the so-called metabolic syndrome, such as obesity and high cholesterol, and consists of an insufficient production of insulin – hence the need to make frequent use of the drug.

Type 2 is often associated with poor diet, cholesterol, hypertension, overweight and sedentary lifestyle. As well as hypertension and obesity, recent researches already point to a direct relationship between poverty and inequality in access to healthy food with the highest incidence of these diseases worldwide.

In addition, the complications of diabetes, which can damage the retina, peripheral nerves, kidney failure and even amputations (the so-called diabetic foot) increase hospital demand and overload the health system.

Detailed data on Brazil are to be released on December 6 in the IDF report.

According to the preliminary version of the Vigitel survey (Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey), by the Ministry of Health, in September this year, 8.2% of the country’s population aged over 18 claims to have diabetes – about 17 million. The incidence is higher among women (9%) and grows with age (25% of the elderly aged 65 years and over reported having diabetes).

Awareness

Ricardo Cohen, who is also a researcher, recently published an article in the specialized magazine “The Lancet” in which he indicates how losing about 15% of weight can help with the remission of type 2 diabetes.

“But it’s not just about losing weight,” says the doctor. “It is important to remove the stigma that, as in obesity, the culprit of having diabetes is the patient. Awareness campaigns in this case are essential because we know that there are many people diagnosed with diabetes who do not take the disease seriously, no they take care of themselves, because they know that the cause is usually genetic and, therefore, they believe they have nothing to do.”

Another research coordinated by the physician and published in June 2020 in the journal “Jama” (Journal of the American Medical Association) shows how metabolic surgeries are effective in reducing up to 82% of kidney disease in patients with type 2 diabetes.

“The costs of dialysis in the SUS today are extremely high, and many of these patients are there because they have diabetes. It is on this front that awareness campaigns must be carried out to act in the initial stage of the disease. If you have diabetes, look for your health clinic or a doctor, start treatment early, don’t leave it for when you have complications. It is much easier to contain a fire in a ten-story building that is still on the first floor than when it has already spread to the ninth,” he says.