Integrated response to diabetes

Diabetes is a leading threat to public health and, along with other non-communicable diseases (NCDs), is a major contributor to morbidity and mortality globally. The largest burden -- 80% (28 million) -- occurs in low- and middle- income countries, making NCDs a major cause of poverty and an urgent development issue. Building awareness of this issue is the main focus of World Diabetes Day, which will be on Sunday, 14 November 2010.

"You can not talk about public health today without addressing the rise of non-communicable diseases, especially in low- and middle-income countries", said Dr Nils E Billo, Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union), which is one of the key partners of the NCD Alliance.

"Many of these diseases are linked, such as diabetes and tuberculosis, so when you have a rapidly increasing burden of diabetes, you will also see an impact on TB control. Studies have shown that people with diabetes have a two-three times greater risk of developing tuberculosis."

According to the International Diabetes Federation (IDF), the disease now affects over 300 million people worldwide and will cost the global economy at least USD 376 billion in 2010, or 11.6% of total world healthcare expenditure. A further 344 million people are at risk of developing type II diabetes -- the most common form of the disease. If nothing is done to reverse the epidemic, IDF predicts that by 2030, 438 million people will live with diabetes at a cost projected to exceed USD 490 billion.

"For patients, the danger is that the mortality risk attributed to diabetes is much higher for people with active TB disease. Communities will see the impact in reduced quality of life and productivity and increased poverty. For health systems, the impact will be a greatly increased case load of patients needing chronic care", said Dr Billo.

According to a research study done by the University of Texas School of Public Health Brownsville Regional Campus, people with type-II diabetes are not only at greater risk of developing active TB, their chronic high blood sugar is associated with an altered immune response to TB. In addition, patients with diabetes and TB take longer to respond to anti-TB treatment and are more likely to have multidrug-resistant TB.

The Union hopes to see health responses to diabetes that are integrated with programmes addressing risk factors like those of TB. The linkages of diabetes with poverty also need further attention from the governments and other stakeholders.

Bobby Ramakant – Citizen News Service (CNS)

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