The number of people around the world suffering from diabetes has skyrocketed in the last two decades, from 30 million to 230 million, claiming millions of lives and severely taxing the ability of health care systems to deal with the epidemic, according to data released by the International Diabetes Federation. The demographics of the diabetes epidemic are also changing rapidly at the same time. While the growing problem of diabetes in the United States has been well documented, the federation’s data shows that 7 of the 10 countries with the highest number of diabetics are in the developing world.
Type I diabetes is an autoimmune disease; it appears in childhood, is lifelong, and currently must be treated with insulin. Type II diabetes typically appears in middle age. It is linked to obesity and therefore is more prevalent in developed countries with relatively affluent lifestyles, sedentary occupations, and dietary overindulgence.
According to the American Diabetes Association's journal, Diabetes Care, Asia accounts for 60% of the world's diabetic population. In recent decades, Asia has undergone rapid economic development, urbanization, and transitions in nutritional status. China now has the largest number of diabetics over age 20, around 39 million people or about 2.7 percent of the adult population, according to the federation. The group also mentions India with the second largest number of cases with an estimated 30 million people, or about 6 percent of the adult population.
There are many factors driving the growth in diabetes worldwide, but most experts agree that changes in lifestyle and diet are the chief culprits, in addition to genetic predisposition. As developing countries rapidly industrialize, people tend to do work involving less physical activity. At the same time, the availability of food that is cheap but high in calories becomes more common.
Typically, type II diabetes occurs after a person becomes obese, when insulin resistance occurs; the diabetes comes next. When this occurs, the cells do not respond properly to insulin; glucose does not enter the cells and blood glucose (sugar) levels rise. When fat is stored in the "wrong" places (blood vessels, heart and muscles) in the body, insulin resistance is much more likely to occur. Experts are not sure exactly how the association works.
The most common treatment for type II diabetes today involves initially placing the patient on a special diet; sometimes they may need to take pills that increase insulin secretion and also make the cells more sensitive to insulin. Occasionally they are given tablets to bring down the production of glucose. However, after a few years, for about one-third of all patients these treatments gradually lose their efficacy and insulin injections are needed.
World-renowned British specialist Dr David Cavan, Director of policy at the International Diabetes Federation, hands patients a lifeline with a simple regime that can reduce the devastating effects of type II diabetes. His plan includes adopting a healthy diet, getting support from your family, boosting exercise, assessing current diabetes drugs, keeping up to date with monitoring the condition – and, finally, being realistic about what you want to achieve.
According to Dr Cadan, people with type II diabetes will be motivated to change their lifestyle if they realize that it is possible to become free from diabetes rather than if they think that whatever they do, they will always have it. He added that reducing sugar and understanding that some starchy carbohydrates have almost the same effect as eating sugar can bring about swift changes.
According to the International Diabetes Federation and other major professional organizations, the global population of individuals with diabetes (type I and II) was about 240 million in 2010, and is expected to rise to 300 million by 2025. The corresponding market of products used to diagnose and treat diabetes was $118.7 billion for 2012, and is expected to rise to almost $157 billion over the next five years. The market for monitoring equipment stands at approximately $14 billion and is set to rise toward $21 billion by 2017.
Working towards introducing innovative solutions in this area, French pharmaceutical company, Servier, is planning to pioneer a tiny drug-loaded implantable pump, developed by a Boston-based start-up, Intarcia Therapeutics Inc., which is anticipated to transform the global market for patients with diabetes.
Servier has agreed to pay Intarcia Therapeutics Inc. $171 million up front, with potential additional payments that could increase the total to more than $1 billion, for rights to co-develop the device for most markets outside the U.S., the companies said. Closely held Intarcia retains full rights to the treatment for the U.S. and Japan. The pump hasn’t yet been approved for sale; the companies plan to submit it to regulators in the first half of 2016.
In Sweden, the researchers from Stockholm University say that they have uncovered a new mechanism that encourages glucose uptake in brown fat. They explain that brown fat's main function is to create heat by burning fat and sugar. By using this new knowledge, the researchers say they may be able to stimulate this signalling pathway with drugs, lowering blood sugar levels and potentially even curing type II .
The brown fat is active in adults, acting as one of the bodily tissues that can be encouraged to take up large amounts of glucose from the bloodstream to use as a fuel source to create body heat, the researchers said. As such, increasing the uptake of glucose in brown fat can quickly decrease blood sugar levels, they added.
In a person with the condition, the body's tissues are unable to respond to insulin, rendering them unable to take up sugar from the blood. Because insulin is released after eating to regulate blood sugar, when the insulin signal no longer functions properly, blood sugar levels rise. Very high blood sugar levels are dangerous to organs in the body and can lead to , kidney failure, blindness, peripheral nervous system damage, amputations and even early death.
"This is completely new and groundbreaking research," Prof. Tore Bengtsson of Stockholm University's Department of Molecular Biosciences said.
On December 20, 2006, the United Nations (UN) passed a resolution to designate November 14 as World Diabetes Day. The occasion aimed to raise awareness of diabetes, its prevention and complications and the care that people with the condition need. World Diabetes Day was first commemorated on November 14, 2007, and is observed annually.
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