COVER STORY
Nowadays, diabetes is one of the major health problems. It affects one in every ten adults worldwide. Every year, 14 November is observed as World Diabetes Day to raise awareness about a disease that has become one of the leading causes of illness and death globally.
Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose levels. Hyperglycaemia, also known as high blood sugar, is a common effect of uncontrolled diabetes.
Diabetes is often recognised by what doctors call the ‘four Ps’: polyuria (frequent urination), polydipsia (excessive thirst), polyphagia (increased hunger) and polyneuropathy (nerve pain or tingling in the hands and feet). Common symptoms also include blurred vision, fatigue, unintentional weight loss, slow wound healing, and increased susceptibility to infections such as those of the skin or urinary tract.
Many myths still surround diabetes. Some people believe that eating too much sugar causes it, or that those with diabetes cannot eat sweets or carbohydrates. Others think insulin cures diabetes, or that only overweight or older people develop the disease. Some even turn to herbal or alternative medicines, believing they can cure diabetes. In reality, such treatments can make the condition worse and delay proper medical care.
Diabetes, however, is not caused by eating sugar, nor can it be prevented by cutting carbohydrates from your diet. Insulin is not a permanent cure; it is only a treatment. Thin people can also develop diabetes, especially type 1, as it is not related to body weight. Both adults and children may get diabetes due to rising obesity and a sedentary lifestyle. It can sometimes be asymptomatic and may lead to serious health complications.
THE ALARMING SURGE OF DIABETES
According to the World Health Organization (WHO), the number of people living with diabetes rose from about 200 million in 1990 to 530 million in 2021, and it is projected to reach 640 million by 2030. The prevalence has been rising more rapidly in low- and middle-income countries than in high-income ones.
According to the International Diabetes Federation (IDF), around 33 million adults in Pakistan are living with diabetes, giving the country one of the highest prevalence rates in the world. The prevalence of diabetes among adults in Pakistan is estimated at around 31.4 percent.
Globally, in 2022, about 14 percent of adults aged 18 years and older were living with diabetes, compared to 7 percent in 1990. More than half (59 percent) of adults aged 30 years and above with diabetes were not taking medication to manage their condition. Treatment coverage remains lowest in low- and middle-income countries.
In 2021, diabetes was the direct cause of 1.6 million deaths, and 47 percent of these occurred before the age of 70. In addition, diabetes caused around 530,000 deaths from kidney disease and contributed to roughly 11 percent of all cardiovascular deaths.
Health issues related to diabetes
Over time, diabetes can damage blood vessels in the heart, eyes, kidneys, and nerves. People with diabetes are at higher risk of developing heart attacks, strokes and kidney failure. It can also cause permanent vision loss by damaging the blood vessels in the eyes. Many people with diabetes develop foot problems due to nerve damage and poor blood flow, which can lead to ulcers and, in severe cases, amputation.
Early diagnosis and management
To prevent type 2 diabetes and its complications, maintaining a healthy body weight and staying active are key. Experts recommend at least 150 minutes of moderate physical activity per week, along with a balanced diet low in sugar and saturated fats. Avoiding tobacco is equally important, as smoking raises the risk of both diabetes and its related complications.
In 2021 alone, diabetes and diabetes-related kidney disease were responsible for more than 2 million deaths worldwide. Moreover, about 11 percent of cardiovascular deaths were linked to high blood glucose levels.
Early diagnosis is vital and can be achieved through simple, low-cost blood glucose tests. People with type 1 diabetes require insulin injections to survive, while those with type 2 diabetes can often manage their condition through lifestyle changes. However, some may also need medications or insulin therapy to help control their blood sugar levels effectively.
Along with medicines to lower blood sugar, people with diabetes often need medication to control blood pressure and reduce the risk of complications. According to the World Health Organization, more than half of people living with diabetes were not taking medication for their condition in 2022. Treatment coverage was lowest in low- and middle-income countries.
Additional medical care may be needed to manage the effects of diabetes, such as foot care to treat ulcers, screening and treatment for kidney disease, and eye exams to detect retinopathy, which can lead to blindness.
Promoting awareness
Raising awareness about diabetes plays an essential role in its prevention, diagnosis, and effective management. Awareness can be promoted through health talks, seminars, and social media campaigns, as social media is a powerful tool with widespread access. Role plays, presentations, free screening camps, and the promotion of healthy lifestyles can also help dispel myths about diabetes and contribute to a healthier society.
Diabetes and wellbeing
The theme for World Diabetes Day 2025 is ‘Diabetes and Wellbeing’, which focuses on workplace health, mental wellbeing, and preventive lifestyle measures for better disease management.
RISK FACTORS
Since 2000, deaths caused by diabetes have been steadily rising. In contrast, the overall risk of dying from any of the four major non-communicable diseases:
cardiovascular diseases, cancer, chronic respiratory diseases, or diabetes between the ages of 30 and 70 actually fell by 20 percent worldwide between 2000 and 2019.
The risk factors for diabetes can be broadly divided into two categories: modifiable and non-modifiable. Modifiable factors include obesity, lack of physical activity, unhealthy eating habits, and the use of tobacco and alcohol.
Non-modifiable factors, on the other hand, include age, ethnicity, family history, and gestational diabetes. Certain medical conditions such as hypertension, dyslipidaemia, and insulin resistance disorders can also increase the risk of developing diabetes.
TYPES OF DIABETES
There are several types of diabetes. The most common forms include:
Type 2 diabetes: With this type, your body doesn’t make enough insulin and/or your body’s cells don’t respond normally to the insulin (insulin resistance). This is the most common type of diabetes. It mainly affects adults, but children can have it as well.
Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
Type 1 diabetes: This type is an autoimmune disease in which your immune system attacks and destroys insulin-producing cells in your pancreas for unknown reasons. Up to 10 percent of people who have diabetes have Type 1. It’s usually diagnosed in children and young adults, but it can develop at any age.
Gestational diabetes: This type develops in some people during pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes, you’re at a higher risk of developing Type 2 diabetes later in life.