Today marks the annual World Diabetes Day, drawing attention to one of the world’s most serious and rapidly rising public health challenges. The theme for this year, ‘Diabetes across life stages’, recognises that diabetes can affect people of all ages. Diabetes is a chronic disease and is often tied to unhealthy diets, lack of exercise and smoking. This about sums up the lifestyle many across the world are currently leading, particularly in developing countries like Pakistan. As such, it is not surprising that the prevalence of diabetes has risen from 200 million in 1990 to 830 million in 2022, rising more rapidly in low- and middle-income countries than in high-income countries, as per the World Health Organisation. According to the International Diabetes Foundation (IDF), an estimated 34.5 million of these diabetics call Pakistan home as of 2024. This is the fourth largest population of diabetics in the world and the countries in the top three (China, India and the US) all have significantly larger populations. In terms of age-standardised prevalence among adults aged 20 to 79, Pakistan’s 31.4 per cent prevalence is the highest in the world.
The fact that a country that struggles to even adequately feed most of its people has the world’s biggest diabetes problem shows the changing nature of global food consumption patterns. Fast food is no longer the province of the rich world and, with healthy options increasingly becoming unaffordable for many, developing countries like Pakistan are developing diets that can kill. The fact that unhealthy foods and the companies that sell them often face less health-related regulations in Pakistan, at least ones that are enforced, than they do in richer countries only compounds the problem. It also does not help that regular exercise is just not a part of the lives of most Pakistanis. After all, those struggling to afford food are not exactly going to be lining up for a gym membership and public parks are not very accessible, especially for women. But rising prevalence is only part of the country’s diabetes struggle. Untreated, the disease can lead to kidney failure, blindness, heart problems and lower-limb amputation, something which many of the nation’s people are learning to their woe.
Around 29 per cent of the diabetes cases in the country are undiagnosed, contributing to almost 230,000 diabetes-related deaths in 2024. Around 35 people also lose a limb daily due to diabetic complications. There is also an economic cost to this crisis, with costs for the healthcare system reaching a shocking $2.73 billion last year. So what have the nation’s health authorities done about all of this? The answer is: very little. Pakistan reportedly ranks second-last globally in terms of diabetes-related health expenditure. This is rather unsurprising given that public health expenditure is less than one per cent of GDP. There also do not appear to have been many serious efforts to encourage and/or help Pakistanis exercise more and, while a ‘Healthy Diet-Health Forever’ campaign was launched in 2023, most people do not seem to have switched to healthier food. One is far more likely to catch Pakistanis having fizzy drinks with their biryani than eating salads. But then, how many people can afford a salad? That is usually considered a premium option in this country. And with produce prices skyrocketing, even healthy food at home is a stretch. This is a shame because healthier foods and lifestyles would kill the diabetes problem at its roots while also lowering the burden that boosting diabetes diagnosis and treatment will bring. If the nation continues to decide to forego that burden by skimping on health expenditures, this may well become the world’s diabetes capital in both percentage and absolute terms.
