The estimated mortality from diabetes was 5 million people in 2015, according to the International Diabetes Federation (IDF). This far exceeds the estimated deaths from war and violence. “Yuval Noah Harari could not have been more accurate in his book Homo Deus when he said that sugar is more dangerous than gunpowder!” says Dr Larry Distiller, Specialist Physician/Endocrinologist and Principal Physician, and Executive Chairman of the Centre of Diabetes and Endocrinology (CDE).
In 2004, a renowned epidemiologist, Professor Paul Zimmet, stated that ‘what HIV/Aids was to the last 20 years of the 20th century, diabetes will be in the first 20 years of this century’. “Unfortunately, he has been proven to be correct,” says Distiller. In 2001, it was estimated that by 2025 there would be over 350 million people in the world with type 2 diabetes. This number was exceeded in 2011. There are now over 415 million people with diabetes in the world, with current estimates of over 642 million by 2040 likely to be exceeded. “Currently, almost 1 in 11 of the world population has diabetes. The largest increase will be in developing countries, where diabetes is expected to double in the next 15 years. South Africa has the highest number of adults living with diabetes in Africa,” he says.
The reason why these numbers matter, says Distiller, is that the diagnosis of diabetes confers a massively increased risk of coronary heart disease and stroke. Diabetes is linked closely to the other well-known risk factors for heart disease and death, namely high blood pressure, high cholesterol and obesity.
“79% of those dying from diabetes in developing countries are under the age of 60 years, just when these people should be in their most economically productive years. Apart from the personal and emotional trauma caused by early death, the potential effect on the economy is immeasurable,” he adds.
Diabetes remains the most common cause of blindness in the Western World, the leading cause of kidney failure, dialysis and transplantation and the most common factor in lower limb amputations. It is also a major cause of acute hospitalisation. Distiller says that good management of diabetes has the potential to reduce acute hospitalisation rates by 85%, eye complications and renal failure by 60% and amputation rates by over 80%. “The potential cost savings run into billions of Rands.”
“The problem is that diabetes, despite its frequency, is both an expensive and difficult condition to treat. It requires ongoing, in-depth management, education, monitoring and constant review and intensification of medication, with many patients eventually requiring insulin for control. And as complications develop, the cost of management goes up incrementally and exponentially,” he says.
“The bottom line is that the most important person in the management of diabetes is the person living with diabetes. The majority of diabetes care is self-administered. People with diabetes have to decide when to take their medication, what goes onto their plate on a daily basis and whether or not they will exercise. This can be overwhelming. Much needs to be done to assist people living with diabetes.” For this reason, CDE has launched a free CDE Club App providing information, a tool to track progress and even earn rewards. The aim of the App is to step in and empower people with diabetes so they can meet their daily self-management demands. “The App is free for anyone living with diabetes, you do not need to be a member of CDE to access it,” he explains.
“The diabetes tsunami is here. Unless we meet it head on with appropriate management this condition is single-handedly set to break the health care system, if not the entire economy, in the next decade,” concludes Distiller.