Michigan Daily Life

Erik Bendl and his dog, Nice, walk with a globe to promote diabetes prevention through diet and exercise. Obesity is the most important risk factor for Type 2 diabetes. (Don Campbell/The Herald-Palladium/Associated Press)

The number of adults with diabetes has quadrupled worldwide in under four decades to 422 million, and the condition is fast becoming a major problem in poorer countries, a World Health Organization study showed on Wednesday.

In one of the largest studies to date of diabetes trends, the researchers said aging populations and rising levels of obesity across the world mean diabetes is becoming "a defining issue for global public health."

Type 2 diabetes is a long-term condition characterized by insulin resistance. Patients can manage their diabetes with 
medication and diet, but the disease is often life-long and is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

"Obesity is the most important risk factor for Type 2 diabetes and our attempts to control rising rates of obesity have so far not proved successful," said Majid Ezzati, a professor at Imperial College London who led the WHO research.

Published in The Lancet journal ahead of the United Nations World Health Day on April 7, the study used data from 4.4 
million adults in different world regions to estimate age-adjusted diabetes prevalence for 200 countries.

It found that between 1980 and 2014, diabetes has become more common among men than women, and rates of diabetes rose significantly in many low and middle income countries, including China, India, Indonesia, Pakistan, Egypt and Mexico.

"If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active, and avoid excessive weight gain," Dr. Margaret Chan, the WHO's director-general, said in a statement from the WHO's Geneva headquarters.

"Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes."

The study found that northwestern Europe has the lowest rates of diabetes among women and men. 

"The lack of rise of diabetes in Western European countries and some other developed countries, including Canada, interestingly, in the recent years was quite interesting," Prof. Goodarz Danaei, co-lead author of the study and an assistant professor of global health at Harvard Chan School, said in an interview with CBC News.

 No country saw any meaningful decrease in diabetes prevalence, it found.

The researchers estimated the global cost of diabetes at $825 billion US dollars per year. In Canada in 2014, the costs to the health system directly was $8 billion US, Danaei said. 

Dr. Jan Hux, the chief science officer at the Canadian Diabetes Association, said in this country, people with diabetes account for:

  • 30% of strokes.
  • 40% of heart attacks.
  • 50% of kidney failure requiring dialysis.
  • 70% of amputations.

"I have had patients tell me, 'Oh doctor, I don't have diabetes. I just have a little sugar.' This is far more than a little sugar if you look at the downstream consequences," Hux said.

Hux said the biggest concern is that rates of diabetes are now becoming unsustainable in countries that can't afford to manage it.

The largest increases in diabetes rates were in Pacific island nations, followed by the Middle East and North Africa, in countries like Egypt, Jordan and Saudi Arabia.

Danaei said the increases there were because of the "usual offenders:" higher intakes of energy dense-food such as fried starches, as well as lower physical activity among people who are moving to urban areas and adopting sedentary lifestyles.

The data also showed that half of adults with diabetes in 2014 lived in five countries — China, India, the United States 
Brazil and Indonesia. Rates more than doubled for men in India and China between 1980 and 2014. 
With files from CBC News