The greatest threats to public health are far from shocking or contagious. They are familiar and common. Globally, non-communicable diseases such as cancer, hypertension and asthma account for 38 million deaths per year. Of these diseases, diabetes--a condition that's often the result of excess body weight and physical inactivity--is expected to increase rapidly to become the world's seventh largest killer by 2030. Though this seldom makes headlines and is as confronting to our vanity as it is our health, the implications are alarming. By preventing and managing diabetes, we can, however, defy expectations and chart a different reality. This is a life and death battle that we must all sign up for.
More than one out of every four diabetes-related deaths globally, occurs in the WHO South-East Asia (SEA) region.
In the WHO South-East Asia (SEA) region, the stakes are particularly high. In SEA countries, diabetes, which can cause serious damage to every major organ system in the body, resulting in heart attacks, strokes, kidney disease and nerve damage, is a major public health issue. More than one out of every four diabetes-related deaths globally, occurs in the region. Its prevalence also exacerbates difficulties in the control of major infectious diseases such as tuberculosis. Though Type 1 diabetes is thought to be caused by genetic or environmental factors, Type 2, or 'adult-onset' diabetes, is primarily the consequence of lifestyle factors. Type 2 diabetes accounts for 90% of all cases.
The negative by-products of the region's vast social and economic changes are culpable. Sedentary lifestyles coupled with sugary, salty and fatty diets that are also rich in starchy carbs--including white rice and refined flours--are driving the epidemic, which in the region affects primarily those who are in their productive prime. Rather than being a disease solely of the middle classes of high-income countries--as is often imagined--it affects all classes and countries, leading to adverse economic consequences in the developing world. Diabetes not only affects a person's ability to work and earn income, but also limits the wider economy by creating an unhealthy workforce while consuming limited health budget resources. If the diabetes epidemic is exacerbated, so too will be its harm to the health and economies of the SEA region. Charting a different course is vital.
If the diabetes epidemic is exacerbated, so too will be its harm to the health and economies of the SEA region.
There are individual steps that we must all take. Eating healthily and avoiding sugary drinks is a good place to start, and can be done by taking simple measures such as passing up fatty snacks that are rich in calories but offer little in the way of nutrition, and choosing to drink tea without sugar and opting for water instead of soft drinks. Vegetables, fruits and foods high in complex carbohydrates provide the fibre and nutrients necessary for taxing work schedules, while drinking water rather than soft drinks aids hydration at the same time as avoiding unnecessary calories. Controlling portion sizes is also important. This can be achieved by better understanding the needs of our bodies and the caloric density of the foods that we eat, as well as revising how we should feel when we are 'full'. Instead of portion-sizes that match the size of our plates, our portion sizes should match our energy needs.
Committing to regular exercise, which helps control weight, is also necessary. Adults aged 18-64 should do 30 minutes of moderate-intensity aerobic activity at least five times a week. This does not have to be a regimented process. Swimming, hiking, playing football and dancing, for example, are all great for aerobic fitness, and are best enjoyed in the company of others. For those with children, family-based activities are an excellent way to get exercise and promote healthy habits in kids. Physical activity, however, does not always need to be planned. Simple changes of habit, such as taking the stairs or walking to work, are also useful in burning calories and helping to mitigate the risk of diabetes.
Preventing the disease requires much more than individual action: it requires society-wide awareness and behavioural change.
Still, preventing the disease requires much more than individual action: it requires society-wide awareness and behavioural change. Community groups, such as those managing school or work canteens, can facilitate positive decision-making by offering healthy options on their menus and by promoting the benefits that these provide. Schools and workplaces can similarly promote exercise by factoring physical activity in to the workday and by providing the resources to facilitate it, as well as organizing social sporting competitions and events. Governments, meanwhile, should work with consumer groups and the private sector to regulate the marketing of food to children and to explore innovative partnerships for transmitting positive health messages. They can also insist on accurate food labelling to help consumers make decisions that will be positive for their health. They can tax sugary beverages and re-invest the revenue in health promotion activities.
Governments should work with consumer groups and the private sector to regulate the marketing of food to children... They can tax sugary beverages...
However successful prevention efforts are, diabetes will, to some extent, continue to afflict public health due to non-modifiable risk factors such as ageing and genetics. Early detection of the disease is vital to limiting its impact. We can all facilitate this by regularly visiting healthcare services for assessing diabetes risk. For those that already have diabetes, strict adherence to diet and exercise regimes and timely medication is essential to limiting complications. Governments, meanwhile, must increase access to healthcare and promote educational campaigns regarding self-care, as well as making treatment less costly. Diabetes can be managed successfully. Diabetes does not have to lead to complications or be fatal.
Diabetes rarely makes headlines, despite its appalling impact on public health and the wider damage this causes. On World Health Day 2016, we have the potential to re-calibrate our priorities, recognize the public health threat diabetes poses and do something about it. We can defy expectations and beat the diabetes epidemic. The battle must begin.
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