The Blind Leading the Blind

Diabetes is often thought of as a disease that plagues overweight people in developed countries. However, because of changing lifestyles around the world, including an increase in sedentary jobs and over-consumptive diets loaded with processed food, people from developing countries are becoming heavier and are increasingly getting diabetes. Dr. David Friedman, Eye Health Technical Advisor, Helen Keller International, reported that “diabetes is becoming an enormous problem globally even among the poorest people in the world.”

The rise of diabetes in poor and developing countries not only poses a challenge to public health but also to how the disease will be measured and interpreted around the world. This is especially true because it is increasingly difficult to collect valid data in developing countries. According to Peter Byass, Umea Centre for Global Health Research, “Poverty in material terms is inextricably linked with the poverty of data.”

This week, the New York Times published an article stating that “China has the world’s biggest diabetes epidemic, and it continues to get worse.” According to a study by the American Medical Association, “In China 11.6% of adults have the disease, compared with 11.3% in the United States.”  The study also concluded that “Half of the almost 99,000 people tested had ‘prediabetic’ blood glucose levels.”

Diabetes is not only rising in China, but also in countries like India and Bangladesh. According to the President of the Diabetic Association of Bangladesh, “South East Asia will be the new diabetes capital of the world.” He also noted that, “Diabetes is a very costly disease because once you have it, you have it for life.”

In 2012, diabetes cost $245 billion in the United States due to heart disease and stroke, high blood pressure, kidney disease, and multiple other factors including diabetic retinopathy, a disease that can lead to total blindness (click here to learn more).  This makes it imperative that when we examine diabetes we look at the whole picture, including the root causes and consequences of the disease, especially because diabetes may result from societal choices and economic trends.

Since diabetes is becoming increasing prevalent, in order to discuss how we can treat and prevent the disease in all countries, we need to search for innovate ways to collect data and measure the impact of the disease, recognizing that there may not be a best practices approach. It will also be important to discuss how to measure the effectiveness of innovative treatment programs and preventative measures because it is often more valuable to figure out how to deliver a treatment than to determine what the treatment will be.

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References:

Byass, P. (2009) “The unequal world of health data.” PLoS Medicine 6 (11): e1000155

Friedman, David. (2012) “Diabetic Retinopathy,” Helen Keller International, http://www.youtube.com/watch?v=7QlT4SDSOQQ

McNeil, Donald G. (2013) “Diabetes epidemic grows in China,” http://www.nytimes.com/2013/09/10/health/diabetes-epidemic-grows-in-china.html?ref=health

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