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Diabetes cases to double by 2030

Close up of syringe for insulin injection. The number of diabetes cases is expected to double by the year 2030 in sub-Saharan Africa, fueled by urbanization, diet, poor access to health care, late diagnoses and lack of understanding about a disease that i Phuong Tran/IRIN
Without a major breakthrough in preventing and treating diabetes, the number of cases in sub-Saharan Africa is projected to double, reaching 24 million by 2030, according to the Brussels-based International Diabetes Federation (IDF).

A recent study, Diabetes in sub-Saharan Africa, led by the University of Yaoundé in Cameroon and published in the British medical journal, The Lancet, said inadequate donor attention and national prevention programmes were creating a global "public health and socioeconomic time bomb".

Diabetes is caused by inherited genetic factors and lifestyle choices, and manifests when the body does not produce enough insulin, or cannot break down sugar in the blood, according to the World Health Organization. The disease usually requires long-term treatment and can lead to costly and serious health complications, including heart failure.

In the 34 poorest African countries, the cost of diabetes per person is more than double their average income. In 2010 an estimated 6 percent of total mortality in sub-Saharan Africa will probably be caused by diabetes - a three-fold increase in the past 10 years, the IDF noted.

Jean Claude Mbanya, IDF president and the study's lead researcher, told IRIN that diabetes had been misunderstood as a rich country problem, despite medical data compiled by IDF showing that 70 percent of cases were reported in low- and middle-income countries.

"There is also the perception that when diabetes does affect people in low-income countries, it only affects those who are the wealthy elite. This is absolutely not the case - diabetes is devastating for the poor, affecting breadwinners," he told IRIN.

Researchers acknowledged that data was scarce in Africa and estimates were based on a limited number of studies. "More studies would increase our confidence in the numbers, but this does not mean they are wrong ... Most people in Africa who have diabetes are undiagnosed and, therefore, even when statistics are available from health systems, they will always underestimate the size of the problem."


Diabetes patient Sophe Sar, 29, from Dakar, Senegal prepares one of her three daily injections of insulin 201006281907100312
Photo: Phuong Tran/IRIN
Sophie Sar
Sophie Sar, 29, was diagnosed with diabetes in Dakar, capital of Senegal, when she was nine years old. Doctors prescribed insulin, the main anti-diabetic drug, three times a day, costing her almost US$3 per dose. "Every penny I earn as a hairdresser goes to insulin," she told IRIN.

She earns around $6 a day if she has three clients; when she falls short, an uncle lends her money. Her medically approved diet is unaffordable: "We eat mostly rice here in Senegal, but I can only have a few cups of it a day. I am supposed to eat more vegetables but they are so much more expensive." 

The authors call for diabetes treatment to be funded in the same way as HIV/AIDS drugs are, along with "support for delivery mechanisms and chronic disease education and care models".

Also needed are "socio-culturally appropriate health promotion campaigns" to address health beliefs in African, mostly rural, settings, that raise the risk of diabetes – such as obesity being a sign of "good living", and a preference for foods with a high saturated fat content, as well as improved access to care and affordable treatment.

"Late diagnosis of diabetes, coupled with inequalities in access to major anti-diabetes drugs ... leads to early presentation of diabetic complications and premature deaths," the study noted.

"HIV/AIDS, malaria and tuberculosis are important conditions, but they are not the only conditions," IDF's Mbanya told IRIN, questioning donor spending priorities that appeared to overlook "chronic non-communicable diseases", or non-infectious diseases requiring long-term treatment.

According to UNAIDS, 6 percent of patients infected with HIV died in 2008 - roughly the same percentage of global patient deaths IDF estimates will be caused by diabetes in 2010.

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