Half the world has diabetes: the prelude to healthcare systems collapse


15518505_mLast August, The Guardian online highlighted how the impressive spread of diabetes in the UK was basically anticipating NHS default.

Such statement is so incredible if we think at the size and structure of one of the biggest national healthcare systems, so powerful and recognized to be featured at the opening ceremony of the London Olympic Games in 2012.

Over the past 10 years, at least 1 million people became diabetic; today, the total number in the UK is more than 3 million. Of these, only 6 out of 10 are being treated appropriately, while the rest (almost half of the total) is not taking good care, by skipping positive dietary and lifestyle choices, therefore facilitating the onset of diabetes-related complications such as circulation problems, dementia, extremities necrosis, limb amputation and stroke (together with all the ensuing direct and indirect consequences, both in terms of quality of life and cost).

The cost of care for diabetics in the UK is 14 billion euros per year: 80% of this figure is used to treat predictable complications.

Unfortunately, Diabetes UK (the British charity providing all this information) has foreseen an increase to 5 million cases in Britain by 2025.

The cost of treating diabetes is not as scary as that derived from managing any related clinical complication, so frequent and widespread to pretty much lead any healthcare system to bankruptcy.

A study published in September 2015 in JAMA does confirm this evidence: the American researcher A. Menke compared the data on diabetes prevalence in the adult US population between 1988 and 1994 and then at a later period of time, between 1999 and 2012 (A Menke et al, JAMA. 2015 Sep 8; 314(10):1021-9.doi: 10.1001/jama.2015.10029).

The results are extremely scary and may well cause shivers to any public administrator.

In 2012, the estimated prevalence of diabetes rose to 14% of the population, while the pre-diabetic state affected 37% of the population in 2011 and 38% in 2012.

The pre-diabetic state is defined by levels of glycated haemoglobin up to 6.4% and between 100 and 125 of basal glycaemia. In most cases, these conditions evolve into diabetes shortly after.

All this resembles a lot what we have described, only a few months ago, for the Chinese population.

Italy and many European countries are not far behind. The yearly national stats book for 2014 showed that 5.5% of Italians is diabetic (5.3% men; 5.6% women), for a total of 3 million people suffering from the pathology.

The percentage has gone from 3.9% in 2001 to 5.5% in 2014. The differences in geographic location, however, show how the biggest diffusion of the pathology happened in the south of the country (6.6%) and in the islands (6.0%), where the Mediterranean diet is evidently an ancient memory.

According to the Italian Barometer Diabetes Observatory (IBDO), the disease incidence is expanding year after year. At least 1.8 million people (an additional 4% of the adult population) suffer from impaired glucose tolerance, the same condition described in JAMA as pre-diabetes.

When studying such frightening scenario, which also saw the dramatic rise of diabetes in people who are using carbs in the wrong way (for example in China, where more than 10% of the population is diabetic, and almost 40% of the population is in the process to develop this condition), it becomes clear how prevention is no longer an individual problem.

The analysis of the social costs generated by such conditions should be highly prioritised with a firm eye on ethical principles.

Personally, I would be rather angry if the country where I pay taxes was no longer able to treat the acute appendicitis of my son because burdened by the costs of those continuing to have a sugary breakfast with croissants and sweet snacks, while drinking coffee from automatic distributors (knowingly adding sugar to each cup even when not requested).

In an article published here recently, we have already expressed our very critical opinion around the pro-diabetic role of sweetening and sugar and on the problems caused by an excessive intake of carbohydrates.

For years, we have been helping those looking for a real change by creating therapeutic paths designed to guide people towards good health through proper food choices, by controlling inflammation (responsible for insulin resistance), encouraging physical activity and by providing a comprehensive guidance on short fasting and the importance of breakfast.

While respecting individual freedom, every country should consider essential the implementation of educational schemes for children and adults based upon accepted and well documented health principles.

On this regard, the war to ban unnecessary sweetening has still not won against the powerful sugar lobbies and we know that the debate around the issue will be tough and long-lasting.

Learning how to fight against diabetes to bring it back to a reduced, more physiological rate of incidence is an important task that should be pursued not only by the single individual, but also (and especially) by those who are in charge of shaping and influence the society and its conduct through various forms of advertisement and rewarding/fining programs.