SPEAKING
FREELY Diabetes: Asia's ticking time
bomb By Paul Zimmet
Speaking Freely is an Asia Times
Online feature that allows guest writers to have
their say. Please click hereif you are interested in
contributing.
One could be
forgiven for thinking communicable illnesses, such
as HIV/AIDS and the newly feared bird flu, are the
major disease threats for Asia in the next and
coming decades.
After all, an Asia Pacific
Economic Cooperation (APEC) meeting has been
called to focus on bird flu, scientists are
fretting over a bird flu vaccine and Asian bird
flu casualties are being cited as early signs of a
potential pandemic. Every year we hear the
increased Asian death forecasts for HIV/AIDS, as
the disease
continues its
relentless march of devastation in the region.
It would be foolish in any way to discount
the potential impact of these diseases. But a much
greater health concern looms on the horizon and
risks being overlooked. It is diabetes and it is
far more certain than bird flu to prematurely
claim millions of lives. Similarly,
diabetes-related deaths in Asia over the next few
decades will dwarf those caused by HIV/AIDS.
Sound like a stretch?
Not
according to the World Health Organization (WHO),
which has just released a report claiming chronic
diseases, dominated by diabetes, now cause twice
the number of deaths than infectious diseases
(including HIV), maternal/perinatal conditions and
nutritional deficiencies combined.
The
report, Preventing Chronic Diseases: A Vital
Investment, claims that this trend will continue.
In the next decade, the number of global lives
claimed by diabetes is set to grow by a quarter,
driven by rising obesity and inactivity. It could
cause the first life-expectancy reduction in more
than 200 years. And nowhere is the problem more
serious than in Asia.
In Asia there are
now 90 million people with diabetes. Asia is home
to four of the world's five largest diabetic
populations - India, 33 million people with
diabetes; China, 23 million; Pakistan, 9 million;
and Japan, 7 million. The United States is also in
the top five with an estimated 18 million
suffering from the disease.
Globally the
WHO estimates the global diabetes population will
grow to more than 200 million in 2010 and 330
million in 2025. The burden in Asia will increase
- in less than a decade 60% of all diabetes cases
globally will be owned by Asia.
Asia
should be in a state of panic. While diabetes can
be treated, with limited access to treatments a
majority of people affected will die prematurely.
Even with treatments diabetes kills people
prematurely, as well as robs them of their quality
of life, and puts significant strain on resources.
There is a common misconception that
diabetes is not lethal, with deaths often
attributed to complications rather than the
disease itself. But diabetes puts people at risk
of many diseases and premature death, as it causes
damage to many body tissues and progresses to
strokes, heart disease, kidney failure, blindness,
susceptibility to serious infections and
amputations due to loss of circulation.
Diabetes has crept up on Asia with
progressive Westernization or "Coca-Colanization"
of its countries, which has seen the adoption of
fatty-food diets and sedentary lifestyles.
Disturbingly, the non-insulin dependant variety of
diabetes (type 2), with typical onset in late
adulthood in most parts of the world, is surfacing
in children in Asia.
With scarce health
resources Asia is ill-prepared to tackle diabetes
effectively, and is likely to be distracted by
more immediate threats such as bird flu, which
countries outside the region are asking Asia to
address. There is also a lack of recognition of
the problem with many governments, and public
health planners in Asia remain largely unaware of
the future potential for increases in obesity and
diabetes and its serious complications.
Unless this situation is rectified, there
will be a huge economic burden on Asia - both from
direct health-care costs plus indirect costs from
a decline in workplace productivity. In addition
there will be losses from premature morbidity and
mortality.
Diabetes could cripple the
budgets of Asian nations, particularly in
developing nations. Diabetes is expected to cost
the larger Asian economies up to $500 billion each
in the next decade due to lost productivity and
premature deaths.
At the 6th International
Diabetes Federation Conference for Asia in Bangkok
last week I predicted when the history of this
century is written it will be diabetes, not bird
flu or HIV/AIDS, that will have had the most
devastating impact on the Asia Pacific.
There is no doubt that if bird flu is
serious enough to warrant an APEC meeting later
this year, a similar meeting on diabetes is long
overdue. Diabetes has to be addressed in a
significant way in Asia. It is not the bird flu or
HIV/AIDS. But it is the killer disease that we are
not prepared for, with the potential to claim
millions of lives.
Professor Paul
Zimmet is director of the International
Diabetes Institute and Head of the World Health
Organization Collaborating Center for the
Epidemiology of Diabetes.
(Copyright
2005 Paul Zimmet )
Speaking Freely
is an Asia Times Online feature that allows guest
writers to have their say. Please click hereif you are interested in
contributing.
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