Mini Review Management of Diabetes Epidemic: Global Perspective

Eight million largely preventable deaths from treatable diseases, costed $6 trillion in lost economic welfare in low-and middleincome countries in 2015. If current conditions persist, low-and middle-income countries could lose collectively $11 trillion in gross domestic product, by 2030 (Harvard Gazette, June 2018, June issue of Health Affairs). The analysis is based on the findings from the Global Burden of Disease (2015) Project, including estimates of morbidity and mortality of 38 diseases that are survivable in wellresourced health care settings, and calculations of the number of deaths across 195 countries, that could be prevented, if that same standard of care were available everywhere. The American Heart Association developed methodology to project future costs of care for hypertension, coronary artery disease (CAD), heart failure, stroke, and all other related causes from 2010 to 2030. This methodology avoided double counting of costs, for patients with multiple cardiovascular conditions. By 2030, 40.5% of the adult US population is projected to have some form of CAD. Between 2010 and 2030, real (208 billion) total direct medical cost of CAD management, are projected to triple from 273 billion to 818 billion. According to Margaret Chan, the Director-General of World Health Organization (WHO), Member States of WHO, have set an ambitious target to reduce premature mortality from non-communicable diseases (NCDs)-including diabetes-by one third; achieve universal health coverage; and provide access to affordable essential medicine-to all by 2030. In her address in the first WHO Global Report on diabetes, she continues to say, “We have enormous task at hand, which is why I welcome the publication of the first report [1]. The report makes an important contribution to our understanding of diabetes and its consequences”. Incidence of type-2 diabetes has increased in the last two decades by four-fold. The Non-communicable Disease (NCD) Risk Factor Collaboration Group (NCD-Risk), in their seminal article in The Lancet (April 2016) concluded that, “if the post-2000 trends continue in the incidence and rise of type-2 diabetes, the probability of meeting the global target of halting or reducing the rise in the prevalence of type-2 diabetes by 2025 to 2020 levels worldwide, is lower than one percent” [2,3]. If the expert group like NCD Risk Factor Collaboration has no hope, how can one rely on the ambitious target of the participating nations of WHO, and their commitment to such healthcare policies. If you carefully look at the national level programs for reducing, reversing or prevention of type-2 diabetes epidemic in countries like China and India, it becomes evident that there is no way, we will see such drastic reduction in the incidence of excess weight, obesity, and type-2 diabetes in the near future [4]. Since the lifestyle diseases like excess weight, obesity, and metabolic syndrome contribute significantly to the increase in type-2 diabetes, they are not discussed separately under this theme [5-12]. In this overview, we will briefly discuss the diabetic “tsunami” from a global perspective, to create awareness in the scientific community, so that researchers, clinicians, healthcare workers, and policy makers, take this twin epidemic (obesity and diabetes) seriously, and develop novel strategies to reduce the healthcare burden from these metabolic diseases, of great public health interest.