World Diabetes Day
World Diabetes Day was observed yesterday for the 30th time since it was established in 1991 by the International Diabetes Federation and World Health Organization. It occurs on November 14th each year as that is the birthday of Sir Frederick Banting, who co-discovered insulin with Charles Best in 1922. Today, it is the world’s largest diabetes awareness campaign as it is observed by more than 1 billion people in over 160 countries.
World Diabetes Day was created in response to growing concerns about the escalating health threat of diabetes. Today, it aims to be a platform to promote advocacy efforts and highlight the importance of making coordinated efforts to confront diabetes as a critical global health issue. Every year, the World Diabetes Day campaign focuses on a theme that can run for multiple years, with the theme from this year until 2023 being: Access to Diabetes Care — If Not Now, When?
Access to diabetes care is something I recently realized that I take for granted. Traveling to Paris, I absentmindedly forgot my insulin at home. ALL my insulin. Even worse, I realized this mere seconds as the train pulled away from the station- like the dramatic start to a diabetes horror movie. After the initial panic (and multiple aftershocks of panic), I mapped out my plan. Luckily, I was wearing my continuous glucose monitor and it was working well, so I could track my glucose in real time and receive alerts should any issues come up. Next, I called my provider to get their suggestions for the situation. As I was traveling to a high-income city in a high-income country, they suggested to simply visit an endocrinologist if I could find an open office, or urgent care at a hospital if I couldn’t. From there, I could receive a prescription for replacement insulin and return to my normal routine. And that’s exactly how it played out! In fact, the doctor I spoke with informed me that this happens more often than I originally thought. We are human, after all, and it’s difficult to remember every element needed for daily diabetes care all the time.
But my story highlights a crucial convenience that I am lucky to have: access to the care I need, when I need it, to allow for proper diabetes management. What would have happened if I couldn’t locate a doctor or pharmacy for a few days? Or if my continuous glucose monitor had an issue and I needed different testing supplies? Diabetes care is extremely comprehensive, requiring everything from insulin to measurement devices to doctors and educators. There are about 537 million people worldwide who live with diabetes and the majority of them aren’t fortunate to have access to these resources: roughly 336 million people with diabetes live in low- and middle-income countries (LMICs) that lack adequate access to diabetes care. In a study by The Lancet on the access to diabetes care in LMICs, fewer than one in ten people with diabetes received coverage of comprehensive treatments for diabetes based on established guidelines. Furthermore, only 50% had coverage for glucose-lowering medications such as insulin, and fewer than 33% had coverage for diet, exercise, or weight-loss counseling. Similarly, the ability to treat common co-morbidities related to diabetes, such as cardiovascular disease, hypertension, and high cholesterol was insufficient, as well.
Modern diabetes care is amazing in its capabilities, and developing technologies suggest an even brighter future: new insulins that can guard against hypoglycemia, artificial intelligence that will close the loop between continuous glucose monitors and insulin delivery systems, and non-invasive glucose monitors such as DiaMonTech’s D-Pocket that will allow for consistent, convenient, and unlimited measuring. However, any treatment is only empowering if it is accessible to the user.
With an estimated 10% of adults living with diabetes globally, and another 7% with pre-diabetes, the World Health Organization has classified diabetes as a global epidemic. To turn the tide, it will be vital for those with diabetes in LMICs to receive the same access to care that I and others enjoy in higher income countries. Although World Diabetes Day technically lasts just one day, the IDF provides ways that we can get involved and help out any time of year. You can visit their website if you are curious about ways to get involved and improve access. After all, great technology won’t have much benefit if the people who need it most can’t get it.
