Background 

Dr. Fredrick Banting, a Canadian Physician, who invented Insulin and got the Nobel prize for it along with John Macleod in 1923, was born on November 14, 1891. In his honor, his birthday is celebrated as World Diabetes Day (WDD) in his honor. Launched in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO), WDD aims to promote the importance of coordinated and concerted action to confront diabetes as a critical global health issue. The event unites a global audience of more than one billion people across more than 160 countries to raise awareness of the need for better care, education, and resources to support people living with diabetes and help delay or prevent the condition in those at risk.

The challenge of diabetes is many fold more since half of the 537 million cases globally and 8.7 million of nearly 37 million cases in the USA are not even aware that they have diabetes. So, the theme for the year is “Know your risk and know your response.”

Diabetes: How common is it? Where is it prevalent maximum?

Diabetes is currently the fastest growing disease. As per the World Atlas of Diabetes, in 2021, it is estimated that 537 million people have diabetes globally. This means the number of people with diabetes in the world is more than the total number of people staying in the USA, Canada and Mexico combined! On the World Diabetes Day in 2023, the World Atlas of Diabetes 2023 will bring new statistics for diabetes. 

China, India, Pakistan, the USA, and Indonesia are the top five countries with the highest number of diabetes patients currently and will continue to remain so for the next 20 years (See figure 1). Barring the USA, all other countries are in Asia and thus Asia is the major continent contributing to the global burden of Diabetes.

BMI 23: Asians are at high risk for diabetes and at lower body weight as compared to Europeans and white population. Therefore, for screening purposes, it is recommended that Asians be screened at Body Mass Index (BMI) of 23 and above unlike other population where screening is recommended for BMI of 25 and above. 

Diabetes in Arizona: Nearly 700,000 people with diabetes in Arizona at present. One in ten Arizonians suffer from diabetes and one in three are in the prediabetes phase with much higher risk to develop diabetes (See the Figure 2). 6.8 billion dollars is the diabetes related cost in Arizona.

ACCESS TO DIABETES CARE 

The theme for World Diabetes Day 2021-23 is access to diabetes care.

In 2023, the campaign focuses on the importance of knowing your risk of type 2 diabetes to help delay or prevent the condition and highlighting the impact of diabetes-related complications and the importance of having access to the right information and care to ensure timely treatment and management (See figure 3)

In many cases, type 2 diabetes and its complications can be delayed or prevented by adopting and maintaining healthy habits. When not detected and treated early, diabetes can lead to serious and potentially life-threatening complications. For people at risk of type 2 diabetes, knowing your risk and what to do is important to support prevention, early diagnosis, and timely treatment. For people living with diabetes, awareness and access to the correct information and best available medicines and tools to support self-care is vital to delay or prevent complications. This year the focus of diabetes day education and theme revolves around this. 

The World Health Organization sets up the following targets by 2030 for all the countries and regions of the world.

1. 80% of people living with diabetes are diagnosed.
2. 80% of people with diagnosed diabetes have good   control of glycaemia.
3. 80% of people with diagnosed diabetes have good control of blood pressure.
4. 60% of people with diabetes of 40 years or older receive statins.
5. 100% of people with type 1 diabetes have access to affordable insulin and blood glucose self-monitoring.

Governments need to commit themselves with manpower, material and other resources and modify the policy in favor of diabetes control more seriously. 

What can we do to help reduce and prevent diabetes for us and our families?

The focus and slogan for this year’s diabetes day theme answers this question. “Know your risk and know your response”. At an individual level we can contribute by taking preventive measures to ensure that we do not develop diabetes or if we have it, it remains under control and no complications occur. These steps include following risk factors and preventive measures. 

Weight:

The heavier we are, the greater the risk. Being overweight increases the risk for diabetes, as well as other heart related conditions. Even the children who are overweight are at risk for diabetes. Preventing overweight and obesity and if overweight, reducing and controlling weight will help in preventing diabetes and many other diseases.

Exercise:

Exercise can greatly help prevent diabetes, and also helps diabetic patients have better control of their disease state and reduce the chances for further complications. 30 minutes of moderate-strenuous exercise like brisk walking for 5 days a week can be greatly beneficial. 

Diet: 

Modification of diet towards less processed food, more fruits and vegetables and food with less glycemic index helps to control diabetes. Total portion consumed needs to be checked with our daily requirement and excess food consumption be avoided. 

Smoking:

Smoking increases insulin resistance which causes increased levels of blood sugar. This can lead to kidney, heart, and blood vessel related complications in diabetic patients. Quitting smoking is very important. 

Regular medical checkups:

Get yourself examined for diabetes every year since diabetes is a silent disease and 50% of them are not diagnosed yet. We should get ourselves and our family members screened once a year at least for diabetes. Asian Pacific Community in Action and National Kidney Foundation are ‘not for profit’ organizations in Phoenix that help to get yourself screened free of cost for diabetes and guide for non-medical and lifestyle intervention to prevent complications and refer you for medical treatment.
At the Asian Pacific Community in Action, a not-for-profit organization we try to reach out to the community who are in need, with less education and with language barriers to get them to health screening for diabetes and putting them with appropriate healthcare facilities for their diabetes control and prevention. The disparity of disease in the Asians and Pacific Islanders needs to be documented and then brought to the notice of the Government and policy makers. We at Asian Pacific Community in Action in collaboration with NYU Center for the Study of Asian American Health, plan with our partners to study Community Health Resources and Need Assessment (CHRNA) and community can participate in this study by clicking this link https://www.apcaaz.org/beewell  and complete the study. That way we can contribute to our community’s future planning.