WHO/QR Mattingly
On World Health Day, the World Health Organization (WHO) in Viet Nam highlights the staggering global burden of diabetes and calls on all communities across the country to work together to effectively manage and prevent the disease.
Diabetes is one of the four major noncommunicable diseases (NCDs). IThe WHO WHO Global report on diabetes highlights that diabetes prevalence has been steadily increasing in recent years. Today, around422 million adults affected, four times more than there were in 1980. Diabetes is rising fastest in the world’s low- and middle-income countries. In 2012, diabetes caused 1.5 million deaths. Higher-than-optimal blood glucose levels caused an additional 2.2 million deaths, by increasing the risk of cardiovascular and other diseases.
In the Western Pacific Region alone, it is estimated that 131 million people (8.4% prevalence) were living with diabetes in 2014. In Viet Nam, the prevalence of diabetes is growing at alarming rates and has almost doubled within the past 10 years. Today an estimated 1 in 20 Vietnamese adults has diabetes.
“Diabetes ─ long perceived as a disease of the affluent ─ is is now common even in the poorer segments of the population. in Viet Nam. Its impact is felt by individuals, families, communities and national economies, yet much of its burden is avoidable," said Dr Lokky Wai, WHO Representative to Viet Nam. "It is only by working together that we can truly stop the rise of diabetes in Viet Nam."
What is diabetes?
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough of the blood sugar-regulating hormone insulin or when the body cannot effectively use the insulin it produces. Hyperglycaemia, or elevated blood sugar, is a common effect of diabetes that eventually leads to serious damage to many of the body's systems, especially the nerves and blood vessels.
Type 1 diabetes cannot yet be prevented. Type 1 diabetes is the result of the body not being able to produce enough insulin and usually starts as a child. Type 2 diabetes results from the body's ineffective use of insulin. Type 2 diabetes comprises 90% of people with diabetes worldwide and is largely the result of excess body weight and physical inactivity. Symptoms may be similar to those of type 1 diabetes but are often less noticeable. Thus, the disease is diagnosed sometimes several years after onset, once complications have already risen.
Consequences of diabetes
Diabetes can increase the overall risk of premature death, as well as complications such as heart attack, stroke, kidney failure, leg amputation, vision loss and nerve damage. In pregnancy, poorly-controlled diabetes can lead to fetal death and other complications. The disease and its subsequent complications can also cause substantial economic loss to people with diabetes and their families, and to health systems and national economies through direct medical costs and loss of income.
Actions needed and WHO recommendations
Preventing diabetes requires taking a life-course approach by improving early childhood nutrition; providing supportive environments for physical activity; and developing interventions that can support its prevention and control. The starting point for living well with diabetes is early diagnosis. No single intervention or policy can address diabetes. Through a coordinated, multisectoral approach with policies in urban planning, education, transport, agriculture and financial resources we can promote good health for everyone.
WHO applauds Viet Nam for having passed a national multi-sectoral strategy for non-communicable diseases (NCD) for the period of 2015-2025, which includes the prevention and control of diabetes. The national strategy promotes healthy lifestyles through multi-sectoral action. Building on the strategy, WHO is supporting the Ministry of Health to advocate for a new law on the harmful use of alcohol.
In addition to prevention, the only sustainable option is management of cases. In Viet Nam this requires improving early detection and access to services and essential medicines for diabetes especially at the primary level. The government must aim for inverting the pyramid of care which means shifting diabetes care and long term treatment away from the hospital-based and shift a mainly curative to a primary and people-centred approach. This can be done by strengthening the primary health care system to make services and long term care available to the people in commune health centres. WHO is working with the Ministry of Health to promote this new approach in Ha Nam province.
WHO also recommends individuals in Viet Nam to reduce the impact of diabetes by
- achieving and maintaining healthy body weight;
- being physically active, with at least 30 minutes of regular, moderate-intensity activity on most days;
- having a healthy diet including fruits and vegetables and reducing sugar and saturated fat intake; and
- avoiding tobacco use.
“Together, we can halt the rise in diabetes and provide care to improve quality of life for the millions of people living with the disease. I am pleased to see that the government of Viet Nam has began to act, but much more concerted action is needed involving health-care providers; civil society; producers of medicines, technologies and food; from people living with diabetes; and from each of us. Viet Nam cannot afford to give in to this disease. We must all put a stop to diabetes once and for all," concluded Dr Wai.