Diabetes

Key facts

• Diabetes is one of the most common chronic conditions in Europe. At least 64 million adults and around 300 000 children and adolescents are estimated to be living with diabetes in the WHO European Region.
• In 2019 diabetes caused approximately 186 000 deaths in the Region. This figure has increased in recent years and is expected to double from 2005 to 2030.
• An estimated 1 in 3 people living with diabetes remains undiagnosed and up to half may not meet their treatment targets in the Region.
• The Region has the highest burden of type 1 diabetes globally.
• As populations age and risk factors such as obesity increase, 1 in 10 Europeans could have diabetes by 2045.
• Some types of diabetes can be prevented by targeting risk factors with interventions such as improving nutrition, increasing physical activity, reducing obesity, reducing tobacco use and providing more health-supporting environments.
• Many diabetes risk factors are related to socioeconomic status and the impact of social, economic and environmental determinants of health.
• Inequalities in diabetes exist across the Region; for example, rates of diabetes among women can be 5 times greater in some countries of Europe than others.
• If diabetes is not diagnosed and managed correctly, life-threatening acute events such as comas can occur, as well as progressive disability from complications of the condition.
• High blood-glucose levels cause progressive damage to blood vessels all over the body, resulting in a variety of complications. Important complications of diabetes include permanent vision loss and blindness from damage to blood vessels in the eye, ulcers and amputations from nerve damage in the feet, and kidney disease.
• The risk of heart attack and stroke increases up to 4-fold for people living with diabetes.
• People with diabetes can live well but are often held back by unsupportive health systems. Treatments for diabetes and its complications exist but are not always available, accessible and affordable in the Region.

What is diabetes?

• Type 1 diabetes is characterized by insufficient production of insulin - a hormone that regulates glucose (sugar) in the blood - by the pancreas. This type of diabetes is usually genetic, and is treated with daily insulin given through a pump or injections. It often presents quite suddenly in young people, with symptoms including excessive urination, thirst and unintentional weight loss.
• Type 2 diabetes is characterized by ineffective use of insulin. It accounts for around 90% of people with diabetes and is largely preventable. Risk factors include excess weight (especially around the waist), and other factors that contribute to weight gain such as low levels of physical activity. It often presents in middle age, although the prevalence is rising among children and adolescents. Symptoms can be mild and diagnosis can often be delayed until after complications have already occurred. Type 2 diabetes is more common among people of South Asian, African and African-Caribbean descent.
• Gestational diabetes is characterized by high blood-sugar levels during pregnancy.

How can the burden of diabetes be reduced?

Prevention

As some types of diabetes and other major noncommunicable diseases (NCDs) share common modifiable risk factors, prevention must be integrated into population approaches. Focusing on effective and affordable prevention and management of a combination of risk factors for diabetes all at once can prevent disability and death and improve quality of life.

People with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) are at an intermediate stage between normal blood glucose and diabetes, and are at high risk of developing type 2 diabetes. This risk can be drastically reduced through intensive interventions such as improvements in diet and weight, as well as with medications.

Treatment

Diabetes can be diagnosed through relatively inexpensive testing of blood glucose. However, an estimated 1 in 3 people in our Region remains undiagnosed.

Type 1 diabetes must be managed with insulin, whereas type 2 diabetes can be treated by reducing risk factors with or without oral blood glucose-lowering medications.

Additional care is needed to manage the effects and complications of diabetes, such as foot care for ulcers, eye exams to screen for retinopathy (eye damage which causes blindness), testing and treatment for kidney disease, and reduction of cardiovascular disease risk through control of blood pressure and cholesterol. Vaccination for seasonal influenza and COVID-19 is also recommended.

Effective control of blood glucose is crucial, and home monitoring of glucose for people using insulin is a cost-effective way to reduce complications. However, these medications and wider measures are not consistently available, accessible and affordable across the Region.

Medicines, technologies, and complication screening and care should be available and affordable for those who have diabetes. The inclusion of diabetes management in universal health coverage packages is crucial to effectively control diabetes and reduce harm.

Support for self-management of chronic conditions such as diabetes, including through therapeutic patient education, is effective in reducing health-care costs and improving health outcomes.

WHO response in Europe

The WHO Regional Office for Europe's vision is to reduce the risk of diabetes and to ensure that all those diagnosed have access to quality care and equitable, comprehensive and affordable treatment.

We aim to support countries to implement cost-effective prevention and control programmes. This includes reducing risk factors through multisectoral, population-based policies and strengthening primary health care while prioritizing vulnerable populations.

Public link

Please use the above public link if you want to share this noodl on another website.