The overall risk of dying among people with diabetes is at least double that of their peers without diabetes. On World Health Day, 7 April, the World Health Organization is calling for a two pronged approach: interventions to prevent diabetes, and interventions to manage diabetes for people who have already developed the condition in order to reduce its progression. "Actions are needed both by governments and by people themselves", says Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean.

He adds: "While individuals need to take responsibility for their own health through maintaining a healthy lifestyle, governments are responsible for creating environments that promote healthy living and for establishing measures that reduce the exposure of the population to risk behaviours that can lead to diabetes".

Diabetes is a pandemic that remains hidden throughout most of the world, with up to half of all people with diabetes globally remaining undiagnosed. WHO projects that diabetes will be the 7th leading cause of death by 2030. In the Eastern Mediterranean Region, 14% of the population has diabetes. Studies indicate that in some countries, more than 20% of adults have diabetes.

Diabetes is one of the four main noncommunicable diseases and together with cancer, heart attacks and strokes and lung disease, is responsible for 1.7 million deaths in the Region every year. These diseases all share four main lifestyle-related risk behaviours, namely unhealthy diet, physical inactivity, tobacco use and inappropriate use of alcohol. "Efforts to address the diabetes burden should be considered within the context of the overall efforts to combat the four main noncommunicable diseases", says Dr Alwan.

Diabetes can to a large extent be prevented or delayed through simple measures that can be taken by both individuals and governments.

Individuals can take these actions: - achieve and maintain a healthy body weight - become active and stay active throughout the life course - eat a healthy diet of between 3 and 5 servings of fruit and vegetables each day and reduce sugar, salt and saturated fat intake - avoid tobacco use – smoking increases the risk of heart attacks and strokes Governments can take these actions: - conduct national public awareness campaigns on diabetes, diet and physical activity - create and protect physical environments that promote physical activity - regulate the marketing of unhealthy foods and non-alcoholic beverages to children - restrict the marketing of and increasing taxation on foods high in saturated fats and free sugars - subsidize the production and marketing of healthy food options - ensure free access to acceptable standard for health care for people with diabetes.

Governments should also implement certain key measures that reduce exposure to risk behaviours for heart attacks and strokes, which contribute significantly to complications and death among people with diabetes. These key measures focus on reducing the salt content of commercially produced foods, and reducing tobacco use and exposure to tobacco smoke.

"People with diabetes can live healthy and productive lives if the condition is diagnosed early and effectively managed by health care providers and by people themselves", reaffirms WHO Regional Director Dr Alwan. Early detection and appropriate management – including the use of medications, lifestyle measures and regular follow-up – can prevent or slow the progression of the condition, and the development of complications. Ineffective management of diabetes can lead to heart attacks, strokes, kidney failure, blindness, impotence, amputations and infections.

The potential impact of simple diet modifications and increased physical activity on preventing and improving diabetes is huge. Individuals and governments can all take action to change current unhealthy behaviours, in order to reduce diabetes.

On World Health Day and beyond, everyone can take action and make change. Everyone can play a role in preventing and managing diabetes, and reducing the escalating burden.

Source:WAM