The PAHO Panorama of Diabetes in the Americas, released in the run up to World Diabetes Day (November 14) calls on countries to improve early diagnosis, increase access to quality care for diabetes control, and develop strategies to promote healthy lifestyles and nutrition.

At least 62 million people live with diabetes in the Americas, a number which is expected to be much higher given that around 40% of those with the disease are unaware they have the condition. If current trends continue, the number of people with diabetes in the region is projected to reach 109 million by 2040.

The increase in cases of diabetes over three decades is linked to an increase in risk factors – Two-thirds of adults in the Americas are overweight or obese, and only 60% get enough exercise. The report also points to an alarming trend among young people in the region: over 30% are now considered to be obese or overweight – almost double the global average.

“These high rates of diabetes highlight the urgent need for countries to focus on prevention and the promotion of healthy lifestyles,” said Dr. Anselm Hennis, Director of the Department of Non-communicable Diseases and Mental Health at PAHO. “At the same time, it is crucial to ensure early diagnosis and good disease management, which are key to controlling diabetes and preventing diabetes-related disability and poor health.”

The report shows, however, that just 12 countries in the region have the six basic technologies required for the management of diabetes in public health facilities, including equipment for measuring blood glucose, tests for the early diagnosis of complications, and urine test strips for glucose and ketone analysis. “It is crucial that everyone, everywhere has access to these basic diagnosis and management tools needed to prevent related disability,” Dr. Hennis added.

The report also notes that people with diabetes have higher risks for severe forms of COVID-19 and death, highlighting the importance of integrating diabetes care into preparedness and response plans for emergencies.

In order to reduce the prevalence of the disease and enable those with diabetes to lead healthier lives and avoid complications, the report calls on countries to:

• Improve the capacity for early diagnosis of diabetes and for the prevention of diabetes-related complications;
• Increase availability and access to quality diabetes care, including essential medicines such as insulin, glucose-monitoring devices, and self-management support;
• Build strategies and policies to promote healthy lifestyles and nutrition and prevent obesity.
• Strengthen surveillance and monitoring to ensure good diabetes control.

Diabetes in the Americas

Diabetes is a chronic, metabolic disease, characterized by elevated levels of blood glucose. Type 2 diabetes is the most common type, which usually occurs in adults when the body becomes resistant to or fails to produce enough insulin. Type 1 diabetes occurs when the pancreas produces little or no insulin by itself.

Diabetes is the sixth leading cause of mortality in the Americas and was responsible for over 284,000 deaths in 2019. It is also the second highest cause of disability in the region, preceded only by ischemic heart disease. Diabetes is the leading cause of blindness in people aged 40 to 74, lower extremity amputations, and chronic kidney disease. In addition, diabetes triples the risk of death by cardiovascular disease, kidney disease, or cancer.

While type 1 diabetes cannot be prevented, it can be managed. Measures are available, however, to prevent type 2 diabetes, including policies and programs to promote good health and nutrition, regular exercise, avoiding smoking and controlling blood pressure.

PAHO continues to support countries in designing, implementing, and evaluating strategies to prevent and control diabetes. PAHO’s Strategic Fund works to strengthen universal access to essential medicines and technologies for the treatment of diabetes in the region, enabling Member States to obtain insulin at low-cost prices. The WHO Global Diabetes Compact also reinforces this commitment and provides a roadmap for countries to tackle diabetes.

World Diabetes Day is held every year on 14 November on the birthday of Dr. Frederic Banting, a co-discoverer of insulin, to raise awareness of diabetes.