On 14 November, the international community commemorates World Diabetes Day to raise awareness of this chronic disease. This is particularly important in the African Region, where more than half of the 19 million people living with diabetes don’t know they have it.
Diabetes occurs when a person is unable to make enough insulin (type 1) or to use the insulin the pancreas produces (type 2), leading to high levels of blood sugar. Risk factors for diabetes include being overweight and physically inactive or having a family history of the disease. If left unmanaged, diabetes can result in serious complications including kidney failure, stroke, lower limb amputations, and blindness. In addition, for millions of low-income households, the costs of accessing lifelong care for diabetes and other noncommunicable diseases can push families into poverty.
We are also seeing that people with diabetes are at higher risk of severe illness when infected with COVID-19. In South Africa for example, over 50% of hospitalized COVID-19 patients had diabetes.
The theme of World Diabetes Day 2020 is “the nurse and diabetes” because nurses play key roles in providing lifelong care for people with diabetes, including screening, regular check-ups, psychological support and information on self-management and healthy living. In the African Region, nurses make up more than half of the health workforce, but they often have heavy workloads, with a regional average of only 10 nurses and midwives per 10,000 people.
At WHO, we are working with countries to train more nurses and other health-care workers and to expand access to services to prevent and manage diabetes using the WHO Package of Essential Noncommunicable Disease Interventions (WHO PEN) for Primary Health Care in Low-Resource Settings and other technical packages. So far, 25 countries in the Region have adapted WHO PEN protocols, and this has strengthened decentralized services and improved early detection and care for management of diabetes. We have also trained frontline health-care workers, including nurses, in integrated management of hypertension and diabetes in Burkina Faso, and provided several countries with basic equipment used in diagnosis and management of diabetes.
This year in response to stockouts of essential medicines, we collaborated with Novo Nordisk to donate a six-month supply of insulin and glucagon to 29 African countries. The donation comes at a time when many people with diabetes are facing challenges in accessing life-saving care in the context of the COVID-19 pandemic.
Longer term, as the prevalence of diabetes increases in African countries, more investment is needed to include noncommunicable diseases in essential health service packages and to ensure a constant supply of essential medicines like insulin.
Nurses and other health workers also need to be enabled to play their roles in diabetes prevention and management, including being provided with training, equipment and conditions of service that create a conducive work environment.
We can all take action to prevent diabetes by maintaining a healthy lifestyle, including avoiding sugary drinks, processed foods, tobacco and alcohol, and doing around three hours of physical activity every week, like walking, dancing or playing sport. Everyone should also be aware of early symptoms of diabetes (excessive urination and thirst, constant hunger, weight loss, vision changes and fatigue) and seek care promptly.
Together we can beat diabetes.