Diabetes is a chronic condition where blood glucose (sugar) levels are too high.
There are many types of diabetes:
Type 1 diabetes is an autoimmune disease where the pancreas produces little or no insulin by itself
Type 2 diabetes is when the body becomes resistant to insulin, causing high blood sugar levels
Over 90% of people with diabetes have type 2 diabetes, which is driven by socio-economic, demographic, environmental, and genetic factors.
Key contributors to the rise of type 2 diabetes include: urbanization, an ageing population, decreasing levels of physical activity and increasing overweight and obesity prevalence
Gestational Diabetes is a temporary condition that can develop during pregnancy in women who do not already have diabetes. Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. These women and possibly their children are also at increased risk of type 2 diabetes in the future.
There are also other rarer types of diabetes, including monogenic diabetes and Latent autoimmune diabetes of adults.
Quick facts
Diabetes is a chronic metabolic health condition that affects how your body turns food into energy. With diabetes the body does not make enough insulin or cannot use it as well as it should. When there isn’t enough insulin, too much blood sugar stays in your bloodstream.
Untreated diabetes can result in serious damage to the heart, blood vessels, eyes, kidneys, and nerves.
In high-income countries, diabetes is a leading cause of cardiovascular disease (caused by high blood glucose), blindness, kidney failure, and lower limb amputation.
There is a treatment gap as more than half of people living with diabetes do not receive proper medication
Diabetes is a leading cause of death and disability, and while the risk of death from diabetes is higher in men than in women overall, diabetes increases the relative risk of cardiovascular disease in women more than in men.
Diabetes Prevalence
Type 2 diabetes is the most common form, accounting for an estimated 95% of all cases.
In 2022, 14% of adults aged 18 years and older were living with diabetes globally.
Around 830 million people worldwide have diabetes, the majority living in low-and middle-income countries;
The prevalence of diabetes is rapidly increasing in low- and middle-income countries (LMICs) than high-income countries (HICs). In addition, nearly 80% of people living with diabetes live in LMICs;
The prevalence of diabetes is highest in the Eastern Mediterranean region (13.7% of adults aged 18 and older);
1 in 6 (more than 20 million) live births across the world are affected by gestational diabetes
More than 20 million live births (1 in 6 live births) across the world are affected by gestational diabetes;
Diabetes directly causes an estimated 1.6 million deaths worldwide.
Diabetes Prevention
There is no known way to prevent type 1 diabetes. Women may be able to reduce the risk of gestational diabetes by maintaining a normal weight before getting pregnant. Behavioral measures can help prevent or delay the onset of type 2 diabetes. The World Health Organization recommends that individuals:
Maintain a healthy body weight
Stay physically active with at least 150 minutes of moderate exercise each week
Eat a healthy diet, avoiding high intakes of sugars and saturated fat
Do not use tobacco, including cigarettes and smokeless tobacco
Moderate consumption of alcohol
Limit long term exposure to air pollution
Diabetes Treatment
One of the best ways to treat diabetes is to keep a healthy lifestyle. People with type 1 diabetes need insulin injections for survival. Some people with type 2 diabetes will need to take medicines to help manage their blood sugar levels. These can include insulin injections or other medicines. Some examples include:
Metformin
Sulfonylureas
Sodium-glucose co-transporters type 2 (SGLT-2) inhibitors.
Along with medicines to lower blood sugar, people with diabetes often need medications to lower their blood pressure and statins (for high cholesterol levels) to reduce the risk of complications.
Additional medical care may be needed to treat the effects of diabetes:
foot care to treat ulcers
screening and treatment for kidney disease
eye exams to screen for retinopathy (which causes blindness)
Cost-effective interventions appropriate for implementation in LMICs to manage both diabetes and its associated complications include:
Medication (insulin for people living with type 1 diabetes, oral medication and possibly insulin for people with type 2 diabetes)
Blood pressure control
Foot care
Screening and treatment for retinopathy
Blood lipid control to regulate cholesterol levels
Screening for early signs of diabetes-related kidney disease and treatment.
How is GACD addressing the diabetes burden?
In 2013, GACD pledged $27 million to support 17 research projects conducted in 22 countries focused on type 2 diabetes prevention and management.
You can find out more about the GACD projects addressing Diabetes by visiting our projects page.
In 2018, the GACD launched a funding call on scale-up of interventions targeting diabetes and/or hypertension, representing a further $51 million investment. Both funding calls emphasized the use of implementation research methods to adapt and implement evidence-based strategies for preventing and controlling diabetes in underserved contexts.
You can find out more about the GACD projects addressing scale up of diabetes interventions by visiting our projects page
Several GACD working groups are also advancing knowledge about diabetes prevention and treatment through, for example:
Conducting and publishing a systematic review of gaps in available clinical guidelines for diabetes management in LMICs.
Developing a set of common measures used to measure diabetes outcomes or progression. These common measures form part of the GACD Data Dictionary, which aims to standardise data collection, and thus increase the potential for aggregating information, across GACD and other research projects.
Creating a set of guidelines for process evaluations of diabetes projects.
In collaboration with the London School of Hygiene and Tropical Medicine, identifying strategies for managing diabetes in humanitarian settings during the COVID-19 pandemic.
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