In 2011, the industry saw new data from 3 major public health organizations – the Centers for Disease Control and Prevention (CDC), the National Diabetes Information Clearinghouse (NDIC), and the International Diabetes Federation (IDF). Typically, the CDC releases its National Diabetes Fact Sheet every 2 years as does the NIDC. On November 14, 2011, the IDF published the 5th Diabetes Atlas, which provides country-by-country statistics on diabetes every 2 to 3 years (see sidebar).

Danilo Verge, Vice President, Medical Affairs of Novo Nordisk, discusses this public health data and its impact on diabetes treatment and care today.

Q:  What does this data mean and how does the data differ?

A:  All the data point to an explosive increase in the incidence (new number of cases per year) and the prevalence (how many people out of the total population) of diabetes worldwide. Looking at studies in the same country over several years, there is no country which shows a decrease in diabetes. As a matter of fact, the projections that all 3 organizations had made had to be readjusted upwards.

As far as the United States, the data provided by the CDC and NIDC is exactly the same and it estimates the prevalence of diabetes for the adult population (20 years and older) at 11.3% (25.8 million people).¹ The IDF reports an estimated 23.7 people with diabetes in the United States.² Other figures, such as incidence of diabetes, deaths due to diabetes, also differ, primarily due to this difference in defining the age range for the “adult” population.

Q:  How do we make sense of this data?

A:  This is cause for great concern, as diabetes not only exacts a heavy toll in terms of serious health issues for the individual (complications leading to kidney failure, amputations, blindness, heart attack, stroke, etc) but also of serious financial burden for the countries most exposed to the disease. All 3 agencies point to the fact that deaths due to diabetes are almost certainly an underestimation of reality, since more than a third of countries do not have any data on diabetes-related mortality and also because existing routine health statistics underestimate the number of deaths due to diabetes, including the United States. In fact, the CDC states that “studies have found that only about 35% to 40% of decedents with diabetes had it listed anywhere on the death certificate and about 10% to 15% had it listed as the underlying cause of death.” ¹ It is worth noting that overall, the risk for death among people with diabetes is about twice that of people of similar age but without diabetes.

Q:  What impact will data forecasts like these really have on diabetes treatment and care?

A:  It should have enormous impact, for all the reasons mentioned above. Unfortunately, governments are slow to realize the huge burden diabetes will become in a relatively short time. Actually, it already is a significant burden on the populations of many countries. One of the many downsides of diabetes is its chronic nature, which does not coincide with political 4-year cycles, so it’s easy for politicians and other government officials to put it aside in favor of other, more acute issues that are more plausible to generate more immediate gain.

In terms of treatment, the best treatment is prevention. There are 3 times more people at risk of getting diabetes than there are people with diabetes. The good news is that prediabetes may be reversible, and that it is proven that diet and exercise should suffice to turn blood sugar levels to normal. Once someone gets the disease, it’s a lot cheaper in the long run to ensure that the patient keeps her blood glucose levels as close to normal as possible through the appropriate use of medications, while maintaining the importance of lifestyle modifications like diet and exercise. Emergency room visits can also put a strain on medical costs and in many cases “this more expensive care could be avoided with adequate access to preventative and/or primary care.”³

Sources
1. Centers for Disease Control and Prevention. National Diabetes Fact Sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
2. International Diabetes Federation web site. One adult in ten has diabetes in North America. http://www.idf.org/sites/default/files/attachments/NAC-Press-Release-WDD.pdf. Accessed December 7, 2011.
3. Bunker, Katie. Paving the way to a healthier America. Diabetes Forecast. http://forecast.diabetes.org/magazine/your-ada/paving-way-healthier-america. January 2009.

© 2011 Novo Nordisk All rights reserved. 1211-00006341-1 December 2011