The number of adults with diabetes has quadrupled worldwide in four decades, a World Health Organisation study showed yesterday. The figure rose from 108 million in 1980 to a staggering 422 million in 2014.

Exacerbated by ageing populations and rising levels of obesity, the condition is increasingly becoming a problem, especially in low- and middle-income countries. It is estimated that 1.5 million people died in 2012 due to diabetes and the WHO projects that it will be the seventh leading cause of death by 2030.

It is in this context that the organisation is dedicating World Health Day, being marked today, to this non-communicable disease.

Adopting the theme Beat Diabetes, World Health Day aims to increase awareness of the burden and consequences of the disease and to scale up its prevention by strengthening care through effective and affordable actions. Its other main goal is to enhance surveillance through the launch of the first global report on diabetes which advocates for stronger health systems and more effective management of the disease.

Malta has one of the highest prevalence rates of diabetes worldwide. WHO data estimates the number of local patients to grow from 39,000 in the year 2000 to an alarming 57,000 by the year 2030.

The disease is directly linked to obesity and according to a 2015 report, Malta leads the EU in having the highest overweight and obesity rates. Nearly 70 per cent of men and 60 per cent of women over the age of 18 are overweight.

In a study published in The Lancet magazine only last week, Maltese men were crowned the heaviest in Europe, having the highest body mass index (27.8kg/m2) along with males in Ireland and Cyprus.

Consultant diabetologist Sandro Vella said in an interview with Times of Malta that patients with a body mass index (BMI exceeding 35kg/m2) are at “an 80-fold risk of developing type 2 diabetes over a 10-year period compared to individuals with a BMI of less than 22kg/m2”.

The condition is increasingly becoming a problem in many countries

He explained that obesity – especially central obesity, which affects the abdominal area – is associated with insulin resistance, which renders the body less responsive to the physiological effects of insulin secreted by the pancreas. In a bid to overcome this problem, the beta cells of the pancreas increase their insulin secretion and eventually, their function fails, resulting in the clinical manifestations of diabetes.

Maltese children are at high risk of developing diabetes. The Health Behaviour in School-aged Children (HSBC) report, published last month, showed that while the obesity rate in 11-year-olds had fallen, Maltese children were still the most obese in more than 40 countries.

Leading a healthy lifestyle – that is, maintaining normal body weight, engaging in regular physical activity and eating healthy – is the best way to prevent diabetes and its several complications.

Regulating sugar consumption as much as possible is a must.

Currently, Malta does not have data on the amount of sugar the population consumes. But a National Food Consumption Survey, currently under way, is to provide authorities with this information for people aged seven years and over once it is completed. The pilot phase has been finalised and the full survey fieldwork commenced in October.

The Health Promotion and Disease Prevention Directorate has ongoing initiatives aimed at increasing awareness on healthy eating which includes the limitation of foods high in sugar, besides salt, saturated and trans fats.

Reading labels and choosing products that are low in sugar, considering cooking methods and ensuring adequate portion sizes is essential.

Global expert on nutrition, Robert Lustig, who delivered a public talk on sugar and its detrimental effect on metabolismin Malta last weekend, highlighted in an interview with Times of Malta the fact that cutting down on sugar is, however, not that straightforward. Sugar hides in three-quarters of all processed food and most food in Malta is imported and thus processed to increase its shelf life.

He added that hidden sugar is also difficult to identify as it can be marked in many different ways on food labels and processed foods that contain sugar do not necessarily have a sweet taste.

While Malta is not expected to take such drastic measures as the UK, which is introducing a tax on sugary drinks in two years’ time in its bid to stop rising rates of obesity and diabetes, this health topic is high on the government’s agenda. Tackling obesity will in fact be one of Malta’s health priorities during its EU presidency in 2017.

What is diabetes?

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.

Type 1 diabetes

Type 1 diabetes is characterised by deficient insulin production and requires daily administration of insulin 3. The cause of type 1 diabetes is not known and it is not preventable with current knowledge.

Symptoms include excessive excretion of urine, thirst, constant hunger, weight loss, vision changes and fatigue. These symptoms may occur suddenly.

Type 2 diabetes

Type 2 diabetes results from the body’s ineffective use of insulin. Type 2 diabetes comprises the majority of people with diabetes around the world and is largely the result of excess body weight and physical inactivity.

Symptoms may be similar to those of type 1 diabetes, but are often less marked. As a result, the disease may be diagnosed several years after onset, once complications have already arisen. (WHO)

Common consequences of diabetes

• Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves.

•  Diabetes increases the risk of heart disease and stroke. In a multinational study, 50 per cent of people with diabetes die of cardiovascular disease (primarily heart disease and stroke).

•Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation.

•Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. One per cent of global blindness can be attributed to diabetes.

•Diabetes is among the leading causes of kidney failure.

•The overall risk of dying among people with diabetes is at least double the risk of their peers without diabetes. (WHO)