WORLD DIABETES DAY: Asia on brink of diabetic disaster, warns study

Paris: Health services across Asia could crash in the face of a worsening epidemic of obesity-led diabetes, experts warn.

In 2003, 194 million people in Asia had diabetes and by 2025, the tally could be 333 million, according to a paper published by the British journal The Lancet ahead of World Diabetes Day on November 14.

“Childhood obesity has increased substantially and the prevalence of Type 2 diabetes has now reached epidemic levels in Asia. The health consequences of this epidemic threaten to overwhelm health-care systems in the region,” the study says sternly. “Urgent action is needed, and advocacy for lifestyle changes is the first step.”

The review, lead-written by South Korean diabetes specialist Yoon Kun-Ho, a professor at Kangnam St Mary’s Hospital in Seoul, says Asia is riding the express lane to a crisis with far-reaching social and economic repercussions.

Many of its causes are familiar to western economies, where insulin resistance, which leads to diabetes, has surged along with waistlines, it says. The paper points the finger of blame at energy-dense diets saturated in fat and sugar that have come along with urbanisation and prosperity, and at a sedentary lifestyle based around the TV and computer screen.

In South Korea, the proportion of plant-derived food in the local diet plunged from 97 per cent in 1969 to 79 per cent in 1995, while the animal-food intake rose sevenfold. In Japan, five-year-old boys in metropolitan Tokyo had 12.6 per cent of fat in their daily diet in 1952; in 1994, it was 33.2 per cent.

In the US, prevalence of Type 2 diabetes has doubled from four to eight per cent of the population in 40 years. In newly-developed economies in Asia, the rate today is similar or even higher — only it has taken just a couple of decades for this to occur.

In Chinese adults, the rate of diabetes tripled from one per cent to 3.2 per cent between 1980 and 1996, while in Indonesia, South Korea and Thailand, prevalence has risen threefold to fivefold over the past 30 years.

Diabetes in Asia particularly strikes people aged between 45 and 64, whereas in Europe and North America, populated mainly by people of European descent, diabetes mainly affects people older than 65. This raises the worrying question whether Asians are genetically more susceptible to obesity and diabetes, says the study.

When compared like for like, in terms of age, sex and body mass, Asians, especially Asian women, have a higher proportion of body fat than their counterparts of European origin, and this fat is likelier to be stored around the abdomen.

According to a World Health Organisation (WHO) report, a substantial proportion of Asian people with a body-mass index of less than 25 — which is the “overweight” threshold according to the conventional yardstick — are at high risk of Type 2 diabetes and cardiovascular disease.

In addition, several studies suggest Asians may lack suffient beta cells in the pancreas, or have flaws in these cells. These problems make them resistant to insulin, the precursor condition to Type 2 diabetes.

The authors say governments across the region should launch emergency plans to tackle the problem, focussing first and foremost on weight control and exercise.

“Improvement of public health remains an urgent need, since the looming epidemic of diabetes and its complications threatens to drain health care resources,” they say.

Diabetes is a chronic condition in which the body does not produce enough of the hormone insulin, or cannot make proper use of the insulin it does produce, a condition called insulin resistance. As a result, there are wild fluctuations of glucose in the blood. This can eventually lead to blindness, heart disease, amputations and kidney failure.

Type 1 diabetes is linked to genetic predisposition. The more common Type 2 diabetes results mainly from an unhealthy diet and inactivity.