On the eve of World Diabetes Day on November 14, the Pan American Health Organization (PAHO) urges better control of diabetes to prevent related complications as well as potentially life-threatening complications associated to COVID-19 infections. PAHO also calls for continued access to primary health care services and treatment for persons living with diabetes amid the new coronavirus.
“We are doubly concerned about the risk that diabetes may pose to those living with the disease in general and during the pandemic in particular,” said PAHO Director Carissa F. Etienne. “People with diabetes, who do not have access to health services and medications that allow adequate control, are at greater risk of developing complications such as visual impairment, kidney disease and lower extremity amputations, but are now also at greater risk of becoming seriously ill if they contract COVID-19,” she said.
In the Americas, more than 60 million people are living with diabetes, primarily type 2, and if no action is taken, it is estimated that there will be more than 100 million adults with the disease by 2040. In addition, each year more than 340,000 people in the region die from diabetes-related complications. Meanwhile, COVID-19 has already infected more than 21 million people in the region and cases continue to rise.
COVID-19 Pandemic and Diabetes
The COVID-19 pandemic has disrupted the daily routines of millions of people in the region and has made the disease more difficult to manage. Fewer people have attended health care facilities for follow up visits due to stay-at-home measures, fear of infection by the new coronavirus, and disruptions in health care services. A recent PAHO/WHO survey documented that more than half of the countries in the Americas reported that diabetes and diabetic complications management services were disrupted during the COVID-19 pandemic, with limited access to essential medicines and technologies.
“Many people may not be receiving their diabetes medications or may not be accessing the care they need to manage their disease, which is very worrisome, given that those living with diabetes are at greater risk of developing severe forms of COVID-19,” said Anselm Hennis, director of PAHO’s Department of Noncommunicable Diseases and Mental Health.
PAHO urged countries to ensure that diabetes care remains fully available to patients during the pandemic. This may mean offering care outside traditional settings, using digital health solutions, disseminating information and bringing care closer to the population through community health workers. Insulin must also remain accessible and affordable to those who need it.
The Organization also called on health professionals – including nurses, who are recognized this year by the World Diabetes Day campaign for their critical support of people with diabetes – to ensure that people with diabetes understand their risk and have access to quality health services, information and tools to manage their disease. PAHO also called on those living with diabetes to control their disease by staying active, eating healthy and monitoring their condition, particularly during the pandemic.
“While many may be afraid to visit a clinic, now is not the time to skip diabetes monitoring visits,” warned PAHO Director Etienne. “People can still get the care they need and their prescriptions, but they must remember to practice physical distancing, wash their hands often, and wear masks,” Etienne noted.
Slowing the progression of diabetes
Overweight and obesity, which affect more than 60% of adults in the region, are strongly linked to diabetes, a chronic progressive disease characterized by elevated blood glucose levels. Type 2 diabetes – which accounts for the majority of global cases and is largely due to excessive body weight, unhealthy diet and physical inactivity – is on the rise worldwide. Since 1980, the number of people with Type 2 diabetes in the region has tripled.
Diabetes complications can be prevented through improved treatment and quality of care. Diabetes can be prevented through health and fiscal policies, legislation, environmental changes and public awareness to prevent risk factors, including obesity, unhealthy diet and sedentary lifestyles.
Examples of these interventions include taxes on sugary drinks, bans on the advertising of ultra-processed foods for children, front-of-package food labeling to advise consumers of high salt, sugar and fat content, and promotion of safe and accessible recreational spaces to encourage active living. A healthy diet and 30 minutes of moderate physical activity every day can reduce the likelihood of children and adolescents becoming overweight.
As part of the Global Action Plan for the Prevention and Control of Noncommunicable Diseases, PAHO supports countries in the region in these efforts to reduce diabetes-related complications and premature mortality. PAHO also helps countries to purchase medicines to treat diabetes at affordable prices, reducing the costs associated with treating this chronic disease.