Report on Global Diabetes Diagnosis Gaps and Alignment with Sustainable Development Goals

A recent global analysis reveals a significant deficit in diabetes diagnosis, posing a substantial challenge to the achievement of Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all at all ages. The findings underscore the urgent need for enhanced public health strategies focused on screening, diagnosis, and management of non-communicable diseases (NCDs).

Executive Summary of Findings

A systematic review published in The Lancet Diabetes & Endocrinology, analyzing data from 204 countries and territories between 2000 and 2023, identified critical gaps in the global diabetes care continuum. These gaps directly impact progress towards SDG Target 3.4, which calls for a one-third reduction in premature mortality from NCDs.

• Global Undiagnosed Population: 44% of individuals aged 15 and older living with diabetes, predominantly type 2, are unaware of their condition.
• Awareness Rate: Consequently, only 56% of people with diabetes are formally diagnosed.
• Treatment Efficacy: Among those receiving treatment, only 40% achieve optimal blood sugar control, indicating significant challenges in disease management post-diagnosis.

Analysis of Disparities and Impact on SDG 3

The study highlights profound disparities in diabetes diagnosis and care, which reflect systemic inequalities that hinder the realization of SDG 3, particularly Target 3.8 concerning universal health coverage.

Geographic and Socioeconomic Disparities

A clear divide exists between high-income countries and low- and middle-income countries (LMICs). Higher-income nations demonstrate greater success in diagnosing diabetes, pointing to disparities in healthcare access, infrastructure, and public health awareness. This gap undermines the principle of universal health coverage by leaving vulnerable populations in LMICs without access to essential diagnostic services, a cornerstone of SDG 3.

Age-Related Vulnerabilities

Younger populations are disproportionately affected by the diagnosis gap, a critical concern for long-term public health and sustainable development.

• Only 20% of individuals under the age of 35 with diabetes are aware of their condition.
• This is largely attributed to a lack of routine screening protocols for this age group, as organizations like the American Diabetes Association typically recommend screenings for adults 35 and older.
• Late diagnosis in younger individuals increases the likelihood of premature and severe complications, directly conflicting with the goals of SDG 3.

Public Health Implications and Alignment with SDG Targets

Delayed or missed diabetes diagnosis leads to severe health consequences, increasing the burden on health systems and preventing progress on key SDG 3 indicators.

Consequences of Late Diagnosis

Failure to diagnose diabetes in a timely manner allows for the progression of the disease, leading to preventable complications. This directly impedes efforts under SDG Target 3.4 to reduce mortality from NCDs.

1. Heart Disease
2. Kidney Failure
3. Nerve Damage
4. Vision Loss

Symptoms and the Importance of Screening

While some symptoms can indicate diabetes, the asymptomatic nature of its early stages highlights the necessity of proactive screening as a public health strategy. Strengthening national capacities for early warning and risk reduction (SDG Target 3.d) through widespread screening is essential.

• Increased thirst or hunger
• Frequent urination
• Blurry vision
• Unexpected weight loss
• Fatigue

Recommendations for Prevention and Achieving SDG 3

Addressing the global diabetes crisis requires a dual approach focused on improving diagnosis and strengthening prevention, particularly for type 2 diabetes. These preventative measures are cost-effective interventions that align with the broader objective of promoting health and well-being under SDG 3.

Lifestyle Interventions for Prevention

1. Dietary Modification: Adopting diets such as the Mediterranean diet, increasing plant-based food intake, and reducing consumption of red, processed, and ultra-processed foods can significantly lower the risk of type 2 diabetes.
2. Physical Activity: Incorporating regular physical activity, such as at least 15 minutes of fast walking daily, is a proven method for reducing the risk of diabetes and other chronic diseases.

Ultimately, focusing on risk factor reduction and prevention is critical to alleviating the burden of diabetes, ensuring healthier populations, and making substantive progress toward the health-related targets of the Sustainable Development Goals.

Analysis of the Article in Relation to Sustainable Development Goals (SDGs)

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  This is the primary SDG addressed in the article. The entire text focuses on diabetes, a major non-communicable disease (NCD). It discusses the prevalence of undiagnosed cases, the importance of early diagnosis and treatment to prevent severe health complications, and strategies for prevention through lifestyle changes. The article’s core message aligns with the goal of ensuring healthy lives and promoting well-being for all ages.

• SDG 10: Reduced Inequalities

  The article explicitly points out significant disparities in diabetes diagnosis, which relates directly to reducing inequalities. It highlights inequalities based on both economic status and age. The text states, “higher-income countries were doing better at diagnosing people than low- and middle-income countries,” indicating a gap between nations. Furthermore, it reveals an age-based inequality, noting that “People under 35 years were much less likely to be diagnosed,” with only “20% of young adults with diabetes” being aware of their condition.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.4: Reduce premature mortality from non-communicable diseases

  The article directly supports this target by focusing on diabetes, a key NCD. It emphasizes that early diagnosis and management are crucial “to prevent or delay long-term complications such as heart disease, kidney failure, nerve damage, and vision loss,” all of which contribute to premature mortality. The discussion on preventing type 2 diabetes through diet and physical activity also aligns with the “prevention and treatment” aspect of this target.

• Target 3.8: Achieve universal health coverage, including access to quality essential health-care services

  The high rate of undiagnosed diabetes (44% globally) implies a lack of access to essential healthcare services like routine screening and diagnosis. The disparity mentioned between high-income and low- and middle-income countries further underscores the challenge of achieving universal health coverage. The article’s call for regular blood sugar checks and screenings is a call for improved access to these fundamental health services.

• Target 10.2: Empower and promote the social, economic and political inclusion of all, irrespective of age… or economic or other status

  This target is relevant due to the health inequalities identified in the article. The finding that only “20% of young adults with diabetes were aware of their condition” points to a lack of health inclusion for younger populations, who are often overlooked in routine screening recommendations. Similarly, the lower diagnosis rates in low- and middle-income countries reflect an economic-based exclusion from adequate healthcare.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator for Target 3.4: Prevalence of undiagnosed diabetes

  The article provides a clear metric: “Forty-four percent of people age 15 and older living with diabetes are undiagnosed.” This percentage serves as a direct indicator of the gap in diagnosis and treatment. A reduction in this figure would signify progress in managing NCDs.

• Indicator for Target 3.4: Effectiveness of treatment

  The article states that “about 40% of people with treated diabetes were getting optimal results and lowering their blood sugar.” This statistic can be used as an indicator to measure the quality and effectiveness of diabetes treatment. An increase in this percentage would show improvement in health outcomes for diagnosed individuals.

• Indicator for Target 10.2: Diagnosis rate by age group

  The article provides a specific data point for age-based inequality: “Just ‘20% of young adults with diabetes were aware of their condition.'” This can be used as an indicator to track progress in closing the health awareness and diagnosis gap for younger people. Comparing this to the overall awareness rate (56%) highlights the disparity.

• Indicator for Target 3.8 and 10.2: Diagnosis rate by country income level

  While not providing specific numbers, the article makes a qualitative statement that serves as an implied indicator: “higher-income countries were doing better at diagnosing people than low- and middle-income countries.” Quantifying this difference would create a clear indicator for measuring progress towards universal health coverage and reducing health inequalities between countries.

SDGs, Targets, and Indicators Table

Source: cnn.com