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347 million people worldwide have diabetes.
WHO projects that diabetes will be the 7th leading cause of death in 2030. It is estimated that above 40 years of age,one in three men and one in four women have diabetes or prediabetes.
Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of type 2 diabetes.

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 (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. The cause of type 1 diabetes is not known and it is not preventable with current knowledge.

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

Type 2 diabetes
Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body’s ineffective use of insulin. Type 2 diabetes comprises 90% of people with diabetes around the world (5), and is largely the result of excess body weight and physical inactivity.

Gestational diabetes
Gestational diabetes is hyperglycaemia with onset or first recognition during pregnancy.
Symptoms of gestational diabetes are similar to Type 2 diabetes. Gestational diabetes is most often diagnosed through prenatal screening, rather than reported symptoms.

Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG)
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.

What are 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. 50% 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 percent 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.

How can the burden of diabetes be reduced?
Prevention
Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:
achieve and maintain healthy body weight;
be physically active – at least 30 minutes of regular, moderate-intensity activity on most days.
More activity is required for weight control;
eat a healthy diet of between three and five servings of fruit and vegetables a day and reduce sugar and saturated fats intake;
avoid tobacco use – smoking increases the risk of cardiovascular diseases.

Diagnosis and treatment
Early diagnosis can be accomplished through relatively inexpensive blood testing.

Treatment of diabetes involves lowering blood glucose and the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications.

Interventions that are both cost saving and feasible in developing countries include:

moderate blood glucose control. People with type 1 diabetes require insulin; people with type 2 diabetes can be treated with oral medication, but may also require insulin; blood pressure control; foot care.

Other cost saving interventions include:
screening and treatment for retinopathy (which causes blindness);
blood lipid control (to regulate cholesterol levels);
screening for early signs of diabetes-related kidney disease.
These measures should be supported by a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use.

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Key facts

Physical inactivity is the fourth leading risk factor for death worldwide. Approximately 3.2 million people die each year due to physical inactivity.

Physical inactivity is a key risk factor for noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes.

Physical activity has significant health benefits and contributes to prevent NCDs.
Globally, one in three adults is not active enough.

WHO defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure – including activities undertaken while working, playing, carrying out household chores, travelling, and engaging in recreational pursuits.

The term “physical activity” should not be confused with “exercise”, which is a subcategory of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness. Both, moderate and vigorous intensity physical activity brings health benefits.

The intensity of different forms of physical activity varies between people. In order to be beneficial for cardiorespiratory health, all activity should be performed in bouts of at least 10 minutes duration.
WHO recommends:
for children and adolescents: 60 minutes of moderate to vigorous intensity activity per day;
for adults (18+): 150 minutes of moderate-intensity activity per week.

Benefits of physical activity
Regular physical activity of moderate intensity – such as walking, cycling, or doing sports, has significant benefits for health. At all ages, the benefits of being physically active outweigh potential harm, for example through accidents. Some physical activity is better than doing none. By becoming more active throughout the day in relatively simple ways, people can quite easily achieve the recommended activity levels.

Regular and adequate levels of physical activity:
improve muscular and cardiorespiratory fitness; improve bone and functional health; reduce the risk of hypertension, coronary heart disease, stroke, diabetes, breast and colon cancer and depression; reduce the risk of falls as well as hip or vertebral fractures; and
are fundamental to energy balance and weight control.

Risks of physical inactivity
Physical inactivity is the fourth leading risk factor for global mortality and causes 6% of all deaths. It is only outstripped by high blood pressure (13%) and tobacco use (9%) and carries the same level of risk as high blood glucose (6%). Approximately 3.2 million people die each year because they are not active enough.

Physical inactivity is on the rise in many countries, adding to the burden of noncommunicable diseases and affecting general health worldwide. People who are insufficiently active have a 20% to 30% increased risk of death compared to people who engage in at least 30 minutes of moderate intensity physical activity on most days of the week.

Physical inactivity is the main cause for approximately:
21–25% of breast and colon cancers
27% of diabetes
30% of ischaemic heart disease.
Reasons for physical inactivity

The levels of physical inactivity increased across the globe. Globally, around 31% of adults aged 15 and over were not active enough in 2008 (men 28% and women 34%). In high-income countries, 41% of men and 48% of women were insufficiently physically active, as compared to 18% of men and 21% of women in low-income countries. Low or decreasing physical activity levels often correspond with a high or rising gross national product. The drop in physical activity is partly due to inaction during leisure time and sedentary behaviour on the job and at home. Likewise, an increase in the use of “passive” modes of transportation also contributes to physical inactivity.

Several environmental factors which are linked to urbanization can discourage people from becoming more active, such as:
fear of violence and crime in outdoor areas
high-density traffic
low air quality, pollution
lack of parks, sidewalks and sports/recreation facilities.

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