Type 2 diabetes is often seen as a condition affecting older, unproductive adults in wealthy countries. However, the reality is that 70% of people with diabetes now live in low and middle-income countries and the economic impact of diabetes is much greater in poorer countries. Yet the majority of the spending, 90% of all medical expenditures for diabetes care, is made in the United States, Canada, the countries of Western Europe, and other wealthy countries. This is the conclusion of the most comprehensive investigation of the economic impact of diabetes ever to be conducted in low and-middle-income countries.
The new data from the International Diabetes Federation (IDF) comes from researchers in five African countries who interviewed 2,300 men and women with type 2 diabetes and an additional 2,300 of their neighbours who did not have diabetes. The studies reveal that people with diabetes have roughly 3 times the rates of heart disease, stroke, kidney disease and heart failure than their otherwise similar neighbours. People with diabetes also have; more tuberculosis, HIV/AIDS and malaria. All these diseases lead to very high out-of-pocket medical expenses and lost income due to complications such as blindness, paralysis, amputation, pain, cognitive deficits, and other disabling problems. One out of 6 of the people interviewed said that they could not work at all because of their health; 1 out of 3 said they could not work as much they wanted, and 3% said that they had to work more than they wanted to cover their medical expenses. 1 out of 5 reported that they were not able to buy much needed food because of medical expenses, and more than half said they could not buy all the medicines they needed.
Perhaps the most surprising findings were that 15% of the family members had quit work to care for a family member with diabetes, 20% had to cut back on work and 15% had to work more to contribute to the cost of medicines and care for a family member with diabetes. The result of this, according to Jonathan Betz Brown, PhD, Chair of the IDF Task Force on Health Economics and of the Kaiser Permanente Center for Health Research, the global study leader, is that “children are kept out of school and deprived of food, families lose farms and businesses, and women and girls are forced to stay home to care for parents. In the end, these family tragedies add up to a less educated and smaller workforce, greater social disorganization, and slower economic growth.”
“You might think that the best way to help children in Africa would be to ignore chronic illnesses like diabetes,” said the African study leader and IDF Vice President, Dr. Kaushik Ramaiya, of Shree Hindu Mandal Hospital in Dar es Salaam, Tanzania, “but, in developing countries, children's' lives and prospects depend on the survival and strength of their parents and grandparents. When a father is fired because of a stroke, or a mother cannot raise crops and animals, or cook, because of blindness or an amputation, the entire family can find themselves homeless and pulled into dire poverty.”
Findings from the African study show that people with diabetes on the continent have many more medical problems than people of comparable age and sex; are much less able to function physically and work; are more frequent and more intensive users of medical care and drain precious economic resources from their family and society.
The lead investigators in each study were recruited locally and all enjoy international reputations for their research. IDF President Professor Jean Claude Mbanya led the study in Cameroon, Dr. Eva Njenga in Kenya, Mr. Stephane Besançon in Mali, Dr. Paul Rheeder in South Africa, and Dr. Kaushik Ramaiya in Tanzania. Other studies are underway in 17 cities in China, in Kazakhstan and in three countries in Central America.
These are preliminary results and the data continue to be analysed. Final results will be published at a later time.
- CitizenNews Service (CNS, www.citizen-news.org)