470 million people suffer from diabetes today, and this number will continue to increase by a whopping 72% in the next few years. That’s without including COVID. And these are only the known and diagnosed cases, with the real at-risk population probably being 5 times more, making it one out of two people on earth!
If I take my nuclear family of 5 people, 4 are diabetic. We are an average family with reasonably healthy habits and no known predispositions, though we may have got tested, unlike many others. Now that’s a serious epidemic scale at the population level if extended.
Add the close connection between COVID-19 and diabetes in terms of comorbidity and after effects. This is a flashing warning sign that we are sitting on the edge of a diabetes precipice. What makes the dramatic growth in the at-risk population really puzzling is that this is an age-old problem that seems to be accelerating exponentially. The first time that blood sugar could be measured was in 1969 through blood tests, and treatment standards have only accelerated since then!
Every year, there are new technologies measuring and combating diabetes coming to the market. Indeed the total value of the diabetes market, including all the devices, therapies, medicines etc., will probably be worth 100 billion dollars per annum! So what’s missing is worth pondering over. It’s almost a trillion dollar question, given the potential loss of economic vibrancy and output by the at-risk population. Considering that diabetes is detected on an average 7 years late and most diabetics are now used to the idea of being on medication for life, along with being exposed to other downstream multi organ failures from the brain and eyes to the heart and feet, it’s truly a silent and slower Thanos!
The answer to the puzzle is hiding in our plain eyesight. At least 90% of diabetics are suffering from what is called Type 2 diabetes, which is largely a lifestyle condition. 3 key factors are at work here. The first is rapid automation, better transportation and gadgets that hook humanity into leading more sedentary lifestyles. The second one is the increase of processed foods being consumed, which increases sugar consumption, therefore reducing nutritional intake. And lastly, not surprisingly, stress and worsening sleep habits which make life complex while externally making it seem like we are progressing.
Let’s term this as the Holy Trinity of Food, Fitness and Fun (the 3Fs), with it being a function of health metabolism. And diabetes is ultimately a problem of metabolism gone amok, just as cancer is the process of cell division going haywire. The interesting factoid here is that we don’t know exactly how metabolism works, nor do we know how it differs within people given their individual genetics, constitution, habits and environment. A singular focus on blood glucose as a marker distorts the differences in the population by forcing it to the mean. More importantly, the call to action in terms of resetting the 3Fs is missing. As the one person in my family without diabetes, if I wanted to beat my high probability of developing it, I would need to check my sugar through one device, then meet a doctor (who probably has little information about said variations) once a month, then have a separate fitness trainer and a nutritionist all of whom have no consolidated picture of my health condition. Forget this big picture, I’m still unsure of the impacts of what I eat! Is it life threatening for me if I have 3 bananas on a given morning or a Big Mac everyday for breakfast?
Imagine it this way, it’s like owning a car whose engine (metabolism), steering (fitness), fuel (food) and regular maintenance (fun) is out of sync with each other. This metaphoric car, which is our body-machine, will not work too long despite an expert driver! That’s the story of our life even with medical advancements. We have fancy systems which do not talk to each other, and as a result of this, our lifestyle continues to suffer, medicines continue to pile on, and progressive deterioration in organs continues to worsen. And we’re under the impression that we’re managing diabetes. As COVID makes it painfully clear, the future is to track health and lifestyles, and subsequently keep monitoring and improving.
Once we understand the gaps in our existing infrastructure and how the various systems are collectively failing to bring an improvement, solutions can start emerging! And thankfully, there are new technologies on the horizon that will provide us with a way to monitor diabetic health with rich information on an ongoing basis, connect the 3Fs seamlessly, and work towards improving, reversing and preventing this epidemic from taking control of our lives. Thanks to those, we may be sitting on the cusp of a revolution where we’ll become healthier and more productive as we start living longer.