The World Health Organization (WHO) has identified five core targets that countries should be fulfilling in order to reduce diabetes-related risks and to ensure equitable access to comprehensive and affordable diabetes care.

In a new report, the WHO highlights that around 537 million adults are now estimated to have diabetes, 80% of whom live in low-income and middle-income countries. The impact and cost of the condition is expected to increase significantly in the coming years, with disadvantaged populations affected disproportionately.

Population-based studies show that currently, the delivery of evidence-based care for people with diabetes is suboptimal even in well-resourced health systems. Many countries have a high number of people who remain undiagnosed and many of those affected go without timely care for extended periods.

The lead author of the report is Prof Edward Gregg of the RCSI’s School of Population Health. He warned that diabetes “is one of the world's most challenging public health issues due to its high and growing prevalence and the impact it has on individuals, health systems and national economies”.

“Yet we know that the worst outcomes from diabetes can be prevented and that many interventions are cost-effective and feasible to implement. However, there are enormous global gaps in their delivery,” he commented.

The WHO report identifies the following five core national targets for UN members:

-Of all people with diabetes, at least 80% have been clinically diagnosed

-For people with diagnosed diabetes, 80% have HbA1c concentrations below 8·0% (63·9 mmol/mol)

-80% of those with diabetes have blood pressure lower than 140/90mm/Hg

-At least 60% of those with diabetes who are 40 years or older are receiving therapy with statins

-Every person with type 1 diabetes has continuous access to insulin, blood glucose meters and test strips.

In high-income countries, the current proportions of people who meet recommended targets for risk factors, such as HbA1c or blood pressure, ranges from 50% to 70%.

The situation is even worse in low and middle-income countries, with just half of those diagnosed achieving HbA1c targets and only one in four having good blood pressure control.

“While these goals are ambitious, their achievement can reduce the number of people living with diabetes and greatly improve the outcomes and quality of life of people who are diagnosed with the condition. We hope this report serves as a helpful framework for countries to take action and reduce the burden of diabetes globally,” Prof Gregg said.

He emphasised that type 2 diabetes can be delayed or prevented through intensive lifestyle interventions and medication for individuals at high risk, as well as population-wide changes to diet, physical activity levels and the prevalence of obesity.

“For people with diagnosed diabetes, delivery of essential medications and management of glycaemia and cardiometabolic risk factors, alongside early screening for complications via well organised care, can reduce acute and chronic complications and extend life,” he added.

The report is published in the journal, The Lancet, and can be viewed here.