“Diabetes has reached pandemic proportions worldwide,” said Dr Bayat. “Currently we have over 537 million people living with diabetes, and this is postulated to increase by about 46%, to reach almost 780 million, by the year 2045. Africa has the highest growth of any continent in the world with 134% increase in the number of people living with diabetes.”
Dr Bayat explained that on a pharmacy level this means that over the next 20 years, considering the number of scripts being processed and the number of patients pharmacists are doing abnormal glucose tolerance (AGT) checks on, pharmacies are going to need to make double the amount of space to treat these patients. “It really is going to burden our healthcare system more than we can imagine,” he said.
“The most worrying thing is that most people are not aware of their diagnosis. Currently almost 55% of people in sub-Saharan Africa, including SA, are undiagnosed. If we look by age, we see a large number of people living with diabetes in their 30s, 40s, and 50s, and 80% of all deaths from diabetes occur in the age group which is under the age of 60.
TREATMENT HAS EVOLVED
Dr Bayat explained that our understanding has evolved and so too have our treatment options. In 1921 we had the discovery of insulin, In the 1950’s we had sulfonylureas, and biguanides (metformin) in 1960. “But in the last 20 years, we’ve seen this absolute explosion of drugs. In 2010 we had the advent of the SGLT 2 inhibitors and mark my words when I tell you there's lots of new therapies which are coming out called GLP, GIP, GGG, combinations which will change the way we look at diabetes completely.
REALITY OF THE RULE OF HALVES
“Despite all our advances, what we have is called the rule of halves. The ‘rule of halves’ states that only around 6% of people with diabetes are estimated to achieve well-managed diabetes and desired health outcomes,” said Dr Bayat. “Basically, for every 100 people living with diabetes, only six will achieve well managed diabetes with good outcomes. That’s quite frightening, especially because in SA that number is much worse. In SA less than one in 12 people with diabetes are expected to reach treatment targets, and over six out of 10 people with diabetes do not know they have diabetes.”