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Chronic diseases
Chronic diseases are diseases of long duration and generally slow progression. Chronic diseases, such as
heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of
mortality in the world, representing 60% of all deaths. Out of the 35 million people who died from
chronic disease in 2005, half were under 70 and half were women.
Cardiovascular disease is caused by disorders of the heart and blood vessels, and includes coronary
heart disease (heart attacks), cerebrovascular disease (stroke), raised blood pressure (hypertension),
peripheral artery disease, rheumatic heart disease, congenital heart disease and heart failure. The major
causes of cardiovascular disease are tobacco use, physical inactivity, and an unhealthy diet.
KEY FACTS
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CVDs are the number one cause of death globally: more people die annually from CVDs than
from any other cause.
An estimated 17.1 million people died from CVDs in 2004, representing 29%of all global deaths.
Of these deaths, an estimated 7.2 million were due to coronary heart disease and 5.7 million were
due to stroke.
Low- and middle-income countries are disproportionally affected: 82% of CVD deaths take place
in low- and middle-income countries and occur almost equally in men and women.
By 2030, almost 23.6 million people will die from CVDs, mainly from heart disease and stroke.
These are projected to remain the single leading causes of death. The largest percentage increase
will occur in the Eastern Mediterranean Region. The largest increase in number of deaths will
occur in the South-East Asia Region.
What are cardiovascular diseases?
Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and include:
 coronary heart disease – disease of the blood vessels supplying the heart muscle
 cerebrovascular disease - disease of the blood vessels supplying the brain
 peripheral arterial disease – disease of blood vessels supplying the arms and legs
 rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever,
caused by streptococcal bacteria
 congenital heart disease - malformations of heart structure existing at birth
 deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge
and move to the heart and lungs.
Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents
blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits
on the inner walls of the blood vessels that supply the heart or brain. Strokes can also be caused by
bleeding from a blood vessel in the brain or from blood clots.
What are the risk factors for cardiovascular disease?
The most important behavioral risk factors of heart disease and stroke are unhealthy diet, physical
inactivity and tobacco use. Behavioral risk factors are responsible for about 80% of coronary heart disease
and cerebrovascular disease.
The effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure,
raised blood glucose, raised blood lipids, and overweight and obesity; these are called 'intermediate risk
factors'.
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There are also a number of underlying determinants of CVDs, or, if you like, "the causes of the causes".
These are a reflection of the major forces driving social, economic and cultural change – globalization,
urbanization, and population ageing. Other determinants of CVDs are poverty and stress.
What are common symptoms of cardiovascular diseases?
Symptoms of heart attacks and strokes:
Often, there are no symptoms of the underlying disease of the blood vessels. A heart attack or stroke may
be the first warning of underlying disease. Symptoms of a heart attack include:
 pain or discomfort in the centre of the chest;
 pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.
In addition the person may experience difficulty in breathing or shortness of breath; feeling sick or
vomiting; feeling light-headed or faint; breaking into a cold sweat; and becoming pale. Women are more
likely to have shortness of breath, nausea, vomiting, and back or jaw pain.
The most common symptom of a stroke is sudden weakness of the face, arm, or leg, most often on one
side of the body. Other symptoms include sudden onset of: numbness of the face, arm, or leg, especially
on one side of the body; confusion, difficulty speaking or understanding speech; difficulty seeing with
one or both eyes; difficulty walking, dizziness, loss of balance or coordination; severe headache with no
known cause; and fainting or unconsciousness.
People experiencing these symptoms should seek medical care immediately.
What is rheumatic heart disease?
Rheumatic heart disease is caused by damage to the heart valves and heart muscle from the inflammation
and scarring caused by rheumatic fever. Rheumatic fever is caused by streptococcal bacteria, which
usually begins as a sore throat or tonsillitis in children.
Rheumatic fever mostly affects children in developing countries, especially where poverty is widespread.
Globally, almost 2% of deaths from cardiovascular diseases is related to rheumatic heart disease, while
42% of deaths from cardiovascular diseases is related to ischemic heart disease, and 34% to
cerebrovascular disease.
Symptoms of rheumatic heart disease
 Symptoms of rheumatic heart disease include: shortness of breath, fatigue, irregular heart beats,
chest pain and fainting.
 Symptoms of rheumatic fever include: fever, pain and swelling of the joints, nausea, stomach
cramps and vomiting.
Treatment
 Early treatment of streptococcal sore throat can stop the development of rheumatic fever. Regular
long-term penicillin treatment can prevent repeat attacks of rheumatic fever which give rise to
rheumatic heart disease and can stop disease progression in people whose heart valves are already
damaged by the disease.
Why are cardiovascular diseases a development issue in low- and middle-income countries?
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Over 80% of the world's deaths from CVDs occur in low- and middle-income countries.
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People in low- and middle-income countries are more exposed to risk factors leading to CVDs and
other noncommunicable diseases and are less exposed to prevention efforts than people in highincome countries.
People in low- and middle-income countries who suffer from CVDs and other noncommunicable
diseases have less access to effective and equitable health care services which respond to their
needs (including early detection services).
As a result, many people in low- and middle-income countries die younger from CVDs and other
noncommunicable diseases, often in their most productive years.
The poorest people in low- and middle-income countries are affected most. At household level,
sufficient evidence is emerging to prove that CVDs and other noncommunicable diseases
contribute to poverty. For example, catastrophic health care expenditures for households with a
family member with CVD can be 30 per cent or more of annual household spending.
At macro-economic level, CVDs place a heavy burden on the economies of low- and middleincome countries. Heart disease, stroke and diabetes are estimated to reduce GDP between 1 and
5% in low- and middle-income countries experiencing rapid economic growth, as many people die
prematurely. For example, it is estimated that over the next 10 years (2006-2015), China will lose
$558 billion in foregone national income due to the combination of heart disease, stroke and
diabetes.
How can the burden of cardiovascular diseases be reduced?
Heart disease and stroke can be prevented through healthy diet, regular physical activity and avoiding
tobacco smoke. Individuals can reduce their risk of CVDs by engaging in regular physical activity,
avoiding tobacco use and second-hand tobacco smoke, choosing a diet rich in fruit and vegetables and
avoiding foods that are high in fat, sugar and salt, and maintaining a healthy body weight.
Comprehensive and integrated action is the means to prevent and control CVDs.
 Comprehensive action requires combining approaches that seek to reduce the risks throughout the
entire population with strategies that target individuals at high risk or with established disease.
 Examples of population-wide interventions that can be implemented to reduce CVDs include:
comprehensive tobacco control policies, taxation to reduce the intake of foods that are high in fat,
sugar and salt, building walking and cycle ways to increase physical activity, providing healthy
school meals to children.
 Integrated approaches focus on the main common risk factors for a range of chronic diseases such
as CVD, diabetes and cancer: unhealthy diet, physically inactivity and tobacco use.
There are several treatment options available.
 Effective and inexpensive medication is available to treat nearly all CVDs.
 Survivors of a heart attack or stroke are at high risk of recurrences and at high risk of dying from
them. The risk of a recurrence or death can be substantially lowered with a combination of drugs –
statins to lower cholesterol, drugs to lower blood pressure, and aspirin.
 Operations used to treat CVDs include coronary artery bypass, balloon angioplasty (where a small
balloon-like device is threaded through an artery to open the blockage), valve repair and
replacement, heart transplantation, and artificial heart operations.
 Medical devices are required to treat some CVDs. Such devices include pacemakers, prosthetic
valves, and patches for closing holes in the heart.
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Cancer
Cancer is the uncontrolled growth and spread of cells. It can affect almost any part of the body. The
growths often invade surrounding tissue and can metastasize to distant sites. Many cancers can be
prevented by avoiding exposure to common risk factors, such as tobacco smoke. In addition, a significant
proportion of cancers can be cured, by surgery, radiotherapy or chemotherapy, especially if they are
detected early.
Key Facts
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Cancer is a leading cause of death worldwide: it accounted for 7.4 million deaths (around 13% of
all deaths) in 2004.
Lung, stomach, liver, colon and breast cancer cause the most cancer deaths each year.
The most frequent types of cancer differ between men and women.
More than 30% of cancer deaths can be prevented.1
Tobacco use is the single most important risk factor for cancer.
Cancer arises from a change in one single cell. The change may be started by external agents and
inherited genetic factors.
Deaths from cancer worldwide are projected to continue rising, with an estimated 12 million
deaths in 2030.
Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms
used are malignant tumors and neoplasms. One defining feature of cancer is the rapid creation of
abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the
body and spread to other organs. This process is referred to as metastasis. Metastases are the major cause
of death from cancer.
Global burden of cancer
Cancer is a leading cause of death worldwide. The disease accounted for 7.4 million deaths (or around
13% of all deaths worldwide) in 2004. The main types of cancer leading to overall cancer mortality each
year are:
 lung (1.3 million deaths/year)
 stomach (803 000 deaths)
 colorectal (639 000 deaths)
 liver (610 000 deaths)
 breast (519 000 deaths).
More than 70% of all cancer deaths occurred in low- and middle-income countries. Deaths from cancer
worldwide are projected to continue rising, with an estimated 12 million deaths in 2030.
The most frequent types of cancer worldwide (in order of the number of global deaths) are:
 Among men - lung, stomach, liver, colorectal, esophagus and prostate
 Among women - breast, lung, stomach, colorectal and cervical.
What causes cancer?
Cancer arises from one single cell. The transformation from a normal cell into a tumor cell is a multistage
process, typically a progression from a pre-cancerous lesion to malignant tumors. These changes are the
result of interaction between a person's genetic factors and three categories of external agents, including:
 physical carcinogens, such as ultraviolet and ionizing radiation
 chemical carcinogens, such as asbestos, components of tobacco smoke, aflatoxin (a food
contaminant) and arsenic (a drinking water contaminant)
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biological carcinogens, such as infections from certain viruses, bacteria or parasites.
Some examples of infections associated with certain cancers:
 Viruses: hepatitis B and liver cancer, Human Papilloma Virus (HPV) and cervical cancer, and
human immunodeficiency virus (HIV) and Kaposi sarcoma.
 Bacteria: Helicobacter pylori and stomach cancer.
 Parasites: schistosomiasis and bladder cancer.
Ageing is another fundamental factor for the development of cancer. The incidence of cancer rises
dramatically with age, most likely due to a buildup of risks for specific cancers that increase with age. The
overall risk accumulation is combined with the tendency for cellular repair mechanisms to be less
effective as a person grows older.
Tobacco use, alcohol use, low fruit and vegetable intake, and chronic infections from hepatitis B (HBV),
hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) are leading risk factors for
cancer in low- and middle-income countries. Cervical cancer, which is caused by HPV, is a leading cause
of cancer death among women in low-income countries.
In high-income countries, tobacco use, alcohol use, and being overweight or obese are major risk factors
for cancer.
How can the burden of cancer be reduced?
Knowledge about the causes of cancer, and interventions to prevent and manage the disease is extensive.
Cancer can be reduced and controlled by implementing evidence-based strategies for cancer prevention,
early detection of cancer and management of patients with cancer.
More than 30% of cancer could be prevented by modifying or avoiding key risk factors, according to a
2005 study by international cancer collaborators1. Risk factors include:
 tobacco use
 being overweight or obese
 low fruit and vegetable intake
 physical inactivity
 alcohol use
 sexually transmitted HPV-infection
 urban air pollution
 indoor smoke from household use of solid fuels.
Prevention strategies:
 increase avoidance of the risk factors listed above
 vaccinate against human papilloma virus (HPV) and hepatitis B virus (HBV)
 control occupational hazards
 reduce exposure to sunlight
Early detection
About one-third of the cancer burden could be decreased if cases were detected and treated early. Early
detection of cancer is based on the observation that treatment is more effective when cancer is detected
earlier. The aim is to detect the cancer when it is localized (before metastasis). There are two components
of early detection efforts:
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Education to help people recognize early signs of cancer and seek prompt medical attention for
symptoms, which might include: lumps, sores, persistent indigestion, persistent coughing, and
bleeding from the body's orifices.
Screening programs to identify early cancer or pre-cancer before signs are recognizable, including
mammography for breast cancer, and cytology (a "pap smear") for cervical cancer.
Treatment and care
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Treatment aims to cure, prolong life and improve quality of life for patients. Some of the most
common cancer types, such as breast cancer, cervical cancer and colorectal cancer, have high cure
rates when detected early and treated according to best practice. Principal treatment methods are
surgery, radiotherapy and chemotherapy. Fundamental for adequate treatment is an accurate
diagnosis through imaging technology (ultrasound, endoscopy or radiography) and laboratory
(pathology) investigations.
Relief from pain and other problems can be achieved in over 90% of cancer patients through
palliative care. Effective ways exist to provide palliative care for patients and their families in low
resource settings.
Respiratory tract diseases
Respiratory tract diseases are diseases that affect the air passages, including the nasal passages, the
bronchi and the lungs. They range from acute infections, such as pneumonia and bronchitis, to chronic
conditions such as asthma and chronic obstructive pulmonary disease.
Chronic respiratory diseases
Chronic respiratory diseases are chronic diseases of the airways and other structures of the lung. Some of
the most common are asthma, chronic obstructive pulmonary disease (COPD), respiratory allergies,
occupational lung diseases and pulmonary hypertension.
The most important risk factors for preventable chronic respiratory diseases are:
 Tobacco smoking
 Indoor air pollution
 Outdoor pollution
 Allergens
 Occupational risks and vulnerability
QUICK chronic respiratory disease FACTS
Hundreds of millions of people suffer every day from chronic respiratory diseases. According to the latest
WHO estimates (2007), currently 300 million people have asthma; 210 million people have chronic
obstructive pulmonary disease (COPD) while millions have allergic rhinitis and other often-underdiagnosed chronic respiratory diseases.
Asthma
Key facts
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Asthma is a chronic disease of the bronchial, the air passages leading to and from the lungs.
Some 300 million people currently suffer from asthma. It is the most common chronic disease
among children.
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Most asthma-related deaths occur in low- and lower-middle income countries.
The strongest risk factors for developing asthma are inhaled substances and particles that may
provoke allergic reactions or irritate the airways.
Medication can control asthma. Avoiding asthma triggers can also reduce the severity of asthma.
Appropriate management of asthma can enable people to enjoy a good quality of life.
Asthma is a chronic disease characterized by recurrent attacks of breathlessness and wheezing, which
vary in severity and frequency from person to person. Symptoms may occur several times in a day or
week in affected individuals, and for some people become worse during physical activity or at night.
During an asthma attack, the lining of the bronchial tubes swell, causing the airways to narrow and
reducing the flow of air into and out of the lungs. Recurrent asthma symptoms frequently cause
sleeplessness, daytime fatigue, reduced activity levels and school and work absenteeism. Asthma has a
relatively low fatality rate compared to other chronic diseases.
Facts about asthma
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WHO estimates that 300 million people currently suffer from asthma. Asthma is the most common
chronic disease among children.
Asthma is a public health problem not just for high-income countries; it occurs in all countries
regardless of the level of development. Most asthma-related deaths occur in low- and lowermiddle income countries.
Asthma is under-diagnosed and under-treated. It creates substantial burden to individuals and
families and often restricts individuals’ activities for a lifetime.
The causes
The fundamental causes of asthma are not completely understood. The strongest risk factors for
developing asthma are a combination of genetic predisposition with environmental exposure to inhaled
substances and particles that may provoke allergic reactions or irritate the airways, such as:
 indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution
and pet dander)
 outdoor allergens (such as pollens and moulds)
 tobacco smoke
 chemical irritants in the workplace
 air pollution.
Other triggers can include cold air, extreme emotional arousal such as anger or fear, and physical
exercise. Even certain medications can trigger asthma: aspirin and other non-steroid anti-inflammatory
drugs, and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine).
Urbanization has been associated with an increase in asthma. The exact nature of this relationship is
unclear.
Reducing the asthma burden
Although asthma cannot be cured, appropriate management can control the disease and enable people to
enjoy a good quality of life. Short-term medications are used to relieve symptoms. People with persistent
symptoms must take long-term medication daily to control the underlying inflammation and prevent
symptoms and exacerbations.
Medication is not the only way to control asthma. It is also important to avoid asthma triggers - stimuli
that irritate and inflame the airways. With medical support, each asthma patient must learn what triggers
he or she should avoid.
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Although asthma does not kill on the scale of chronic obstructive pulmonary disease (COPD) or other
chronic diseases, failure to use appropriate medications or to adhere to treatment can lead to death.
WHO strategy for prevention and control of asthma
WHO recognizes that asthma is of major public health importance. The Organization plays a role in
coordinating international efforts against the disease. The aim of its strategy is to support Member States
in their efforts to reduce the disability and premature death related to asthma.
WHO's program objectives are:
 surveillance to map the magnitude of asthma, analyze its determinants and monitor trends, with
emphasis on poor and disadvantaged populations;
 primary prevention to reduce the level of exposure to common risk factors, particularly tobacco
smoke, frequent lower respiratory infections during childhood, and air pollution (indoor, outdoor,
and occupational exposure); and
 identifying cost-effective interventions, upgrading standards and accessibility of care at different
levels of the health care system.
Chronic obstructive pulmonary disease (COPD)
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Chronic obstructive pulmonary disease (COPD) is a life-threatening lung disease that interferes
with normal breathing – it is more than a “smoker’s cough”.
An estimated 210 million people have COPD worldwide.
More than 3 million people died of COPD in 2005, which is equal to 5% of all deaths globally that
year.
Almost 90% of COPD deaths occur in low- and middle-income countries.
The primary cause of COPD is tobacco smoke (through tobacco use or second-hand smoke).
The disease now affects men and women almost equally, due in part to increased tobacco use
among women in high-income countries.
COPD is not curable, but treatment can slow the progress of the disease.
Total deaths from COPD are projected to increase by more than 30% in the next 10 years without
interventions to cut risks, particularly exposure to tobacco smoke.
Chronic obstructive pulmonary disease (COPD) is a lung ailment that is characterized by a persistent
blockage of airflow from the lungs. It is an under-diagnosed, life-threatening lung disease that interferes
with normal breathing and is not fully reversible. The more familiar terms of chronic bronchitis and
emphysema are no longer used; they are now included within the COPD diagnosis.
Symptoms
The most common symptoms of COPD are breathlessness (or a "need for air"), abnormal sputum (a mix
of saliva and mucus in the airway), and a chronic cough. Daily activities, such as walking up a short flight
of stairs or carrying a suitcase, can become very difficult as the condition gradually worsens.
Diagnosis and treatment
COPD is confirmed by a simple diagnostic test called "spirometry" that measures how much air a person
can inhale and exhale, and how fast air can move into and out of the lungs. Because COPD develops
slowly, it is frequently diagnosed in people aged 40 or older.
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COPD is not curable. Various forms of treatment can help control its symptoms and increase quality of
life for people with the illness. For example, medicines that help dilate major air passages of the lungs can
improve shortness of breath.
Who is at risk?
At one time, COPD was more common in men, but because of increased tobacco use among women in
high-income countries, and the higher risk of exposure to indoor air pollution (such as solid fuel used for
cooking and heating) in low-income countries, the disease now affects men and women almost equally.
Almost 90% of COPD deaths occur in low- and middle-income countries, where effective strategies for
prevention and control are not always implemented or accessible.
Risk factors
COPD is preventable. The primary cause of COPD is tobacco smoke (including second-hand or passive
exposure). Other risk factors include:
 indoor air pollution (such as solid fuel used for cooking and heating);
 outdoor air pollution;
 occupational dusts and chemicals (vapors, irritants, and fumes);
 frequent lower respiratory infections during childhood.
Total deaths from COPD are projected to increase by more than 30% in the next 10 years unless urgent
action is taken to reduce underlying risk factors, especially tobacco use.
WHO response
WHO’s work on COPD is part of the organization's overall efforts to prevent and control chronic
diseases. WHO aims to:
 raise awareness about the global epidemic of chronic diseases;
 create more healthy environments, especially for poor and disadvantaged populations;
 decrease common chronic disease risk factors, such as tobacco use, unhealthy diet and physical
inactivity;
 prevent premature deaths and avoidable disabilities from major chronic diseases.
Diabetes
Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when
the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose
in the blood (hyperglycemia).
Type 1 diabetes (previously known as insulin-dependent or childhood-onset diabetes) is characterized by
a lack of insulin production.
Type 2 diabetes (formerly called non-insulin-dependent or adult-onset diabetes) is caused by the body’s
ineffective use of insulin. It often results from excess body weight and physical inactivity.
Gestational diabetes is hyperglycemia that is first recognized during pregnancy.
Key facts
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More than 220 million people worldwide have diabetes.
In 2005, an estimated 1.1 million people died from diabetes.
Almost 80% of diabetes deaths occur in low- and middle-income countries.
Almost half of diabetes deaths occur in people under the age of 70 years; 55% of diabetes deaths
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are in women.
WHO projects that diabetes deaths will double between 2005 and 2030.
Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco
use can prevent or delay the onset of 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. Hyperglycemia, 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 (previously known as insulin-dependent, juvenile or childhood-onset) is
characterized by deficient insulin production and requires daily administration of insulin.
o 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 (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, and is largely the result of excess body weight and physical inactivity.
o Symptoms may be similar to those of Type 1 diabetes, but are often less marked. As a
result, the disease may be diagnosed several years after onset, once complications have
already arisen.
o Until recently, this type of diabetes was seen only in adults but it is now also occurring in
children.
 Gestational diabetes is hyperglycemia with onset or first recognition during pregnancy.
o 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 glycemia (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 in the feet increases the chance of foot ulcers and
eventual 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. After 15 years of diabetes,
approximately 2% of people become blind, and about 10% develop severe visual impairment.
 Diabetes is among the leading causes of kidney failure. 10-20% of people with diabetes die of
kidney failure.
 Diabetic neuropathy is damage to the nerves as a result of diabetes, and affects up to 50% of
people with diabetes. Although many different problems can occur as a result of diabetic
neuropathy, common symptoms are tingling, pain, numbness, or weakness in the feet and hands.
 The overall risk of dying among people with diabetes is at least double the risk of their peers
without diabetes.
What is the economic impact of diabetes?
Diabetes and its complications have a significant economic impact on individuals, families, health
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systems and countries. For example, WHO estimates that in the period 2006-2015, China will lose
$558 billion in foregone national income due to heart disease, stroke and diabetes alone.
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 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 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.