I received a message today on my FB diabetes page from a 23 years old T1 Diabetic young man in a desperate situation; asking me what he can do to control his blood sugar. Well a little deeper; he is diabetic since he was 13 years old, he is half educated, working in a hard job that requires both manual work and standing up for 10 hrs a day, he is using mix insulin (30 - 70) and there is no way that he can control his BS with it as we all know, he can't go low carb because it is very expensive diet as he said and as he described "bread is main part of my meals not because I love it but because it is the cheapest".
He is a poor guy; he has no medical insurance; in his country - insurance for very rich people only!!! And moreover he started to have complications as he already gets the burning and pinning sensation started in his feet to the limit that stopped him from going to work!! Even the option of starting MDI (fast acting and basal) he said he can't do it because of lack of money.
My heart goes out for him , really, this poor young man does not talk about an insulin pump or CGM as many diabetics in other countries get it for free by insurance and take it for granted , he is just talking about his deep sad desire to control his numbers, he cannot think of the privilege of buying Xylitol, Erithritol, swerve or whatever similar; because it is not there in his country and if it is there he cannot afford their high prices - Almond flour for him is a dream because it will get half his salary to buy 1 kg of almond only.
This guy, indeed, is not one guy, there are millions of diabetics just like him or even worse - I met some of them that can't even get the mixtard insulin.
Let me Just try to open your eyes little more on what is going on in the world of diabetes with two examples that I will put between your hands to reveal our out of horizon's reality.
First example is Africa excluding Arab countries: Where the adults' population is 425.5 million - there is 22 million diagnosed diabetics between the age of 20 to 79 years old, this means that the ratio between diabetics and non-diabetics is 1 to 20; while the percentage of non diagnosed diabetics is 62% i.e 13.4 million, and the annual death toll was estimated to be around 481000 in 2014, in which 75% of them under the age of 60!! And the spending on Diabetes treatment in this part of the world is 4.5 billion Dollars a year.
The second example is North America and Caribbean: Where the adults' population is 339.2 million - there is 39 million diabetics between the age of 20 to 79 years old, this means that the ratio between diabetics and non-diabetics is 1 to 9 while the percentage of non diagnosed diabetics is 27% i.e. 10.5 million and the annual death toll was estimated to be around 297000 in 2014, in which 41% of them under the age of 60!! And the spending on Diabetes treatment in this part of the world is 310 billion Dollars a year.
If we run a little comparison here; we will simply notice the following:
- Annual spending on Diabetes treatment in NA and Caribbean is 70 fold higher than Africa.
- Diagnosed Diabetics in NA is almost double the number in Africa but even though no. of annual death is less in NA than in Africa.
- The percentage of undiagnosed diabetics in Africa is more than double than it is in NA.
- The percentage of death below 60 years old in Africa is almost double the same percentage in NA.
So even though the number of diagnosed diabetics (dd) in NA is double the number of dd in Africa but annual death from Diabetes in NA is much less because of the huge spending in Diabetes treatment in NA (70 fold). And of course if you dig little bit deeper you will definitely find out that the complications are much higher in percentage and severity in Africa than it is in NA.
Now the main question that pops up in mind when I read that guy message was: what are the moral obligations we, as diabetics, have towards poor diabetics anywhere in the world, either in Africa, Asia, Middle East, south America or wherever.
And more seriously; what do the big pharma doing (and I mean serious doing) for those so poor diabetics that cannot even buy the right insulin or even any insulin? What I can do for such guy who sends me this message today that made me feel so sad for him and all others that are in his situations and they are tens of millions indeed?
Just for knowledge; a drug like Avandia sold almost 3 billion dollars in 2006 - Yes one drug (that almost stopped in Europe later on because of causing heart problems) sells in only one year around three billion dollars, a number that; if spent in Africa to take care of those poor diabetics maybe it would had been saved tens of thousands of lives.
I am not even talking about statin, insulin, Sulfonylureas, wheat industry, corn flakes, etc… Which are all industries that make billions of dollars of profit out of those poor diabetics who die out of lack of medical care and right food.
We live in a sad reality indeed….
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