Global Diabetes Epidemic
According to Kasia Lipska’s editorial in The New York Times entitled “The global diabetes epidemic,” type II diabetes is no longer a ‘first world’ problem but rather is penetrating the developing world as well. When Lipska went to India to work at a clinic as a medical researcher studying stroke, she was shocked to find that the majority of the health issues that presented themselves at the clinic were related to diabetes, not tuberculosis or dengue fever (illnesses traditionally associated with the developing world). From her own personal experiences and the ethical obligation she felt to improve the conditions she saw, Lipska’s essay attempts to galvanize the reader to take action.
It should be noted that Lipska also uses logos or logical evidence in her work. “Diabetes has become a full-blown epidemic in India, China, and throughout many emerging economies,” she notes. While in the United States there are 24.4 million cases of diabetes, in India there are 65.1 cases; in China 98.4 million. And these numbers are projected to increase, not decrease by 2035. Moreover, Lipska argues that diabetes in developing world nations is even more serious than in the U.S., because of a variety of systemic factors that makes it more difficult for patients to manage their illness.
Thanks to modern medicine, education, and technological innovations, the plight for American diabetics has grown brighter, notes Lipska, citing that “federal researchers reported that health risks for the approximately 25 million Americans with diabetes had fallen sharply over the last two decades” but “elsewhere on the globe, however, diabetes plays out in a dramatically different fashion” (Lipska 2014). In the developing world, effective treatments are luxuries of the very few. Patients lack access to the drugs and treatments needed to contain diabetes, which is a chronic condition that requires constant monitoring. Also, the stressful lives of the poor can make such activities as monitoring their glucose challenging, much less eating the healthy diet necessary to mitigate the complications of diabetes. These complications can include coma, loss of limbs, blindness, and death. On a very basic level, the poor cannot afford to be sick, and Lipska ‘does the math’ to show the sobering costs of the epidemic: “In India, only 10% of people have medical insurance, and patients cover most expenses out of pocket. In some low- and middle-income countries, diabetes patients living on $1 or $2 per day would need to spend as much as 50% of their monthly income to buy just one vial of insulin. Additional materials such as syringes, needles and glucose monitoring tests push costs even higher” (Lipska 2014). However, healthier foods, as in the U.S. are now more expensive in India (as well as less palatable and attractive) than unhealthy, high-sugar food which can trigger the manifestation of the illness.
The reason for this epidemic is similar to that of the U.S.: people are moving less and consuming more calories. In India, the shift has been particularly dramatic, as a population which was primarily used to laboring with its hands is boasting a rising middle class where desk jobs are the norm and where sugary, high-calorie food is in great abundance. Additionally, there appears to be a genetic predisposition to develop diabetes amongst many Indians, combined with a higher incidence of malnutrition in childhood, which also triggers a greater risk. Citing these facts, Lipska suggests that a ‘perfect storm’ supporting a diabetes outbreak is brewing in the region.
As well as taking a toll on the individual, Lipska notes the ethical implications of unchecked diabetes: it is a chronic condition which must be managed for the duration of the sufferer’s life with no cure. It also causes lost productivity in terms of the work that a chronically ill person can no longer offer to the workforce. Prevention is key because India cannot support a population of diabetes of the likely size that it will attain if the epidemic goes unchecked. Yet in a poor country where traditionally food was scarce, a campaign against cheap food can be a hard sell. “In India, it will require better policies that favor fruits and vegetables over refined-food products” but the siren song of McDonald’s is just as potent abroad as it is in the U.S. (Lipska 2014). The Indian government is trying to provide healthy meals to children, to combat the negative effective of malnutrition, which can include diabetes.
A final problem is ignorance: although people are more aware of the consequences of diabetes in the U.S., this is not always the case in the developing world. Lipska ends her essay with a call for action. “Most of us in the West assume we know what the risks and burdens of diabetes are. And if we’re talking about a patient in Kansas City or Tokyo, we’re probably right. But when it comes to diabetes, location is everything, and much of the world is now vulnerable to the most devastating consequences of this disease” (Lipska 2014). Lipska makes clear that although she invokes pathos at times in describing the plight of individual Indians, ultimately her greater concern is the world at large and the impact of diabetes upon the health of the planet, not simply on a personal level.
Reference
Lipska, K. (2014). The global diabetes epidemic. The New York Times. Retrieved from:
http://www.nytimes.com/2014/04/26/opinion/sunday/the-global-diabetes-epidemic.html?hp&rref=opinion&_r=0
