The International Diabetes Federation (IDF) was founded in 1950 some 70 years ago. Seventy years later, the IDF has more than 250 member associations and 160 countries worldwide. Its mission includes promotion of diabetes care and the prevention of diabetes worldwide. At no time could the activities of the IDF be more important than at the present. It was at the end of 2019 that the clusters of pneumonia of unknown aetiology emerged in Wuhan, China. Soon the causative agent, a corona virus, was isolated and the disease is now known as COVID-19. It was declared by the World Health Organisation (WHO) as an outbreak of public health emergency and international concern in January, and under two months later, it was upgraded to a global pandemic.
By the time of writing, there have been greater than 14,650,000 confirmed cases across the world with greater than 600,000 deaths in more than 200 countries or territories. Given the increasing evidence of people with diabetes are two to threefold more likely to experience major morbidity and mortality as a consequence of this pandemic, there is an urgent need to educate both healthcare professionals and people with diabetes of the risks and to help them avoid this potentially lethal viral infection.
1. What went wrong?
It is easy to look retrospectively and level criticism at many national and global agencies. However, we strongly support the important lead and contributions being made by the WHO and we encourage global unity and determination to secure health for all led by WHO with many other supporting organisations such as IDF.
Again, it is easy to criticise individual countries in their handling of the pandemic such as the failure to recognise its seriousness early on and to delay enforcing “lockdown”, an event that happened in many countries. It is unfortunate that several national leaders have tried to minimise the severity and importance of this pandemic. In contrast, several countries including Norway, Denmark, Finland, Germany, New Zealand, Bangladesh and Taiwan have demonstrated leadership in response to the global pandemic and have effectively minimised the devastating consequences in their respective countries. In contrast to these are other large countries whose leaders failed to follow the scientific advice and in which countries the numbers of cases of COVID-19 continue to increase.
2. COVID-19 and Non-Communicable Diseases (NCD)
Non-communicable diseases are responsible for more than 41 million deaths across the world each year and diabetes is an important member of this group of conditions. There is no doubt that the early identification, prevention and treatment of NCDs have been severely disrupted during the COVID-19 pandemic, according to the WHO and many national surveys. Whereas most of the press coverage of this unfortunate happening has referred to heart disease and cancer, diabetes has once again been neglected. The impact of this neglect is probably largest in middle and low income countries which we urgently need to support.
3. Role of IDF in the pandemic
The IDF has been at the forefront of increasing the importance of the COVID-19 pandemic to people with diabetes. It has dedicated a special section of its website (www.idf.org) to help education of both people with diabetes and healthcare professionals in the importance of diabetes control, maintaining exercise where possible and eating a healthy diet during this pandemic. It has also emphasised what care those with diabetes should take including regular wearing of masks in public places, regular washing of hands and avoiding any large gatherings. Webinars are also available including one by the President (AJMB) on living with diabetes during the pandemic. IDF has also worked with friends in other organisations including the Global Coalition for Circulatory Health, the Non-Communicable Diseases Association and others in providing educational materials and webinars. IDF has also worked with other organisations including Life For A Child (LFAC) to ensure an adequate supply of drugs and insulin globally during the pandemic.
The recent issue of DRCP entitled,”COVID-19 and Diabetes: IDF Perspectives” is a further effort to bring scientific facts of the risks, clinical management, prevention and policy development for COVID-19 in people with diabetes. It comprises a large number of individual peer-reviewed articles from across the world including topics such as risk factors for mortality amongst COVID-19 patients, how people with diabetes have dealt with the various complications of diabetes during the pandemic and how sustainable diabetes care can be provided during the pandemic. We were also delighted to include a number of reports from our seven regions of the IDF across the world.
4. Conclusions
Sadly, the end of this pandemic is still not in sight. Further challenges lie ahead including the development of skilled manpower, necessary policies and willingness to address the global pandemic for the sake of humanity rather than individual political goals. We have outlined the many challenges that diabetes services are presented with including the lack of regular medical appointments for those with diabetes and reduced hospital attendance with diabetes emergency because of understandable fear that many people have, knowing that hospitals are likely to include many inpatients with COVID-19 infections. However, these changes also prevent many opportunities for the development of diabetes care including the increased use and indeed widespread use of “telemedicine” with maybe telephone conversations or video consultations. We trust that the readers enjoyed the supplement but more important found it useful for the development of diabetes care and the reduction of morbidity and mortality for our people with diabetes across the globe.