Diabetes is a serious, potentially debilitating and life-threatening non-contagious disease that can impose a heavy impact on individuals and their families, as well as on healthcare systems and national economies. This is particularly the case in low and middle-income countries, home to almost four in five (79%) of all people currently living with diabetes.

Approximately half of the people estimated to be living with diabetes remain undiagnosed. Left untreated with insulin, Type 1 diabetes is fatal.

When people with Type 2 diabetes go untreated or are not sufficiently supported, they are at risk of serious and life-threatening complications such as heart attack, stroke, kidney failure, blindness and lower-limb amputation. Many will be diagnosed with Type 2 diabetes when they seek medical assistance for another problem, unaware that the problem will have been caused by diabetes. Some will be misdiagnosed. Tragically and avoidably, some will be diagnosed post-mortem.

In many cases, if diabetes is detected early, people affected may well be able to prevent or at least delay any serious problems from arising. More must be done to prevent Type 2 diabetes in people at high risk of developing the condition and greater effort must be made to diagnose all forms of diabetes early and prevent its complications. To address the diabetes pandemic, measures should include access to affordable and uninterrupted care for every person living with diabetes, regardless of where they live or their economic circumstances.

We are living extraordinarily difficult times in which people with diabetes are facing an additional major health threat. Regretfully, we have seen that people living with diabetes can be more susceptible to the worst complications of Covid-19. The evidence suggests fatalities are markedly higher among people with underlying health conditions such as diabetes. This is particularly the case among the elderly when diabetes is not under control. An estimated one in five people over the age of 65 are diabetic.

In the current climate, the global diabetes community needs to come together and raise its voice to make sure diabetes, a leading cause of global disability and mortality, receives the attention required.

The centenary of the development of therapeutic insulin in 1921 by Frederick G. Banting and Charles H. Best is a milestone of considerable significance for many in the global diabetes community and a landmark breakthrough in the history of medicine.

The coming years will present an opportunity to raise awareness of diabetes on an unprecedented level, as a number of key dates related to the discovery of insulin are celebrated. While these historic events have saved and improved the lives of millions living with diabetes, it is important to remind ourselves that insulin still remains beyond the reach of many who need it.

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