1. In The name of God Mohammad Afkhami-Ardekani MD Professor of Internal Medicine

2. The Clock is ticking for the world’s leaders
4.6 million deaths due to
diabetes in 2011!
Anually 1 million amputations due to diabetes
One person is dying from diabetes every seven seconds!
IDF 2011 Fact Sheet

3. Diabetes Prevalence was underestimated…
Date
Slide no 3
Diabetes Prevalence was underestimated…
The number of people with diabetes in 2020 has reached a staggering 366 million
IDF Fact Sheet updated in EASD 2011

4. Diabetes epidemic: 54% increase in diabetes from 2010 to 2030
Europe
North America % %
76.7
112.8
47%
58.7
101.0
72%
94% % %
Middle East and North Africa
Western Pacific
Southeast Asia
Africa
SLIDE IS ANIMATED
Speaker Notes:
Number of people with diabetes projected to rise from 285 million in 2000 to million in 2030
Global epidemic driven by an increase in cases of type 2 diabetes, which accounts for 90-95% of cases
Additional notes: IDF diabetes projections include data for type 1 and type 2 diabetes combined
Reference: ADA Diabetes Care; 27 (Suppl. 1): S5-S10
South and Central America
World 2010 = 285 million
2030 = 439 million
Increase 54%
Adapted from IDF Diabetes Atlas 4th ed., 2009 4

5. Diabetes (today – tomorrow) Rapid growth in diabetes prevalence
Novo Nordisk A/S
20 April 2019
Date
Slide no 5
Slide no 5
Diabetes (today – tomorrow) Rapid growth in diabetes prevalence
284.6 million
438.4 million
54% increase in
20 years
2010
2030

6. Estimated Number of People with Diabetes in 2000 and 2030 (and % change)
+176%
+26%
-13%
Wild, S et al.: Global prevalence of diabetes: Estimates for 2000 and projections for 2030 Diabetes Care In press

7. Estimated Number of People with Diabetes in 2000 and 2030 (and % change)
+247%
+308%
+189%
Wild, S et al.: Global prevalence of diabetes: Estimates for 2000 and projections for 2030 Diabetes Care 2004 In press

8. Estimated Number of People with Diabetes in 2000 and 2030
+212%
+242%
+75%
Wild, S et al.: Global prevalence of diabetes: Estimates for 2000
and projections for 2030 Diabetes Care 2004 In press

9. Epidemiological transition” in newly industrialised nations
Aging population
Unhealthy lifestyle choices
Urbanisation
Dietary changes
Reduced physical activity
Speaker Notes:
Global healthcare and hygiene advancements, coupled with a number of social and cultural factors have contributed to the rise in non-communicable diseases such as T2DM. This “epidemiological transition” is currently occurring in many low- and middle-income nations.
Adapted from IDF Diabetes Atlas 4th ed., 2009
Cockram CS HKMJ; 6 (1): 43-52
Mohan et al Indian J Med Res; 125: 9

10. Prevalence of Diabetes and its risk factors in Iran
Methods:
Conducted in 2007
5,287 Iranian citizens included
Sample size aged 15–64 years
Results:
Diabetes %
Hypertension %
Obesity %
Central obesity %
Female
Male
Esteghamati A, et al. Third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) in Iran: methods and results on prevalence of diabetes, hypertension, obesity, central obesity, and dyslipidemia. BMC Public Health May 29;9:167

12. International Diabetes Federation. Diabetes Atlas, 2006
Poor glucose control is associated with increased risk of complications
Stroke
Retinopathy and blindness
Heart disease
Kidney disease
Neuropathy
Diabetic foot disease
Peripheral vascular disease
Erectile dysfunction
Speaker notes:
Diabetes-related healthcare complications are considerable, regardless of whether patients have type 1 or type 2 diabetes. According to the International Diabetes Federation, diabetes is a leading cause of premature mortality and morbidity throughout the world, and it is one of the major causes of blindness, kidney failure and lower limb amputation. Estimates suggest cardiovascular disease accounts for approximately 50% of deaths in people with diabetes (International Diabetes Federation, 2006).
These problems are caused by persistently elevated blood glucose, even in the absence of overt clinical symptoms. Elevated blood glucose is toxic and, together with elevated blood pressure, abnormal lipid levels and blood vessel abnormalities, it causes tissue damage to the kidneys, eyes, peripheral nerves and vascular system.
References: International Diabetes Federation. Diabetes Atlas, Third Edition. International Diabetes Federation, Belgium, 2006:111–2.
International Diabetes Federation. Diabetes Atlas, 2006 12

13. Novo Nordisk A/S 13
20 April 2019
Slide no 13
20/04/2019
1% drop in HbA1C
Correlation between a 1% HbA1C decrease and reduced risk of complications (T2DM)
43%
37%
19%
16%
14%
12%
Stroke
Myocardial infarction
Heart failure
Sustained hyperglycemia can cause serious long-term complications. Hyperglycemia damages the large and small blood vessels; cardiovascular disease is the number one cause of death in patients with diabetes. Damage to small blood vessels can lead to blindness, kidney failure, and nerve damage.
Improving blood sugar levels can help reduce the risk of complications.
Landmark diabetes studies (DCCT, UKPDS) have shown that tight glycemic control significantly reduces the risk of complications.
Every 1% A1C drop can reduce long-term diabetes complications
Cataract extraction
Microvascular disease
Lower extremity amputation or fatal peripheral vascular disease
Cardiovascular complications
UKPDS-Stratton IM et al. BMJ 2000;321:

14. Diabetes-related complication prevalence : IRAN A1chieve14
Diabetes-related complication prevalence : IRAN A1chieve
Complications
Global n=65513
Iran n=919
Cardiovascular (%)
27.2
27.7
Neuropathy (%)
38.4
57.7
Renal (%)
27.9
Eye (%)
26.3
38.0
Foot ulcer (%)
5.4
7.9
A patient can have multiple complications 14

16. Tتrrrtt Comparative prevalence
The comparative prevalence has been calculated by assuming that every country and region has the same age profile (the age profile of the world population has been used). This removes the differences of age between countries and regions, and makes this figure ideal for making comparisons. The comparative prevalence should not be used for assessing the proportion of people within a country or region who have diabetes.