Written by Professor Andrew Boulton, President of the International Diabetes Federation
The global prevalence of diabetes continues to grow, with recent estimates from the International Diabetes Federation (IDF) showing that one-in-11 (463 million) adults are living with the condition. As this figure is expected to rise to 578 million over the next decade, it is crucial there are enough nurses and allied health professionals to support people living with diabetes.
The World Health Organisation (WHO) reports a global shortfall of 5.9 million nurses – potentially leaving millions of people lacking the care they need. Without swift action, people living with diabetes, or at high risk of developing the condition, will be more vulnerable to the life-changing complications associated with the condition, such as heart attack, stroke, loss of vision, kidney disease and lower-limb amputation. As part of World Diabetes Day, which took place on November 14th, and to mark the WHO Year of the Nurse and the midwife, IDF has urged governments and healthcare organisations to invest not only in the recruitment of more nurses, but also in their training, so nurses can provide the best possible support to people living with diabetes.
The role of the nurse in diabetes care
Nurses are at the heart of worldwide healthcare and vital in supporting people living with diabetes and other chronic conditions. The role of the nurse is vital to helping people with diabetes face the challenges associated with life-long care. A survey we conducted recently found that four-in-five nurses (82%) believe that governments are not doing enough to provide professional training in diabetes care. One of these nurses is Judith Mendez RN BSN from Belize, who lives with diabetes and runs the Corozal Branch of the Belize Diabetes Association. Judith believes nurses provide a safe haven for people living with the condition and support them in managing it. However, with Belize having the highest prevalence of diabetes in North America and the Caribbean and governments investing very little in the training of nurses, she is adamant that the system is nearly at breaking point – a view mirrored by many nurses across the globe and a situation made much worse by COVID-19.
IDF estimates that half (232 million) of adults currently living with diabetes remain undiagnosed. The majority have type 2 diabetes, which is preventable in many cases. Nurses play an important role in identifying the signs and symptoms to inform prompt diagnosis and provide important dietary and lifestyle advice to tackle the risk factors. This can help to prevent or delay the onset of type 2 diabetes in people at risk.
Weathering the perfect storm
2020 has been a unique but hazardous year, with the spread of COVID-19 impacting healthcare systems and societies across the globe. This has become a serious problem for people living with diabetes, as they are more susceptible to the severe effects of the virus. Studies have shown that, in some countries, up to half of people diagnosed with COVID-19 diagnoses have had diabetes. The ongoing pandemic has put pressure on crucial healthcare services that support people with chronic conditions. Diabetes is no exception, especially with the prevalence of diabetes continuing to rise and putting more strain on resources. In 2019, diabetes was responsible for at least $760 billion in health expenditure – 10% of the global total spent on healthcare.
COVID-19 has brought much anxiety and uncertainty. Many people living with diabetes feel overly cautious and reluctant to leave their homes for treatment, or they no longer have access to their regular care because services have been scaled back.
Moreover, many people with diabetes, especially the elderly, have been shielding at home, unable even to go out to do their own shopping or exercise outdoors, which has had a huge psychological impact. Diabetes nurses in many countries have been visiting these people at home. This has been important, not only to help people achieve good control of their blood sugar levels but also to provide support and advice where needed. In many countries where diabetes care is more advanced, nurses play a major role in helping people with type 1 diabetes adapt to new technologies, including insulin infusion pumps and glucose monitoring devices. Nurses have been at the forefront of the development of telemedicine for people with diabetes.
Events since the outbreak of COVID-19 nearly a year ago have stretched healthcare resources already struggling to cope with the growing numbers living with diabetes. To tackle this, more nurses and other allied healthcare professionals need to be given more opportunities to improve their understanding of diabetes.
A new generation of diabetes educators
Education is the cornerstone of healthcare, with new treatments and services developing all the time to help medical professionals look after their communities. Three-quarters (76%) of the nurses we spoke to told us there were local and global challenges in the recruitment and training of nurses to support people with diabetes. IDF is an advocate for the promotion of diabetes education and best practice and is playing its part in helping nurses and other health professionals further their professional development.
As part of this year’s World Diabetes Day campaign, nurses and healthcare professionals have been able to freely access the IDF School of Diabetes course on the role of the diabetes educator. The course is certified by the European Accreditation Council for Continuing Medical Education. Upon completion, learners earn one EACCME credit and receive a course certificate.
It is our hope that this type of initiative, along with a collective resolve to invest further in diabetes care and the training of nurses, will help tackle the global impact of diabetes.
The time has come for urgent action
It is critical for national governments and healthcare systems to recognise the growing global impact of diabetes. With numbers continuing to rise, and more than three-quarters of people with diabetes living in low and middle-income countries, this picture can only improve through significant investment in treatment, care and professional training.
COVID-19 has made people living with diabetes more vulnerable and put stress on already overwhelmed healthcare systems across many countries. Action is needed to overcome these challenges and nurses are vital role to the response.
It is imperative that the next steps in the global fight against diabetes deliver real change. Only then will people with diabetes be able to live with their condition with the confidence they will always receive the best possible support.
