Why the US and Russia are fighting diabetes differently

Russia’s diabetes strategy combines free appointments, regional programs, and locally produced glucose sensors Many people think that diabetes is something like gout – that it primarily affects people with a poor diet or a sweet tooth. The idea, besides being annoying for doctors and diabetics themselves, is also dangerous. It leads many to believe that only those who eat donuts and drink coffee with lots of sugar are at risk. In reality, diabetes poses a threat to almost everyone in the modern world. According to the World Health Organization, the number of people worldwide with diabetes rose from 200 million to 830 million between 1990 and 2022, and the number of adults diagnosed with diabetes doubled from 7% to 14%. The number of cases is expected to surge further, driven by the realities of modern life. This presents a genuine challenge for public health officials worldwide. Some nations are already managing the crisis more effectively than others. Read more The Cold War’s strangest diplomatic tool is back on the ice Sedentary killer To begin with, it is important to note that there are two types of diabetes. In type 1 diabetes, the immune system mistakenly destroys the insulin-producing cells in the pancreas. The body virtually stops producing insulin, and the person requires daily insulin injections. Type 1 diabetes often develops during childhood or young adulthood, though it can appear at any age. It is not caused by a high-sugar diet or excess weight. In type 2 diabetes, the body typically continues to produce insulin, but the cells respond poorly to it – a condition known as insulin resistance. Over time, the pancreas may become exhausted and produce progressively less insulin. While a poor diet can contribute to the disease, factors like genetics, being overweight, a sedentary lifestyle, and age put one at greater risk, though young or slim individuals increasingly suffer from diabetes as well.

The key difference is that in type 1 diabetes, the body produces virtually no insulin, whereas in type 2, insulin is present but the body fails to utilize it effectively. Type 1 diabetes always requires insulin therapy; type 2 diabetes can sometimes be managed for a long time through diet, physical activity, and oral medication, though some patients eventually require insulin as well. Type 1 diabetes is virtually impossible to prevent. Type 2 is technically preventable, but difficult to avoid, because most people are even unaware of the danger it poses. Furthermore, its development is fueled by modern lifestyles. Mike Lawson injects insulin to control his Type 1 diabetes, Oakland, California, April 16, 2019. © Paul Chinn/The San Francisco Chronicle via Getty Images Such a diagnosis is by no means a death sentence. In reality, having diabetes means a person must regularly monitor their blood sugar levels and make timely adjustments to their diet and medication. Moreover, a person often doesn’t have to totally exclude the consumption of sugar; sometimes, it is even necessary to maintain balance. If acute crises are avoided, the life of a diabetic differs little from that of other people. However, this requires the right infrastructure. Read more This is how we lose control of AI – one successful task at a time The West’s diabetes blind spot Since a lot depends on healthcare institutions, one might expect Western countries to be good at managing diabetes. Unfortunately, that’s not the case. In the US, for example, due to the national healthcare model, insulin rationing is common. CDC studies have shown that approximately 25% of adults with diabetes reported cutting back on insulin use due to its cost. Skipping or reducing insulin doses leaves diabetics vulnerable and increases the risk of hospitalization, a sharp decline in health, and even death. Complaints regarding a shortage of gluc