Diabetes mellitus, a chronic metabolic disorder characterised by elevated blood glucose levels, has become a burgeoning public health challenge. With its surging prevalence in the region, patients suffering from the disease in Latin America have tripled in the last three decades. The Pan-American Health Organisation (“PAHO”) estimates that 62 million people in the region suffer from diabetes and, at least, 40% of them are unaware of their condition. If the current trend is not curbed, it is expected that 109 million people in Latin America will suffer from the disease by 2040.
The epidemiological panorama paints a grim picture, unveiling an escalating diabetes epidemic that exacerbates the challenges faced by already overwhelmed healthcare systems. A confluence of intricate factors, such as urbanisation, sedentary lifestyles, and an ageing population, fuels the escalating rates of diabetes in the region.
The ramifications of diabetes extend beyond health-related implications, permeating the socio-economic fabric of Latin American societies. The economic burden of diabetes resonates through increased healthcare costs, diminished productivity, and the erosion of quality of life. As vulnerable communities confront inadequate access to healthcare services and limited resources, the burden of managing diabetes becomes even more burdensome.
An executive of the Mexican Social Security Institute (“IMSS”) explained, “Diabetes is a serious public health challenge across Latin America. A lack of early-stage symptoms, irregular health assessments, and the high cost of treatment related to its chronic nature make it a very difficult disease to manage. Worryingly, overall risk factors are increasing and so is the rate of incidence.”
“Diabetes is a serious public health challenge across Latin America …overall risk factors are increasing and so is the rate of incidence.”
An executive of the IMSS, Mexico
With 50% of adults in the region being overweight or obese, genetic, socioeconomic and environmental predisposition are increasing the risk factors of the population developing type 2 diabetes which is associated to high levels of sugar consumption. A study by the World Health Organisation (“WHO”) revealed that the region consumes 99.4 grammes of sugar daily, twice as much as the 49.4 grammes recommended by the WHO.
In Mexico, where more than 30% of the adult population is overweight, the Congress passed a law in 2019 which required warning labels on the front food packages that contain excess sugar calories. Despite the 140,000 annual deaths from diabetes-related complications, major food and beverage companies continue to appeal against the law which is pending a final ruling from the Supreme Court. Uruguay and Peru have implemented similar regulatory frameworks.
In contrast to the food industry, pharma companies are cooperating with local administrations as local governments in Latin America are promoting the use of insulin made by local companies to combat the disease. Their cheaper prices are easier to assume by public systems, most of which cover diabetes treatments through generics, while big pharma focus on pricing strategy and educational therapeutic measures that reduce the risk of pre-diabetes in the region, estimated to be three times the size of current patients.
A public health practitioner in Colombia was not convinced that increasing access to insulin was a viable long-term solution, “Generic insulin can help to reduce the cost of insulin, but it remains expensive for individuals and over the long term it is still highly costly for the public health system. The most serious problem with insulin is that it does not change people’s behaviour, it is seen as a safeguard that allows patients to maintain an unhealthy lifestyle.”
“The most serious problem with insulin is that it does not change people’s behaviour, it is seen as a safeguard that allows patients to maintain an unhealthy lifestyle.”
A public health practitioner, Colombia
Confronting this escalating challenge necessitates a holistic and multi-pronged approach encompassing all major stakeholders. The government must play a central role according to a public health official in Colombia, “Governments need to introduce policies that promote healthier lifestyles, that tax the consumption of excess sugars in drinks or foods, that promote strategies aimed at limiting the consumption of these foods or drinks, especially in children, that create healthy food environments, that protect and raise consumer awareness of the ingredients and additives that they consume in their food, especially ultra-processed foods.”
Similar work is already ongoing in Chile and Argentina, “Chile has also implemented policies aimed mainly at combating some risk factors such as poor diet through restrictions on the advertising of unhealthy foods, as well as banning the sale of junk food in schools and implementing nutrition labelling. Importantly, Chile and Argentina have monitoring systems in place to identify and obtain data on the main risk factors affecting the health of the population. This makes it possible to know how the population is doing in terms of access, care, prevention and attention.”
Introducing effective policy and regulation as well as greater levels of education at an early stage could slow and even reverse the prevalence of diabetes in Latin America but action must be taken now, otherwise the implications will be costly.