How do infectious diseases affect diabetes patients?

Panellists Professor Danny Altmann, Dr Susie Dunachie, Bin Zhou and Dr Tony Harries.

The focus for the March Global Health Forum was on infections and diabetes.

Yesterday was World Health Day and the focus this year was on combatting diabetes across the world.

Diabetes is a very important issue because it affects 422 million people worldwide and can lead to a number of long-term complications, including cardiovascular disease, stroke, chronic kidney failure, foot ulcers, and damage to the eyes. Diabetes also weakens the immune system, leading to a greater frequency of infections among patients.

The Institute of Global Health Innovation’s (IGHI) Global Health Forum for March provided an opportunity to review the impact infectious diseases has on diabetes patients from a global context.

The event was chaired by IGHI’s Professor Majid Ezzati and heard from a number of speakers including Professor Danny Altmann, Head of the Human Disease Immunogenetics Group, Professor of Immunology/Deputy Head of Department in the Section of Infectious Diseases and Immunity and Director of Research Strategy within the Department of Medicine at Imperial.

Together with joint head of the Human Disease Immunogentics Group, Dr Rosemary Boyton, their team are working towards putting together a toolbox where you can take an emerging infectious disease and work out exactly how to treat it taking into account co- morbidities including diabetes. 

Listen to Danny’s full presentation below:

Dr Susie Dunachie from the Medawar Institute at Oxford University and Mahidol-Oxford Tropical Medicine Research Unit at Mahidol University in Bangkok then went onto address diabetes as a Melioidosis Risk Factor.  Melioidosis is a neglected tropical infectious disease caused by a gram-negative bacterium, Burkholderia pseudomallei, found in soil and water. It is quite similar to tuberculosis and is of public health importance in endemic areas, particularly in Thailand and northern Australia and exists in acute and chronic forms. 

Her interest in Melioidosis led her to her interest in diabetes.  In Thailand, diabetes is very much increasing - currently quoted at about 8% prevalence and predominantly type 2.

Melioidosis is also on the rise in northern Thailand and is up there with AIDs and HIV as one of the number one killers from infection. A risk factor for the disease is an ageing population along with the rise in diabetes.  

Listen to Susie’s full presentation below:

Dr Tony Harries from the International Union Against TB and Lung Disease went onto discuss diabetes and tuberculosis (TB) in India. 

He informed us that diabetes increases the risk of TB by of a factor of 2 or 3 times compared with people without diabetes.  The current global diabetic pandemic, particularly in Asia, inevitably means we will see more people with diabetic associated TB in the coming years. 

Listen to Tony’s full presentation below:

The final presentation heard from PhD student Bin Zhou from Imperial’s Environment and Global Health Research Group and discussed the where and when of the global epidemic of diabetes’.

Bin presented data collected from a recent study his group have been working on, published in the journal The Lancet, which compares diabetes levels among adult men and women from 1980 to 2014.
From the results, Bin stated that the age standardised global prevalence of diabetes has increased from around 5% in 1980 for both sexes to around 9% in men and 8% in women in 2014.  The prevalence has almost quadrupled globally over the passed 35 years with the main rise being in Asia. 
The study also found that: - Diabetes has increased most dramatically in Pacific island nations and in the Middle East and North Africa region, which now have the highest diabetes levels in the world. In Polynesia and Micronesia, where prevalence is highest, more than one in five adults have diabetes. In Nauru and American Samoa, the number is nearly one in every three men and women. 

- Among high-income countries, the rise in diabetes was relatively small in western Europe, especially among women. Diabetes was lowest in Switzerland, Austria, Denmark, Belgium, and the Netherlands.

- After age-adjustment, 6.6% of men and 4.9% of women in the UK in 2014 had diabetes.  UK men were 169th in the world (out of 200) in terms of diabetes prevalence, and 33rd in Europe (out of 43 nations). In comparison, UK women were 181st in the world, and 29th in Europe.

- In the USA in 2014, 8.2% of men and 6.4% of women had diabetes, making US rank 114th for men and 146th for women in the world. The number of US men with diabetes has increased by more than two thirds since 1980, when the number was 4.7 %. The figure for women in 1980 was 4.3 %.

- One half of the 422 million adults with diabetes in 2014 lived in five countries: China, India, USA, Brazil and Indonesia.

- If current trends continue, over 700 million adults worldwide would be affected with diabetes by 2025.

Read the full results of the study here.

Listen to Bin’s Full presentation below 

The event concluded with a panel discussion which you can listen to below. 

View the photos from the event here.  

Catch up with the Twitter debate with our Storify of the event here.