Diabetes tends to be one of those metabolic disorders, or diseases, that none of us think too much about until we find out we have it, or are at risk of getting it soon. Afterall, it’s not technically an epidemic the way that an infectious and contagious disease spreads communicably, nor does it spread across the world the way a (e.g. flu) pandemic breaks out. I certainly did not understand the scale and scope of the problem of diabetes until I was prediabetic. But I now tend to think of its spread as at least “socio-economically contagious” because of the way it’s morphed over the last half century from a disease associated with affluence to one that reaches all corners of the world. Experts attribute this to demographic shifts which have resulted in people gaining excess weight, leading sedentary lifestyles and maintaining diets filled with processed foods and sugar.

According to the 2017 estimates of the International Diabetes Federation, 425 million people have diabetes, up to 629 million will have it by 2045, and almost 80% of these diabetics will be in low and middle income countries. And most are type 2: 90% of cases globally (WHO) and 95% of cases in the US (CDC). Altogether this means that some countries and regions—especially China, India, the US and Middle East—have seen their percentages of population with Type 2 increase as much as ten fold in just a couple of decades!

Another alarming element of this growth, as reported on by NBC News and Reuters in November 2018, is that that Type 2 diabetics in developing countries may not receive the insulin they require because of rising demand, cutting off half the 79 million people who are projected to need it by 2030. A 2018 study based on projections by the International Diabetes Federation predicted the worst shortfall for Africa, where insulin is costly because of supply chain dynamics and mark ups—although Novo Nordisk, Sanofi and Eli Lilly (the three largest insulin producers) are trying to make supplies more accessible. While these statistics and risks are overwhelming from a healthcare perspective, what is also dramatic is the relative ineffectiveness of rising public awareness of Type 2. A 2018 Gallup poll, for example, showed that in the US, despite the public’s growing awareness of Type 2 and the efforts of healthcare professionals to help them avoid or reverse it, diagnosis rates have risen in 18 states and declined in none.

Thus, there is a huge gap between individuals’ knowledge of the condition and their response. Sounds like many public interest issues, right? Yet in this case, the public interest boils down to self-interest, so it’s surprising individuals aren’t doing more. On the other hand, in terms of the dietary aspect of Type 2 prevention or reversal, breaking up with sugar is very hard to do. So it’s no wonder that even official multilateral meetings like the one in Singapore 2018 recognize that mass communication of health risks are not sufficient to change habits on a large scale and that a human-to-human approach in encouraging and modeling healthful habits at the community level is necessary. As someone who broke up with sugar, I can see how this would be true—and it’s why Goodbuy Sugar wants to help you.