Ethan Arpi

Diabetes and Development

Morbidly obese boys and girls who slurp down 20oz sodas afterObesity consuming their prepackaged, plastized lunches are the poster children, so to speak, of the diabetes epidemic that is ravaging the United States. But other countries, especially those in the developing world, are no longer immune to the disease that once afflicted only citizens of affluent nations. According to the International Diabetes Federation, the number of diabetics has skyrocketed during the last two decades from 30 million to 230 million. Of the ten countries with the highest number of diabetics, seven are now in the developing world.

Most experts agree that rapid industrialization provides the best explanation for the spike in the number of diabetes cases. In these transitioning countries, labor has become less physically strenuous while cheap, processed foods have become dietary staples. This lethal combination of sloth and carbs has set off what Dr. Martin Silink, the president-elect of the International Diabetes Federation, has called ?one of the biggest health catastrophes the world has ever seen.?

One reason why diabetes has become so much more deadly in the developing world than anywhere else is that the disease requires such intensive treatment. As the New York Times reports, ?While Americans can live for many years with the disease, a person in Mozambique who requires injections of insulin can expect to live just a year; in Mali, such people survive about 30 months.?

So what can be done? Looking at how the United States has tried and failed to fight this chronic disease is a good starting point for tackling diabetes. First, and most importantly, preventative medicine works. That is, the best way to fight diabetes is to prevent it from happening in the first place. Unfortunately, the United States has all but turned its back on preventative medicine. As the Princeton economist Paul Krugman notes, ?Insurance companies are generally unwilling to pay for care that might head off the disease, even though they are willing to pay for the extreme measures, like amputations, that become necessary when prevention fails.?

But for developing nations without our labyrinthine health care system, this is not a problem. By simply following the basics of preventative medicine?a healthy dose of exercise and a diet rich in fresh fruits and vegetables?anyone can significantly reduce the chance of contracting diabetes. Although the BOP in developing countries can?t be expected to purchase their produce from Wholefoods or raise their heartbeats on the elliptical, they can still improve their health through communal activities like urban agriculture and pickup soccer.

The pharmaceutical industry also needs to smarten up and get real about providing medicines at lower prices. Because the potential market is so large, the pharmaceutical industry can still afford to charge less for insulin without substantially diminishing its returns. Other ways corporations can help fight diabetes is through creative business practices. At the beginning of this year a new inhalable form of insulin was approved by the FDA. Such innovative medicines may prove most effective in fighting diabetes in areas where contaminated syringes have a high risk of spreading infectious diseases.

Ultimately, diabetes, unlike many illnesses, is a disease that is completely within our control. Through education campaigns that emphasize the importance of healthy eating and living, we can significantly diminish the onset of the disease. Alice Waters, the culinary mastermind and founder of Chez Panisse in Berkeley, California has created one such program, Edible Schoolyard, in which schools set aside plots of land for students to cultivate their own gardens and incorporate the foods they grow into their meals.

As she explains in Eating for Credit, ?When a healthy lunch is a part of a class that all children have to take, for credit–and when they can follow food from the garden to the kitchen to the table, doing much of the work themselves–something amazing happens. The students want to taste everything. They get lured in by foods that are beautiful, that taste and smell good, that appeal to their senses. When children grow and prepare good, healthy food themselves, they want to eat it, and, what’s more, they like this way of learning.? By following her lead, we might just be able to get boys and girls off the couch and away from those 20oz bottles of soda.