Professor Nam Cho has over 30 years experience researching diabetes, most recently in his position as President of the International Diabetes Federation. In an interview with Morressier he explains what is causing the spike in diabetes cases and why something needs to change to avoid a disaster of epic proportions.
Morressier: Why did you become interested in diabetes research?
Nam Cho: I decided to focus my work on diabetes as it plays a significant role in many diseases – if you remove diabetes from a cancer sufferer, you significantly reduce the number of cancer deaths. The same applies to cardiovascular disease or end stage renal disease and so on. Diabetes is the disease that begins all other diseases in human nature these days.
Morressier: What are some exciting developments in the treatment and management of diabetes that have been shared at IDF conferences?
Cho: Modern technology and how it can play a role in diabetes management is really exciting. IT and AI is increasingly being mixed into management and care these days, that’s what we saw at the 2017 congress. For example, IDF is about to launch a digital service for retinal screening to check for diabetic retinopathy. This way, even people living remotely or in low income countries can check the condition of their eyes without needing to go to a doctor. All they need to do is take a picture of the eye, shoot it into the cloud, and a doctor examines and gets the results in about one minute. This type of technology benefits the patient directly and is a great development.
Morressier: What are the most effective ways of combating the increase of diabetes globally?
Cho: The most effective way is through intervention. It’s too late for prevention. We already have 440 million people diagnosed with diabetes, along with over 400 million people in a pre-diabetes stage. In the last two years there were 34 million people diagnosed with a pre-diabetes condition. So, the most effective way to stop the epidemic is to become actively involved in intervention in this high-risk population. Ensuring they change their diet, exercise, and habits as well as prescribing low-dose medicines early on to prevent diabetes from developing are all essential.
Morressier: What role do you see the government playing in this? Should ‘sugar taxes’ be introduced?
Cho: I disagree with the idea of a sugar tax. If the money is spent on initiatives to prevent diabetes, then I agree with it. But honestly, how much of this money do you really think will be used to benefit taxpayers?
Rather than taxing the issue, I would change peoples’ habits and increase the education and awareness of the disease. In May the IDF will participate in the World Health Assembly in Geneva. Two major topics are junk food and serving size for children. This problem is getting even worse with everyone using a smartphone as it means they don’t even leave the house anymore, they just order junk food. On top of that, children have adapted to eating enormous servings of food. We have to campaign not only to stop eating junk food, but to reduce the serving size so food will not be wasted and children do not overeat.
Morressier: What are the main initiatives the IDF has planned for 2018?
Cho: We are focusing on education and have created a website on diabetes. Any patient can log in free of charge and learn more about how to manage their diabetes. Primary care doctors and specialists can also use it to get information on the most up-to-date treatments.
Another area we are focusing on is the humanitarian effort. We’ve built clinics to look after regional diabetes sufferers. So, for example, people can come to a clinic, take a picture of their eye, see the status of their eye condition, and it only costs a dollar. This clinic will also serve as a disaster headquarters and respond to disasters by sending supplies and critical medicines, such as insulin, to people who are affected.
Morressier: Do you believe the incidence of diabetes globally will continue to rise in the next decades?
Cho: Absolutely. To give you just one statistic, two years ago we reported one out of seven pregnant women are affected by diabetes. Two years later, in 2017, one out of six women globally are affected. In the last two years, ten million people were newly diagnosed. 80% of them were people aged 65 and older, a statistic that will only get worse as our population ages. Also, the obesity epidemic and access to junk food means children are developing diabetes at younger ages. As more people over 65, more women, and more children all develop diabetes, plus we have far more people diagnosed with pre-diabetes, it is becoming a huge problem around the world. Unless we do something soon, we will face a disaster of biblical proportions in the near future.
Professor Cho is the President of the International Diabetes Federation for 2018-19. He graduated from the University of Pittsburgh with a clinical epidemiology degree in 1989 and was a medical faculty member at Northwestern University Medical School in Chicago until he was recruited by the Korean government’s “Korean national brain pool recruitment project” in 1994. He has published over 200 peer reviewed papers on type 1 diabetes, type 2 diabetes, and gestational diabetes.
Image credit: Brooke Lark