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Beating Diabetes

Past ISN President Robert C. Atkins reviews the Society�s recent efforts to combat the global diabetes epidemic

( October 27, 2003) – The facts are stark, and they bear repeating: Chronic kidney disease is on the increase,

thanks in large part to the alarming increase in type-2 diabetes cases worldwide. Diabetes currently affects over 177 million people, and is predicted to rise to over 300 million by 2025. At least 50% of people with diabetes will develop microalbuminuria, the earliest sign of diabetic nephropathy. Among these 50%, almost one third will develop more severe kidney disease and reach end-stage renal disease. In fact, diabetes is the single most common cause for end-stage renal disease worldwide .

Diabetic nephropathy adds enormously to national healthcare costs. Both kidney transplants and dialysis treatments have a tremendous impact on health services, social security, and the individual. It is estimated that dialysis costs approximately euro 30,000 per person per year, whereas a kidney transplant will cost approximately euro 13,000 per person the first year, and over euro 5,000 per year thereafter. Much of the burden of treatment is today felt mainly in the developing world, though no single country will be able to afford the cost of chronic kidney disease in another 25 years.

ISN�s response

Our Society has led the way in drawing attention to this frightening global trend. In conjunction with the International Diabetes Federation (IDF), ISN published an informative report in June 2003 entitled Diabetes and Kidney Disease: Time to Act . The report, which included a CD-ROM component, offers an in-depth look at the current diabetes crisis and is part of a coordinated awareness campaign aimed at the general public and healthcare providers.

Topics covered include information on the classification of diabetes and its prevalence around the world, the stages of diabetic nephropathy, guidelines for the screening of diabetic nephropathy, the risk factors of diabetic nephropathy and how these can be managed, and a review of treatment possibilities for end-stage kidney disease.

Sponsored by an educational grant from Roche Diagnostics, the publication is currently available in English and will soon be translated into French and Spanish.

(More information:

Other initiatives

As part of this year�s World Diabetes Day, celebrated annually on November 14, ISN and IDF are collaborating on a number of awareness projects. The centerpiece of the most prominent collaboration,
, is a microalbuminuria screening day in people with type-2 diabetes. DEMAND�s objectives are to measure the prevalence of microalbuminuria in this population and to increase the awareness of both patients and physicians of diabetic kidney disease and cardiovascular risk s . Detecting microalbuminuria allows treatment to be optimized to prevent or slow down the progression towards renal or cardiovascular complications. The project will be carried out in several countries throughout the world and the total expected number of people to be screened is 25,000. The results of the study will be made available at future events and press activities.

ISN was also instrumental in the official designation of 2003 as the Year of the Diabetic Kidney. The Society has organized recent presentations to the World Bank and the WHO on the global problem of diabetic kidney disease. And in February 2004 ISN will host the Bellagio Rockefeller Conference, addressing the problems of chronic kidney failure in the developing world.

Most members would agree, I believe, that these combined efforts clearly demonstrate ISN�s commitment to combating the spread of diabetes-related kidney disease around the world.

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