Akram Ashyani, Ph. D.（Life Science Platform）
Diabetes–the pandemic of the future
Akram Ashyani, Ph. D.（Life science Platform）
Statistic on diabetes is discussed and information of two open calls for research proposals is provided at the end.
President of the International Diabetes Federation, Professor Andrew Boulton, believes that the time has come to address the diabetes epidemic. Diabetes is on the rise at a shocking rate. It currently affects 537 million persons globally, a 74 million (16 percent) rise in the previous two years. Furthermore, number of adults in a country with diabetes increased to one-fifth or more of all adult people. 
The 10th edition of the IDF Diabetes Atlas shows a steady growth in diabetes prevalence worldwide, reinforcing diabetes as a significant global hazard to individual, family, and societal health. As shown in Fig. 1 it estimates that 643 million people will develop diabetes by 2030 if no effort is taken to solve the problem (11.3 percent of the population). If current trends continue, by 2045 it will rise to 783 million which is 12.2 percent (, p. 7). This represents a 46 percent rise during the same period, compared to a 20 percent increase in population. Obviously this increase in the number of diabetic people cannot be neglected.
Figure 1 Columns shows the age group and number of people with diabetes in adults from 20 to 79 years old in 2021 and black line is the estimated number in 2045 ( p. 35, Figure 3.1 used with the permission of the IDF).
Almost one-half of all persons with diabetes are unaware that they have the disease (, p. 40). Diabetes has resulted in a significant rise in global health spending, Fig. 2 illustrates that from 2007 to 2021 it rises between 232 and 966 billion dollars for persons aged 20 to 79 ( p. 57). Diabetes is now one of the top ten causes of death worldwide, with an anticipated 6.7 million fatalities in 2021 which means every five seconds, one death happened because of diabetes .
Figure 2 Total health expenditure related to diabetes for persons aged from 20 to 79 between 2006 and 2045 ( p. 58, Figure 3.14 used with the permission of the IDF).
Taiwan and diabetes
Diabetes affects one in every eight adults (206 million) in the Western Pacific region, which includes Taiwan (see Fig. 3). It is estimated that diabetes will affect 238 million individuals by 2030 and 260 million by 2045. More than half of diabetic adults are undiagnosed. In 2021 diabetes was the reason of 2.3 million fatalities and it costs USD 241 billion. 
The number of Taiwanese adults from 20 to 79 years old with diabetes is 2,457,200 and number of undiagnosed diabetes cases is estimated at1,115,500, which is approximately half of the diagnosed ones. This is a considerable threat to the Taiwanese health (see Fig. 4).
Figure 3 Diabetes age-adjusted comparative prevalence (percentage) in 2021 of the IDF Western Pacific Region (  p. 98, Map 5.7 used with the permission of the IDF)
Figure 4 Summary of diabetes data in Taiwan ( p. 126, Table used with the permission of the IDF).
The effect of COVID-19 in the people with diabetes
COVID-19 put an extra strain on diabetics, rendering them more vulnerable to the worst effects. The impact of having lockdown, wearing shield, and inducing the risk of COVID induced diabetes on public health is about to be demonstrated. There is widespread fear that the epidemic will lead to an increase the incidence of diabetes and its consequences in the future. 
People with diabetes are especially concerned about the COVID-19 pandemic because they are more prone to the virus’s devastating consequences. Diabetes patients, especially those with poor controlled blood glucose levels, are sensitive than healthy people to COVID-19’s severe side effects. If a diabetic encounter and infectious disease, treatment may be more challenging due to blood glucose fluctuations and, possibly, the existence of diabetes and its complications. It became recently revealed that dependent on the worldwide location, more than 50% of persons infected with COVID-19 developed diabetes. Diabetes has been linked to 25% of COVID-19-related fatalities in the United Kingdom. 
The need for an action
Researchers revealed that ethnic minority diabetic patients are less likely to take medicine for treatment due to financial inequities and a lack of access . Around the world, 88 percent undiagnosed diabetes in adults belongs to low-income and middle-income nations. Even in high-income nations, over one-third (29%) of diabetics are undiagnosed. Clinical diagnosis has a low rate because of lack of healthcare accessibility and capacity. Aside from avoiding diabetes and its consequences, it is critical to give the best possible care to individuals who are affected. 
Fortunately, there is plenty that can be done to lessen the burden of diabetes. Type 2 diabetes may frequently be avoided, and that early identification and access to adequate care for every form of diabetes can help patients to avoid or postpone problems. We should assure low-cost access to the basic components of diabetes care, as well as rapid diagnosis and therapy, and strengthen efforts to avoid type 2 diabetes. These are significant efforts in addressing the diabetes epidemic’s ongoing and fast rise. However, additional action is required. 
Treat and manage diabetes with technologies
Several empirical studies and R&D initiatives confirmed the importance of glucose monitoring devices in diabetes care. This is the next phase in the evolution of combination devices at developing the management of integrated diabetes. While there are several accessible devices, from the standard glucometer to more innovative combination equipment and techniques including artificial pancreas, and equipment which can assist in continuous glucose monitoring (CGM) have grown in popularity. For CGM application and diabetic retinopathy treatment, smart contact lenses equipped with biosensors and medicine delivery materials have been researched. Novo Nordisk’s smart pens can be used as insulin pens and collect dosage data in order to discover trends and personalize therapy. 
Digital technologies are also being used by healthcare practitioners to get rapid access to data, improve the simplicity of self-monitoring, change the right dosage, forecast the progress and avoid dangerous diabetic shock and morbidities. Data analytics, including as prescriptive analytics and AI platforms, aid in CGM, forecast and in the determination of precise insulin dose. Apps are also used to measure calorie consumption, provide nutritional information, and create diet regimens. Bionic systems, such as the artificial pancreas, can not only replicate the pancreas’s function to supply insulin dose, but also their connection with AI platforms can forecast the needed amount, whereas sensors can aid with CGM. The combination devices can offer monitoring and therapy, and they may also save and transfer the data to healthcare specialists for prompt mediation if necessary. 
The next stage in diabetes monitoring is believed to be intelligent diabetic monitoring devices. Concerned about diabetes, the European Commission has launched a project call “Noncommunicable disease risk reduction in adolescents and young (Global Alliance for Chronic Diseases – GACD)”  that will be closed at 17:00:00 in Brussels on April 21, 2022. The European Commission has also issued a call in the “Digital Europe Programme (DIGITAL)” for “Health Testing and Experimentation Facility”. The capability of this schema may include a range of use cases in various fields, such as monitoring the progression of long-term disorders in connection to medication (e.g., diabetes mellitus, neurodegenerative diseases, and so on). The deadline is 17 May 2022 17:00:00 Brussels time .
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