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Eighty per cent of the 300 million people with diabetes live in low- and middle-income countries and women represent half of this worldwide diabetes community. Gender roles and power dynamics shape vulnerability to diabetes, affect women’s health-seeking behaviour, access to health services and influence the impact of diabetes on women’s health. This creates a set of concerns that are specific to women. In addition, as the prevalence of type 2 diabetes in women of reproductive age has increased, so has the prevalence of gestational diabetes mellitus (GDM), a form of diabetes with onset or that is first recognised during pregnancy. GDM is a major cause of maternal and infant morbidity and mortality and a major factor in the intergenerational transmission of diabetes. The International Diabetes Federation (IDF) is responding to this aspect of the global diabetes epidemic by launching a new programme on women and diabetes. This programme will build the evidence base, promote awareness and political commitment, support gender-responsive health systems and empower women to take a leading role in diabetes prevention.
Diabetes, women, low- and middle-income countries, International Diabetes Federation (IDF), gender differences, gestational diabetes, maternal health, diabetes prevention, global advocacy
Disclosure: The authors have no conflicts of interest to declare.
Received: 19 July 2010 Accepted: 10 August 2010 Citation: European Endocrinology, 2010;6(2):10–2
Correspondence: Katie Dain, International Diabetes Federation, 166 Chaussée de la Hulpe, B-1170 Brussels, Belgium. E: Katie.Dain@idf.org
The Indian economist Amartya Sen wrote in 2001 that, ‘gender inequality has many faces’.1 Despite rapid progress in many parts of the world, the many faces of inequality between women and men, girls and boys remain widespread and have critical implications for the spreadand management of diabetes. Sixty per cent of the world’s poor are women,2 two-thirds of illiterate adults are women3 and twice as many women suffer from malnutrition than men.4 These are important contributors to the social and economic determinants that are perpetuating the global diabetes epidemic and challenging global development. Investing in gender equality is a proven catalyst for achieving a range of health and socioeconomic development goals at the top of the international agenda.5 As gatekeepers of household nutrition and lifestyle, women are the main agents of change at the household level and beyond.6 Today, 80% of the 300 million people with diabetes live in low- and middle-income countries (LMICs).7 Women represent half of this global diabetes community, numbering 143 million.7 Diabetes is the seventh leading cause of death in women worldwide8 and diabetes-related complications result in disability, reduced life expectancy and health costs for virtually every society.
The International Diabetes Federation (IDF) is responding to the global diabetes epidemic by launching a new programme on women and diabetes. The programme will take a broad life-course approach, facilitating understanding of how diabetes affects a woman’s health over her own life and that of others across the generations. Interventions at each stage of a woman’s life will be focused upon; during childhood, adolescence, the reproductive years and beyond. The interplay of biological, sociocultural and socioeconomic determinants throughout these stages will be examined. They shape a woman’s vulnerability to diabetes, her health-seeking behaviour, access to health services and health outcomes. IDF is in a unique and powerful position to promote the women and diabetes agenda. As a federation of more than 220 member associations representing over two million members in more than 160 countries and territories, IDF has a global reach and significant ability to leverage support for women living with diabetes. IDF has attained its position as an influential player in global health and development, following the success of UN Resolution 61/225 on diabetes in December 2006 and the recent decision by the UN General Assembly to hold a UN Summit on Non-communicable Diseases (NCDs) in September 2011. The IDF Diabetes Atlas7 is the authoritative source of information on diabetes prevalence, mortality and healthcare expenditure. It also provides information on IDF’s work to enhance the education and skills of healthcare professionals and demonstrates its multidisciplinary strength and capacity to deliver on this important agenda. At the local level, IDF’s member associations boast extensive knowledge and capacity in diabetes management, care and prevention. This will inform and strengthen IDF’s approach to women and diabetes.8
IDF used a rigorous collaborative exercise to develop the women and diabetes programme. It consulted over a period of four months with a group of 50 experts from all regions of the world, drawing on IDF’s existing network of diabetes experts, as well as reaching out to a broader group of gender and health experts for the first time. The logical framework approach was used for programme development. This has been used in international development,9 but the process was adapted to enable online consultation during each stage of the programme design. This collaborative exercise provided a valuable online platform for knowledge exchange and the prioritisation of concerns. Through this, IDF has developed a comprehensive five-year programme. It has also fostered an important network of experts and partners to draw on and collaborate with.