UNDERSTAND DIABETES

TAKE CONTROL

A campaign led by the

International Diabetes Federation
 The premier awareness campaign
of the diabetes world
When does World Diabetes Day take place?
World Diabetes Day takes place on 14 November every
year. The date was chosen because it marks the birthday of
Frederick Banting, who, along with Charles Best, is credited
with the discovery of insulin. While many events take place
on or around the day itself, a themed campaign
runs throughout the year, with actions planned to
influence political opinion and support the goals of
the campaign.
healthcare professionals, healthcare
decision-makers and the media. Numerous local and
national events are organized by the member associations
of the International Diabetes Federation and by other
diabetes representative organizations, healthcare
professionals, healthcare authorities, and individuals who
want to make a difference. World Diabetes Day unites the
global diabetes community to produce a powerful voice for
diabetes awareness.

How did it all begin?

World Diabetes Day was introduced by the
International Diabetes Federation (IDF) and the
World Health Organization (WHO) in 1991, in
response to concern over the escalating incidence
of diabetes around the world. Since then, the event
has grown in popularity every year.

Where does it take place?

World Diabetes Day is celebrated worldwide.
It brings together millions of people in over
160 countries to raise awareness of diabetes,
including children and adults affected by diabetes, The Table of Silence, Targa Jiu, Romania

1
How is it marked?
Diabetes representative organizations, governmental
organizations, companies and individuals develop an
extensive range of activities tailored to a variety of groups.
Activities that are organized each year include:
•• Blue lighting events
•• Human blue circles
•• Dress-up-in-blue days
•• Walks and cycle rides
•• Radio and television programmes
•• Screenings for diabetes and its complications
•• Public information meetings
•• Governmental activities
•• Poster and leaflet campaigns
•• Diabetes workshops and exhibitions
•• Press conferences
•• Newspaper and magazine articles
•• Events for children and adolescents

For further information see section entitled ‘Bring

diabetes to light’ (page 7).

2
 Is there a theme?
Each year World Diabetes Day highlights a theme related
to diabetes. Topics covered in the past have included
diabetes and human rights, diabetes and lifestyle, and
the costs of diabetes. In 2007, the decision was taken
to spread campaign themes over a longer time period.
The theme of diabetes in children and adolescents was
extended to cover 2007 and 2008. For 2009 and beyond,
the Executive Board of the International Diabetes
Federation turned to its global network of diabetes
associations to propose the theme. The most popular Know the warning signs!
www.worlddiabetesday.org

choices were diabetes education and diabetes prevention.

It was felt that significant efforts to prevent diabetes world diabetes day

would not be possible without sufficient diabetes

education. Consequently, the theme chosen was Diabetes
Education and Prevention. A broad theme that will cover
the five-year period from 2009 to 2013.
Recent themes include:
2005: Diabetes and Foot Care
2006: Diabetes in the Disadvantaged and the Vulnerable
2007–2008: Diabetes in Children and Adolescents
2009–2013: Diabetes Education and Prevention
3
Understand diabetes and
take control
The 2009–2013 campaign calls on all those responsible for
diabetes care to understand diabetes and take control. For people
with diabetes, this is a message about empowerment through
education. For governments, it is a call to implement effective
strategies and policies for the prevention and management of
diabetes to make sure that their citizens with and at risk of diabetes
receive the best possible care. For healthcare professionals,
it is a call to improve knowledge so that evidence-based
recommendations are put into practice. For the general public it is
a call to understand the serious impact of diabetes, to know how
to identify the condition and, where possible, know how to avoid
or delay diabetes and its complications.
The 2009–2013 campaign is driven by four aspirational goals:
1. Every government should implement effective strategies
and policies for the prevention and management of
diabetes.
2. Every person with diabetes should receive education to
help them manage their diabetes better.
3. Everyone should know the diabetes warning signs, how
to prevent or delay the complications of diabetes and how
to prevent or delay type 2 diabetes.
4. Every country should celebrate World Diabetes Day.

The World Diabetes Day logo

The diabetes circle, the icon established by the IDF-led
‘Unite for Diabetes’ campaign, was adopted as the World
Diabetes Day logo in 2007. The diabetes circle is a simple
icon that can be easily adapted and used.
The significance of the symbol is overwhelmingly positive. world diabetes day
Across cultures, the circle symbolizes life and health. The 14 November
colour blue reflects the sky that unites all nations and is
the colour of the flag of the United Nations. The blue circle
signifies the unity of the global diabetes community in
response to the diabetes pandemic.
Show your support for World Diabetes Day by using the
logo as widely as possible. It can be downloaded from “The blue diabetes circle signifies unity in
www.worlddiabetesday.org. the global struggle to defeat diabetes.”

4
 World Diabetes Day – A United Nations World Day
World Diabetes Day is an official United Nations World Day.
On 20 December 2006, the UN General Assembly passed
resolution 61/225, which designated the existing World
Diabetes Day as an official world day beginning in 2007.
This landmark resolution also recognized diabetes as “a
chronic, debilitating and costly disease associated with
major complications that pose severe risks for families,
countries and the entire world.”
“Diabetes poses severe risks for families,
countries and the entire world.”
Non-communicable diseases are estimated to reduce GDP
by up to 5% in many low- and middle-income countries.
They are an under-appreciated cause of poverty and now
present a serious barrier to economic development.
UN Secretary-General Ban Ki-moon recently described
the epidemic of non-communicable diseases as posing a
greater threat than infectious diseases: “Cancer, diabetes,
heart diseases are no longer the diseases of the wealthy.
Today, they hamper the people and the economies of the
poorest populations even more than infectious diseases.
This represents a public health emergency in slow motion.”

The United Nations has shown its commitment to the fight

against diabetes by throwing its support behind World
Diabetes Day and by highlighting the global impact of the
disease. The resolution marked the first time that a non-
communicable disease was recognized as posing as serious
a global health threat as infectious epidemics like malaria,
tuberculosis and HIV/AIDS.
The world is experiencing an epidemic of non-
communicable diseases that threatens to overwhelm
healthcare systems worldwide. Diabetes, cardiovascular
disease, cancer and chronic respiratory diseases cause
35 million deaths a year, with four in every five of these
deaths occurring in low- and middle-income countries.

5
Concerted action is need
The passage of UN Resolution 61/225 was a major “Resolution 61/225 “Invites all Member
achievement for all people living with or at risk of diabetes. States, relevant organizations of the
However, it was just the first step in the struggle to reverse United Nations system and other
the diabetes epidemic and save lives. international organizations, as well as
Resolution 61/225 established the global agenda for the civil society including non-governmental
fight against the diabetes pandemic by encouraging all organizations and the private sector, to
nations to develop national policies for the prevention, care
observe World Diabetes Day.”
and treatment of diabetes. The global diabetes community
must remain united to make sure that all nations follow
through on this commitment.
Over 250 million people are living with diabetes. Without
concerted action to fight the disease, this figure will reach
380 million within a generation.

“To do nothing is not an option.”

Read the Resolution online at www.idf.org.

World Diabetes Day provides the opportunity for
orchestrated global action to improve care for the many
millions living with diabetes worldwide and to encourage
governments to do more to prevent diabetes in the many
more at risk.

6
Bring diabet
tes to light!
 How will you bring diabetes
to light?
The monument challenge
In 2007, the global diabetes community rallied behind the
call to light iconic landmarks and buildings in blue to mark
World Diabetes Day. A total of 279 iconic monuments were
lit as beacons of hope for the millions of people worldwide
living with diabetes. In 2008, action to light up in blue
continued, with more than 1000 landmark sites and
buildings participating from a total of 99 countries. A full
list can be found on the World Diabetes Day website. Visit
www.worlddiabetesday.org for more information about
the challenge, along with support material to help you
light a monument in your home town.
9
Engaging political support for World Diabetes Day
In recent years, many individuals and organizations have
shown their support by seeking local, national and regional
proclamations that encourage action to mark World Diabetes
Day and promote key issues. Political representatives around
the world responded by issuing official statements on World
Diabetes Day. Why not approach your local governmental
representative for an official message of support? An official
signing provides an ideal opportunity to support the official
lighting of a local monument and other awareness-raising
activities in your area. You’ll find template documents on the
World Diabetes Day website.
Community action
Each year, diabetes representative organizations, industry
partners and committed individuals organize activities on
or around World Diabetes Day. Typical activities include
walks, cycle rides, educational rallies and exhibitions.
These activities can be linked to an official lighting and/
or the official signing of a proclamation. Recent years have
seen a number of human blue circles organized. It is a
simple idea that has great visual impact. Share ideas and
pictures of events through the World Diabetes Day website
at www.worlddiabetesday.org/activities.

Individual action
Can’t find an event near you but want to join in? There are
many ways that you can get involved. Why not illuminate
your home in blue or light a blue candle for World Diabetes
Day? Dress up in blue for the day and organize a dress-up-
in-blue day for diabetes at your workplace. Whatever your
idea, be sure to register your activity on the website so
that we can share it with the world and add your event to
the global total of people who take part.
Become a World Diabetes Day champion
Do you have an interesting idea that will grab public and
media attention? Do you want to change the way that
people think about diabetes? Are you lobbying your local
or national government to improve diabetes care and
prevention? Are you helping to implement change that
will improve care for people with and at risk of diabetes?
You could be eligible to become a World Diabetes Day
champion.
World Diabetes Day champions show their support by
organizing activities that align with the campaign goals
and promote World Diabetes Day to the public and media,
or promote government action for change. Examples
include government action to improve diabetes care
and prevention, individual or group action to lobby local
or national governments to improve diabetes care, or
awareness-raising activities that attract public and media
attention such as Desert Dingo - the World Diabetes Day
VW Beetle that races to raise awareness of diabetes or
the motorcycle enthusiast who crosses the desert on the
World Diabetes Day bike. Find out more from
www.worlddiabetesday.org/champions.
World Diabetes Day champions are promoted through the
website and are encouraged to work closely with the campaign
team to make the most of opportunities to promote World
Diabetes Day. Contact worlddiabetesday@idf.org and let
us know what you are planning.
10
 Join the cyber celebrations
Across the internet, individuals and online communities
mark World Diabetes Day and add their voices to the call
for action to improve diabetes care and promote the
prevention of diabetes and its complications. There are
many places online to join the movement. Find out more
from the World Diabetes Day website.
Over recent campaigns, World Diabetes Day has extended
its reach through various social networking sites in order
to seek new audiences and further engage the campaign’s
global network of supporters. A variety of information
and material about the campaign, including pictures
of the Blue Monument Challenge, World Diabetes Day
event videos and updated information on the 2009 World
Diabetes Day campaign is available through various sites.
Find World Diabetes Day on the following:
YouTube
•• World Diabetes Day Channel -
http://www.youtube.com/worlddiabetesday
•• International Diabetes Federation Channel -
http://www.youtube.com/user/IntDiabetesFed
Flickr
•• World Diabetes Day group -
http://www.flickr.com/groups/wdd
•• International Diabetes Federation -
http://www.flickr.com/photos/idf/sets/
Myspace
••  http://www.myspace.com/officialworlddiabetesday
Visit these sites to join the campaign and help bring
diabetes to light!

Facebook
•• World Diabetes Day Group -
http://www.facebook.com/group.php?gid=100331240644&ref=mf
•• Become a fan of World Diabetes Day -
http://www.facebook.com/pages/Brussels-Belgium/World-Diabetes-
Day/67935817021?ref=mf

Twitter
••  http://twitter.com/wdd

11
What is diabetes?

Diabetes is a chronic disease that arises when the pancreas

does not produce enough insulin, or when the body cannot
effectively use the insulin it produces. Insulin is a hormone
made by the pancreas that enables cells to take in glucose
from the blood and use it for energy. Failure of insulin
production, insulin action or both leads to raised glucose
levels in the blood (hyperglycaemia). This is associated
with long-term damage to the body and the failure of
various organs and tissues.
Understand diabetes: Know the warning signs*

•• Frequent urination
•• Excessive thirst
•• Increased hunger
•• Weight loss
•• Tiredness
•• Lack of interest and concentration
•• Vomiting and stomach pain (often mistaken as the flu)
•• A tingling sensation or numbness in the hands or feet
•• Other signs include blurred vision, frequent infections
and slow-healing wounds

*These can be mild or absent in people with type 2

diabetes.

12
 Type 1 diabetes
Type 1 diabetes is an autoimmune disease characterized
by the destruction of the insulin-producing cells in the
pancreas. Consequently, people with type 1 diabetes
produce very little or no insulin and must take insulin to
survive. Type 1 diabetes, which used to be called juvenile-
onset diabetes, is most commonly diagnosed in children
and young adults.

Type 2 diabetes
The development of type 2 diabetes is marked by insulin
resistance. People with type 2 diabetes cannot use the
insulin that they produce effectively. They can often
manage their condition through exercise and diet.
However, in many cases oral drugs are needed and often
insulin is required. Type 2 diabetes accounts for over 90%
of the more than 250 million people living with diabetes
worldwide.
Both type 1 and type 2 diabetes are serious and both can
affect children. It is important to know the warning signs
of diabetes.
“There is no such thing as mild diabetes.”
Gestational diabetes
Gestational diabetes (GDM) is a condition in which women
without previously diagnosed diabetes have high blood
glucose levels during their pregnancy. GDM affects about
4% of all pregnant women. It has few symptoms and
usually disappears when the pregnancy ends. However,
GDM poses a risk to both child and mother. Babies of
mothers with GDM are at increased risk of being large for
gestational age (which can lead to delivery complications),
are at higher risk for some other medical complications
after delivery and often have an increased life-long risk of
glucose intolerance and obesity. Women who have had
GDM have a significantly increased risk of developing type
2 diabetes.
Other rarer types of diabetes also exist.

13
The complications of diabetes
Diabetes is a chronic, life-long condition that requires
careful monitoring and control. Without proper
management it can lead to very high blood sugar
levels. These are associated with long-term damage to
the body and the failure of various organs and tissues.
Complications include:
•• Cardiovascular disease, which affects the heart and
blood vessels, and may cause fatal complications such
as coronary heart disease (leading to a heart attack) and
stroke.
•• Kidney disease (diabetic nephropathy), which may result
in total kidney failure and the need for dialysis or kidney
transplant.
•• Nerve disease (diabetic neuropathy), which can
ultimately lead to ulceration and amputation of the
toes, feet and lower limbs.
•• Eye disease (diabetic retinopathy), characterized by
damage to the retina of the eye which can lead to vision
loss.
World Diabetes Day and education
Diabetes is difficult. It imposes life-long demands on
people with diabetes, requiring them to make multiple
decisions related to managing their diabetes. People
with diabetes need to monitor their blood glucose, take
medication, exercise regularly and adjust their eating
habits. Furthermore, they may have to face issues related
© Jesper Westley
to living with the complications of diabetes and may be
required to make considerable psychological adjustments.
As outcomes are largely based on the decisions they take,
it is of paramount importance that people with diabetes
receive ongoing, high-quality diabetes education that
is tailored to their needs and delivered by skilled health
professionals.
Without diabetes education, people with diabetes are less
prepared to take informed decisions, make behavioural
changes, address the psycho-social issues presented by
diabetes and, ultimately, may be ill-equipped to manage
their diabetes effectively. Poor management will result
in reduced health outcomes and an increased likelihood
of developing complications. Education is therefore of
the utmost importance in the prevention of diabetes
complications and central to the World Diabetes Day
campaign. The role of the diabetes educator is of critical
importance within the diabetes care team.
14
 The educator enables people with diabetes to manage
their diabetes-related health to the best of their ability
so that choices and actions are based upon informed
judgement.

Most people with diabetes cannot access diabetes

education due to factors such as cost, distance, and the
lack of appropriate services. Many more may be unaware
of the services that do exist or perhaps not convinced of
the benefits that diabetes education can bring. They may
feel, for example, that interaction with their physician
provides all the education they need. The World Diabetes
Day campaign promotes the importance of structured
diabetes education programmes as key to the prevention
and control of diabetes and advocates for increased
opportunities for diabetes education within healthcare
systems and communities.

“Education is of the utmost importance in

the prevention of diabetes complications
and central to the World Diabetes Day
campaign.”

15
Diabetes education is particularly lacking in developing
countries. Even in developed countries, many people
cannot access education because there are not enough
educators or centres to cope with the rising number
of people with diabetes. The International Diabetes
Federation is working to identify and fill the gaps in the
provision of diabetes education worldwide. In 2003, the
Federation produced International Standards for Diabetes
Education. Revised and updated in 2009, these standards
can be found online at www.idf.org/diabetes_education
along with IDF’s International Curriculum for Diabetes
Health Professional Education.

Diabetes education is best provided by a multidisciplinary

team. While multidisciplinary education is available in
some countries, in many others it is not available and its
value is not fully recognized by the medical profession. The
World Diabetes Day campaign sets out to challenge this.
It is hoped that the awareness raised by the campaign will
encourage healthcare systems everywhere to recognize
the need to provide structured diabetes education and
help establish access to skilled diabetes education as the
right of every person with diabetes.

16
 Understand diabetes: know the risks
There are many risk factors for type 2 diabetes. They
include:
•• Obesity and overweight
•• Lack of exercise
•• Previously identified glucose intolerance
•• Unhealthy diet
•• Increased age
•• High blood pressure and high cholesterol
•• A family history of diabetes
•• A history of gestational diabetes
•• Ethnicity - higher rates of diabetes have been reported
in Asians, Hispanics, Indigenous peoples (USA, Canada,
Australia) and African Americans.

17
World Diabetes Day and primary prevention
At present, type 1 diabetes cannot be prevented. The
environmental triggers that are thought to generate
the process that results in the destruction of the body’s
insulin-producing cells are still under investigation. Type
2 diabetes, however, can be prevented in many cases by
maintaining a healthy weight and being physically active.
In 1985, 30 million people worldwide were thought to
have diabetes. A little over a decade later, the estimate
rose to over 150 million. Today, according to IDF figures, it
exceeds 250 million. Unless action is taken to implement
effective prevention and control programmes, the total
number of people with diabetes will reach 380 million by
2025. The explosion in diabetes will overwhelm healthcare
systems everywhere and subvert the gains of economic
development. Investment in diabetes education and
diabetes prevention programmes will save money in the
long term and deliver significant returns in quality of
life for people with diabetes and people at high risk of
diabetes.
The International Diabetes Federation proposes a simple
three step plan for the prevention of type 2 diabetes in
those at increased risk. IDF recommends that all people
at high risk of developing type 2 diabetes be identified
through opportunistic and self-screening. People at high
risk can be easily identified through a simple questionnaire
to assess risk factors such as age, waist circumference,
family history, cardiovascular history and gestational
history.

18
19
 Once identified, people at high risk of diabetes should
have their plasma glucose levels measured by a health
professional to detect Impaired Fasting Glucose or
Impaired Glucose Tolerance, both of which indicate an
increased risk of type 2 diabetes. Prevention efforts should
target those at risk in order to delay or avoid the onset of
type 2 diabetes.
There is substantial evidence that achieving a healthy body
weight and moderate physical activity can help prevent
the development of type 2 diabetes. In primary prevention
there is an important role for the diabetes educator to
help people understand the risks and set realistic goals
to improve health. IDF recommends a goal of at least 30
minutes of daily exercise, such as brisk walking, swimming,
cycling or dancing. Regular walking for at least 30 minutes
per day, for example, has been shown to reduce the risk of
type 2 diabetes by 35-40%.

19
 Show you care
Wear the diabetes pin to mark World Diabetes Day.
The blue circle is the global symbol for diabetes.
Buy the pin online from the IDF shop and give life to a child with diabetes.
http://shop.idf.org

Income generated by sales of the diabetes pin is used to support children on the
IDF Life for a Child Program. The Program provides life-saving diabetes supplies to
children in developing countries (www.lifeforachild.org).

20
 The International Diabetes Federation
The International Diabetes Federation (IDF) is an umbrella The content of this booklet draws on the following
organization of over 200 national diabetes associations sources:
in over 160 countries. It represents the interests of the
growing number of people with diabetes and those at •• Riley P, McClaughlyn K. Understand diabetes and take
risk. The Federation has been leading the global diabetes control: World Diabetes Day 2009. Diabetes Voice, June
community since 1950. IDF’s mission is to promote 2009.
diabetes care, prevention and a cure worldwide. Led
by the International Diabetes Federation, the Unite for •• Metzger B, et al. New findings in gestational diabetes – the
Diabetes campaign secured a United Nations Resolution HAPO Study. Diabetes Voice, Special Issue: May 2009.
on diabetes in December 2006. The Federation continues •• McGill M, McGuire H. The IDF framework for diabetes
to lead the global effort to implement Resolution 61/225 education – current status and future prospects.
under the Unite for Diabetes banner. The Resolution Diabetes Voice. March 2009.
encourages UN Member States to develop national policies
for the prevention, treatment and care of diabetes in line •• International Diabetes Federation: a consensus on Type
with the sustainable development of their health-care 2 diabetes prevention. Diabetic Medicine, 2007: 24, 451-
systems, taking into account the internationally agreed 463.
development goals, including the Millennium Development •• Patient Education and psychological care. Diabetes
Goals. Voice, Supplement September 2006.
•• Diabetes Atlas 3rd Edition, International Diabetes
The International Diabetes Federation is engaged in action
Federation, 2006.
to tackle diabetes from the local to the global level from
programmes at community level to worldwide awareness
and advocacy initiatives. IDF’s activities aim to influence
policy, increase public awareness and encourage health
improvement, promote the exchange of high-quality
information about diabetes, and provide education for
people with diabetes and their healthcare providers.

21
Find your campaign-
toolkit online at:
www.worlddiabetesday.org/toolkit

22
Information about World Diabetes Day and campaign materials can be found
on the World Diabetes Day website: www.worlddiabetesday.org.

Additional information about the International Diabetes Federation

is available from www.idf.org.

Direct your enquiries to the IDF Executive Office:

International Diabetes Federation (IDF)
Chaussée de La Hulpe 166
B-1170 Brussels, Belgium
tel: +32 2 5385511
fax: +32 2 5385114
For e-mail enquiries about World Diabetes Day, please contact
wdd@idf.org
For general enquiries to IDF, please use
info@idf.org