Food Protection Trends - September/October 2020 - 375

TABLE 1. Estimated prevalence of individuals with diabetes in the United States, the
United Kingdom, and worldwide for 2019 and 2030
Country

Estimated prevalence of individuals with diabetes (×106)
2019
31 million
3.8 million
463 million

United States
United Kingdom
Worldwide

2030
34 million
5.5 million
578 million

Source
(47)
(13)
(47)

TABLE 2. Complications of diabetes adapted from World Health Organization (58)
and Chawla et al. (8)
Complication

Disease

Description

Microvascular

Retinopathy (eye)

Leading cause of blindness and visual disability caused by small blood vessel damage
in the back layer of the eye (retina), resulting in progressive loss of vision.

Caused by damage to small blood vessels in the kidneys and can lead to kidney failure
Nephropathy (kidney) and possibly death. In developed countries, nephropathy is a leading risk factor for
dialysis and kidney transplants.

Macrovascular

Neuropathy (nerve)

Damage to peripheral nerves within the body may result in pain, burning or a loss
of sensation (sensory neuropathy) or can cause loss of control of internal organs,
including the gastrointestinal tract (autonomic neuropathy).

Cardiovascular

Blood vessels may be damaged through "atherosclerosis" (blocking of arteries with
fatty plaques). This damage can decrease blood flow to the heart muscle (causing
a heart attack), brain (leading to stroke), or extremities and can lead to pain
(claudication) and decreased healing of infections.

Foot

Reduction in blood flow and the resulting neuropathy in the lower limb can lead to
ulceration and subsequent limb amputation.

Adapted from the World Health Organization (58) and Chawla et al. (8)

appropriate or effective for conveying accurate food safety
advice, particularly because needs and circumstances differ
greatly between groups (32). Educators should identify and
target vulnerable populations at risk of foodborne infection
according to their specific underlying conditions.
DIABETES MELLITUS AND RISK OF
FOODBORNE INFECTION
One vulnerable group known to have an increased risk
of foodborne infection but tend to be overlooked within
the food safety literature are individuals with diabetes (49).
Diabetes mellitus is a serious, chronic disease characterized
by hyperglycemia (high blood glucose concentration)
that occurs in type 1 diabetes when the pancreas does not

produce enough insulin (a hormone that regulates blood
glucose) and in type 2 diabetes when the body cannot
effectively use the insulin it produces (57). The prevalence
of diabetes has been steadily increasing worldwide over the
past few decades (Table 1). Current trends indicate that the
estimated worldwide prevalence of the condition will rise
by 20% over the next 10 years (47). Aging of the overall
population is considered a significant driver of the diabetes
epidemic (29).
Diabetes is often wrongly assumed to be a condition
affecting only blood glucose levels, resulting in minimal health
consequences (35). However, diabetes can affect the majority
of organs within the body, leading to a number of complications
(Table 2), which can be divided into those caused due to damage

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