Turkey’s Moment of Reckoning on Diabetes?


As COVID-19 began spreading through the world, the race to understand the disease by scientists and doctors took off. After just a few months, it became apparent that people with diabetes seemed to suffer more severe effects; 50 percent of people diagnosed with COVID-19 also suffered from diabetes. As a consequence, countries with a high prevalence of diabetes had to brace themselves for the impact. In the case of Turkey, it was a moment to reckon with reality.


Turkey has the biggest diabetes population in Europe, and it is the third biggest in the world with over six million people. The prevalence rate ranges from 11-14 percent of the population but, most importantly, the proportion of people with undiagnosed diabetes is 38 percent, according to the International Diabetes Federation (IDF).


Explaining the link between diabetes and COVID-19, the IDF says that when people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels. An effect that the Mayo Clinic explains stating that “in people with diabetes there is more inflammation in the body. And so, with COVID, that inflammatory state gets worse much more quickly.”


The story of the disease in Turkey has been almost one century in the making. In 1958, the American Diabetes Association published a paper showing that the incidence of diabetes had been increasing steadily for two decades in Turkey, an increase that was supposedly due to more diagnostic examinations in new hospitals. At that time, studies indicated that the prevalence rate was around 0.76 percent, almost identical to the United States. “For Turkey as a whole, failure to recognize diabetes is still a problem,” read the paper.


Almost four decades after that report, in 1997, the first survey of the Turkish Diabetes Epidemiology Study (TURDEP) was conducted. The study revealed a diabetes prevalence of 7.2 percent, but the rate skyrocketed the following decade, nearly doubling to 13.6 percent in 2010. “These results were shocking in comparison to what had been forecasted by the WHO,” Temel Yilmaz, president of the Turkish Diabetes Foundation, told PharmaBoardroom.


According to Yilmaz, diabetes and related conditions are responsible for one-fourth of the country’s entire healthcare expenditure, however, patients still have access problems to certain drugs. “The industry is in a very difficult position right now. Turkey is one of the countries with one of the lowest drug prices and many patients from neighboring countries come to Turkey to buy drug supplies,” he said.


One of the leading companies working to treat diabetes patients in Turkey, Novo Nordisk, has invested over US 14 million from 2016 to 2020 in R&D, running clinical trials in the country, including for their diabetes and obesity projects. In addition, Novo Nordisk supplies over 50 percent of the insulin used in Turkey.


We are the only company to provide insulin for every type of patient, from children to the elderly

Burak Cem, Novo Nordisk Turkey


“We are the only company to provide insulin for every type of patient, from children to the elderly. We have created great partnerships with the government and civil society to increase awareness and continuous medical education for doctors,” Burak Cem, general manager for Novo Nordisk Turkey, recently told PharmaBoardroom.


Cem insists that the Danish company’s mission is to defeat type 1 diabetes with stem cells, cure type 2 diabetes with smart molecules and decelerate the rapid growth of obesity by pioneering scientific breakthroughs, adding that although Turkey is much more advanced than other countries in the region there is “room for improvement in introducing new treatments to the system.”

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