Diabetes……Think you’re not at risk? Read on!
I was shocked when I read the WHO report on current global trends in diabetes. Diabetes is now the world’s fastest growing disease. Alarmingly, about 50 percent of people with diabetes are not aware they have it. Recent studies have shown that some people suffer from diabetes for up to 7 years without being aware that they have it.
Diabetes is the seventh leading cause of death in developed countries and type II diabetes (mature onset) represents about 85 to 90 percent of all cases of diabetes. Early detection and management allows people living with diabetes to enjoy a healthy life.
Here are some key facts:
- The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 & has been rising more rapidly in middle- and low-income countries.
- The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014.
- Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
- In 2015, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.
What is diabetes?
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.
Type 1 diabetes
Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. The cause of type 1 diabetes is not known and it is not preventable with current knowledge.
Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.
Type 2 diabetes
Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from the body’s ineffective use of insulin. Type 2 diabetes comprises the majority of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity.
Symptoms may be similar to those of type 1 diabetes, but are often less marked. As a result, the disease may be diagnosed several years after onset, once complications have already arisen. Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.
Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes, occurring during pregnancy.
Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. Gestational diabetes usually goes away once the baby is born however; they and their children are also at increased risk of type 2 diabetes in the future.
Gestational diabetes is diagnosed through prenatal screening (a simple glucose screening at 26 weeks), rather than through reported symptoms. Impaired glucose tolerance and impaired fasting glycaemia. Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.
What are common consequences of diabetes?
Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves.
- Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes.
- Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation.
- Diabetic retinopathy is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. 2.6% of global blindness can be attributed to diabetes (3).
- Diabetes is among the leading causes of kidney failure (4).
How can the burden of diabetes be reduced?
Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:
- Achieve and maintain healthy body weight;
- Be physically active – at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control;
- Eat a healthy diet, avoiding sugar and saturated fats intake; and
- Avoid tobacco use – smoking increases the risk of diabetes and cardiovascular diseases.
Diagnosis and treatment
Early diagnosis can be accomplished through relatively inexpensive testing of blood sugar. A simple visit to your local doctor or Prodia lab is all it takes.
Interventions that are both cost-saving and feasible in developing countries include:
- Blood glucose control, particularly in type 1 diabetes. People with type 1 diabetes require insulin, people with type 2 diabetes can be treated with oral medication, but may also require insulin, blood pressure control & foot care.
Other cost saving interventions include:
- Screening and treatment for retinopathy (which causes blindness), blood lipid control (to regulate cholesterol levels), screening for early signs of kidney disease.
As with so many other things, diabetes can easily be treated and managed IF YOU KNOW THAT YOU HAVE IT. If you ignore the signs, it can ultimately be fatal.
Kim Patra is a qualified Midwife & Nurse Practioner who has been living and working in Bali for over 30 years. She now runs her own Private Practice & Mothers & Babies center at her Community Health Care office in Sanur.
Copyright © 2018 Kim Patra
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