By Awa Sowe
Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough or any insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells.
Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.
Sometimes people call diabetes “a touch of sugar” or “borderline diabetes.” These terms suggest that someone doesn’t really have diabetes or has a less serious case, but every case of diabetes is serious.
In an interview with Mr Omar Badjie, Programme manager, Non Communicable Diseases unit, under the Directorate of Health Services, affirmed that 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 glucose. Hyperglycaemia, also called raised blood glucose 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.
He said diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.
According to Mr Badjie , in 2014, 8.5% of adults aged 18 years and older had diabetes. In 2019, diabetes was the direct cause of 1.5 million deaths and 48% of all deaths due to diabetes occurred before the age of 70 years. Another 460 000 kidney disease deaths were caused by diabetes, and raised blood glucose causes around 20% of cardiovascular deaths.
“Between 2000 and 2019, there was a 3% increase in age-standardized mortality rates from diabetes. In lower-middle-income countries, the mortality rate due to diabetes increased 13%”.
He further explained that, Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. In 2017 he reported, there were 9 million people with type 1 diabetes; the majority of them live in high-income countries, adding that neither its cause nor the means to prevent it are known.
Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.
Furthermore, Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from the body’s ineffective use of insulin. He went on to explained , More than 95% of people with diabetes have type 2 diabetes. This type of diabetes 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, after 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 hyperglycemia with blood glucose values above normal but below those diagnostic of diabetes. Gestational diabetes occurs during pregnancy.
Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. These women and possibly their children are also at increased risk of type 2 diabetes in the future. Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.
On some Health impact of diabetes, He mentioned that 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 increase the chance of 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. Close to 1 million people are blind due to diabetes. Diabetes is among the leading cause of kidney failure. People with diabetes are more likely to have poor outcomes for several infectious diseases, including COVID-19.
On prevention he advised people to maintain a healthy body weight; be physically active – doing 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; and avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease.
On treatment Badjie pointed out that early diagnosis can be accomplished through relatively inexpensive testing of blood glucose.
“Treatment of diabetes involves diet and physical activity along with lowering of blood glucose and the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications”.
Interventions that are both cost-saving and feasible in low- and middle-income 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; and foot care (patient self-care by maintaining foot hygiene; wearing appropriate footwear; seeking professional care for ulcer management; and regular examination of feet by health professionals).
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 diabetes-related kidney disease and treatment.
Mariam Jobe a 60-year-old woman , said she was diagnosed with Type 2 Diabetes for more than 30 years ago, and it has been a long road since then. “My doctor explained that diabetes is a chronic condition where the body is not able to regulate the amount of glucose in my body. It means that I need to be extra vigilant in controlling my diet and physical activity,” she said.
She went on: “At first, I was overwhelmed. Diabetes meant so many changes to my life—eating differently, exercising every day, and managing my health. I worried that I wouldn’t be able to make all these changes.
But I was determined to make the most out of this diagnosis. I slowly started to adopt a healthier lifestyle. I exercised more, made healthy eating choices, and attended regular doctor appointments to keep on top of my health.
Life with diabetes is not easy, but it is manageable. Learning to live with diabetes has taught me to be more patient with myself and to appreciate the small changes I make. It has also helped me to appreciate the importance of taking time out of my day to look after myself”.
Lala Ceesay, 32, a diabetes patient, also explained that she changed her relationship with food and learned to eat smaller meals, spread out throughout the day, enjoy healthy foods which makes her feel good. Over time, she added that she became much better at managing her condition.
“I am now so much more aware of the impact of my lifestyle decisions on my long-term health. I take great care to look after myself. I still make mistakes and miss the odd meal or exercise session, but I know how to catch up quickly and stay on top of my health”.
Sometimes drugs are an option. Oral diabetes drugs such as metformin (Glumetza, Fortamet, others) may lower the risk of type 2 diabetes. But healthy lifestyle choices are important. If you have prediabetes, have your blood sugar checked at least once a year to make sure you haven’t developed type 2 diabetes.
According to World Health Organization (WHO), the number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. Prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Between 2000 and 2019, there was a 3% increase in diabetes mortality rates by age.
In 2019, diabetes and kidney disease due to diabetes caused an estimated 2 million deaths. A healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.
