Before you complete the first paragraph of this story, three people will be dead worldwide due to diabetes. And when you finish reading the story one will be dead in Pakistan. Considering such a huge magnitude of the disease, The World Health Organization (WHO) is observing the World health day on 7 April, 2016, with the theme: “Beat diabetes.”
Diabetes is becoming an epidemic in many countries and 80 percent of such countries are low and middle income nation. According to a report published by WHO in 2008, an estimated 347 million people in the world had diabetes and was growing rapidly in low- and middle-income countries. In its 2012 survey, WHO revealed that the disease was the direct cause of some 1.5 million deaths, with more than 80 percent of those occurring in poor countries. It also projects that diabetes will be the 7th leading cause of death by 2030 in the world.
As far as the situation of Pakistan is concerned, it has ever growing burden of disease and fewer resources to tackle it. A report of WHO suggests that 7.1 million people suffer from the disease in Pakistan. And approximately 88,000 people die annually, out of which 35,615 are men while 52,397 are women. Pakistan is one of the 10 countries in the world with the highest prevalence of this chronic diabetes. WHO has also projected that the country would have a diabetic population of around 11.4 million by 2030.
Although it is a quite serious health problem but the good news is that it can be prevented and controlled with some simple lifestyle changes. And for that one needs to know about its nature and complications.
Diabetes is basically a chronic disease which occurs when pancreas does not produce enough insulin or the body does not use the insulin which it produces.“Insulin is the hormone which regulates blood sugar, gives us energy to carry out our routine tasks. When insulin does not work a patient has an increased level of sugar,” says Dr Abdul Razzak Memon, an endicrinologist at Orthopedic and Medical Institute, Karachi.
There are 2 main forms of the diabetes; type 1 and type 2. “People with type 1 diabetes do not make their own insulin and therefore require insulin injections and in type 2, a patient’s body usually produces its own insulin, but not enough or is unable to use it properly,” he adds. Type 2 diabetes usually occurs in obese people who have sedentary life style.
Gestational diabetes is another form which happens during pregnancy.“Women with gestational diabetes are at increased risk of complications during pregnancy and at delivery. They are also at risk of developing type 2 diabetes in the future,” he adds.
The increased blood sugar level is not an ordinary health problem. Over time, high blood sugar can seriously compromise every major organ systems in the body. “It can cause heart attacks, strokes, nerve damage, kidney failure, blindness, impotence, and infections that can lead to amputations,” warns Dr Razzak.
The symptoms of diabetes are sometimes not noticeable. “But some general signs include frequent urge for urination, thirst, weight loss, pain in hands and feet, fatigue (usually in evening), and sweating,” says the doctor.
Interestingly, people are diagnosed with diabetes incidentally. “When a patient is screened before a job, surgical procedure or s/he uses a glucometer of a diabetic at home, and comes to know about the problem,” he adds.
There are number of factors responsible for diabetes. According to Dr Razzak the one of the main reasons is sedentary life style. People are becoming inactive day by day. Remote-controlled gadgets have changed their lifestyle. Now they do not go near a TV to change the channel, they just press the button and switch to their favorite one. They do not walk as well. “Excessive consumption of fast food and cold drinks is causing obesity, which later on leads to diabetes.”
In the past the problem was not widespread. “Hardly three to four percent were diabetic a few decades ago. Now there is approximately 10 to 13 percent diabetic population in the country, which is the result of modern lifestyle.” “I fear that if all the population is tested, the percentage would be doubled,” adds the doctor.
Previously, the disease was common among people in their 50s or 60s. “But now we see patients suffering from the disease in their early 30s and 40s. And type 1 diabetes is also increasing among children as compared to the past,” says Dr Razzak.
The second reason is fast food. Three to four decades back, fast food and colas were not as widespread as they are nowadays. A person would get an opportunity to drink a soft drink in months. “But nowadays drinking two three cold drinks on daily basis is a normal practice. And same is the case with fast food as it is cheap and easily available,” he adds.
If the consequences of diabetes are seen in detail they include heart problems, blood vessels damage, eyes issues, kidneys and nerves dysfunctions. According to WHO 50 percent of people with diabetes die of cardiovascular disease (primarily heart disease and stroke).
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. According to WHO, one percent of global blindness can be attributed to diabetes. And it is among the leading causes of kidney failure too. The agency also warns that the overall risk of death among people because of diabetes is at least double from the risk of their peers without diabetes.
Although the nature of diabetes is terrifying but luckily it can be controlled. For this, some simple lifestyle measures can be effective in preventing or delaying the disease. “To prevent type 2 diabetes and its complications, patients should achieve and maintain healthy body weight and be physically active. “At least 30 minutes of regular, moderate-intensity activity five days a week is helpful in this regard,” says Dr Razzak. If a patient wants to control his weight then he requires more intense activity.
Besides exercise, food is also important and it should be healthy and balanced. “Eat healthy diet consisting of fruit and vegetables. Reduce sugar and saturated fats intake.” Make sure that you do not eat at once. Eat about three to five servings a day. “Tobaco use can increase the problem and lead to cardiovascular diseases. Quit as soon as possible,” warns the doctor.
After prevention comes treatment, which involves lowering blood glucose and the levels of other known risk factors that damage blood vessels. “People with type 1 diabetes require insulin; people with type 2 diabetes can be treated with oral medication, but may also require insulin at a later stage”. Blood pressure control and foot care are also necessary to control the problem.
According to Dr Razzak one must make sure screening and treatment for eye problems, cholesterol levels, and screening for early signs of diabetes-related kidney disease. These measures should be supported by a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use.