Category Archives: Diabetes Education

Uncontrolled Diabetes and its Complications

Uncontrolled Diabetes and its Complications

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 Uncontrolled Diabetes and its complications

If blood sugar is consistently high, over time it can affect the heart, eyes, kidneys, nerves, and other parts of the body. Most people living with uncontrolled diabetes don’t realize that they have a higher chance to suffer from certain conditions until the symptoms begin to manifest.

These other conditions that manifest along side diabetes are often referred to as Complications of diabetes.
Factors that increase the risk of developing complications include: Excessive alcohol intake, Smoking, Obesity, Lack of regular exercise.   Uncontrolled diabetes affects many major organs, including the heart, blood vessels, nerves, eyes and kidneys and when this occurs, it can lead to certain conditions such as: Heart diseases and Stroke; Retinopathy and Eye complications; Kidney Diseases; Foot ulcers and Infections.

Other diabetes related conditions are: skin infections, sores and itching; dental diseases e.g. Gingivitis, periodontitis; Dementia and depression, hearing loss etc.

Uncontrolled Diabetes and the respiratory system:
The effects of protective proteins on the surface of the lungs are neutralized leading to a higher risk of influenza, pneumonia, tuberculosis.

Uncontrolled Diabetes and the Genitourinary system:
Women with Uncontrolled diabetes are said to face a higher risk of urinary tract infections and these are relatively more difficult to treat.
Relationship between Uncontrolled Diabetes and certain heart conditions:

The term “Diabetic Heart Disease” (DHD) refers to heart disease that develops in people who have Uncontrolled diabetes. Examples of heart conditions involved in DHD include: Diabetic Cardiomyopathy (enlargement of the heart muscles) , Heart failure (a condition in which the heart fails to function as a pump), Coronary Heart disease (narrowing of the blood vessels that supply oxygen rich blood to the heart) etc.

Effect on blood vessels and nerves:
Damage to blood vessels that nourish nerves causes tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers.

Effect on the kidneys:
Uncontrolled diabetes can damage the delicate filtering system of the kidneys and can lead to kidney failure or irreversible end-stage kidney disease.

Effect on the eyes:
Diabetic retinopathy potentially leads to blindness and increases the risk of other serious vision conditions such as cataracts and glaucoma.

Effect on the skin, gums, feet and other organs:
Uncontrolled Diabetes may leave one more susceptible to skin problems, including bacterial and fungal infections. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications e.g. blisters and serious infections.

Gum infections also may be a concern, especially if you have a history of poor dental hygiene. Uncontrolled diabetes may also lead to lower than normal bone mineral density, increasing the risk of osteoporosis.

The complications of diabetes are far less common or severe in people who have well controlled blood sugar levels and blood pressure. The good news is that the risk of developing complications is greatly reduced by healthy eating, regular physical activity, well controlled Blood Pressure, reduced stress etc.

It is also very important to follow your treatment plan for diabetes and see your doctor for ongoing care. For those who already suffer from Diabetes related conditions, follow the treatment plan as is advised by your healthcare providers.
This may help avoid or delay further serious problems.

This Article is written by Ella Awele Nwaokolo a student of medicine and surgery of the Olabisi Onabanjo University Teaching Hospital, Ogun State, Nigeria.

To be a guest blogger on the Nigeria diabetes online community blog kindly send your articles to us on thengdoc@gmail.com , follow us on @theNGdoc and like our Facebook page

DO YOU KNOW ANYONE WHO IS DIABETIC?

DO YOU KNOW ANYONE WHO IS DIABETIC?

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Did you answer the question above?  Well, I asked this same question in a gathering of about 150 youths I had the opportunity to address some couple of months back. Surprisingly, almost all of them knew someone who is diabetic; parent(s), relatives, neighbours etc. Some had family members who had died of diabetes. A second question then followed, WHAT DO YOU KNOW ABOUT DIABETES? The second question had only a few respondents. Most of the respondents had inadequate knowledge of the disease.

Diabetes affects all age groups. The 3 most common types of DM are:

  • Type 1 DM (affects young individual)
  • Type 2 DM (affects all age groups but more common between 40 and 50 years)
  • Gestational diabetes (seen in pregnancy)

The classical symptoms of DM include: excessive thirst (polydipsia), excessive urination (polyuria), excessive eating (polyphagia) and weight loss. However, majority of cases of DM could be asymptomatic and clinical features may be manifestation of complications like diabetic ketoacidosis (DKA), retinopathy, nephropathy, neuropathy, leg ulcer, stroke among others.

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According to the International Diabetes Federation (IDF) diabetes atlas, sixth edition published in 2013, 382 million people have diabetes globally and about 175 million others are undiagnosed.

1 in 20 adults are diabetic. $548 billion in health expenditure was spent on diabetes care globally (11% of total budget on health). In 2013 alone, more than 21 million live births were affected by the disease. The world population is currently about 7.2 billion. This means 5.3% of the entire world population is diabetic. About 5.1 million diabetes-related deaths occurred in 2013 representing 8.4% of global all-cause mortality.

Currently, an estimated 19.8 million adults in Africa have diabetes – a regional prevalence of 4.9%. Nigeria has the highest number of people living with diabetes in Africa (3.9 million) and about 1.8 million cases are undiagnosed.

An estimated 522,600 people in the Africa died from diabetes-related causes in 2013. 105, 091 of these occurred in Nigeria. 76% of deaths due to Diabetes Mellitus in Africa occur before age of 60 years.

Comparatively, 35.3 million people have HIV/AIDS worldwide and annual death of 1.1 million was recorded in 2012. The prevalence of HIV/AIDS is also on the decline.

Another question then arises, why is there no attention on DM that is 11 times as prevalent globally as HIV/AIDS and causes 3 times more deaths as HIV/AIDS; and why is it not given the same or more attention than HIV/AIDS? Diabetes is indeed a SILENT KILLER.

 

WHAT CAN BE DONE?

There is clearly growing evidence that earlier detection of people with Impaired Glucose Tolerance and others at high risk, followed by interventions to delay or prevent Type 2 diabetes and improve glucose control, can result in clinically important reductions in the incidence of diabetes, its complications and co-morbidities.

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How do you know if you are high risk? A simple and available option is to take advantage of the several screening programs organised by different advocacy groups.

A second option is to use one of the several questionnaires available e.g Finnish Diabetes risk score. It is simple and can be self-administered.

Good control of the modifiable risk factors is also important and they include:

Obesity (central and total)

Obesity is the most important single risk factor for Type 2 diabetes. The WHO estimates that there are currently 1.1 billion people who are overweight and expect this total to rise to over 1.5 billion by 2015. Studies have shown obesity to be a powerful predictor of Type 2 diabetes development.

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Conscious efforts must be made at maintaining a weight appropriate for age and height. Body Mass Index is a good tool at determining if you are overweight or obese.

The incidence of obesity is increasing worldwide in the developing countries. Consequently the incidence of Type 2 DM is also on the increase in the lower age groups.  Furthermore, interventions directed at reducing obesity also reduce the incidence of Type 2 diabetes.

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Physical inactivity

Physical activity levels have decreased over recent decades in many populations, and this has been a major contributor to the current global rise of obesity. Physical inactivity has been found, in both cross-sectional and longitudinal studies, to be an independent predictor of Type 2 diabetes. For equivalent degrees of obesity, more physically active subjects have a lower incidence of diabetes.

Brisk walking for about 30 minutes daily is the minimum activity expected of an individual.

 

Nutritional factors

Much uncertainty still surrounds the dietary factors involved in developing diabetes, partly because of the difficulty in collecting accurate dietary data. Nevertheless, some of the more consistent messages indicate that a high total calorie and low dietary fibre intake, a high glucose load and a low polyunsaturated to saturated fat ratio (junks, fries etc.) and may predispose to the disease.

 

WHAT WILL HAPPEN IF WE DO NOTHING?

If the current trends continue, by 2035, some 592 million people, or one adult in 10 will have diabetes. This equates to approximately three new cases every 10 seconds or almost 10 million per year. The largest increases will take place in the regions where developing economies are predominant this includes Nigeria. Global health spending on diabetes was estimated to be at least $581 billion in 2013 and $678 billion by 2035. An estimated average of USD 1,437 per person was spent globally on treating and managing the disease in 2013.

 

If you are currently above 16 years, these projections points directly at you as you will be close to or above your 40th birthday by 2035 (the peak age range for developing type 2 diabetes). The good news however is that if the prevention strategies above is adhered to the prevalence of diabetes can be reduced by as much 42% as supported by several studies.

Remember, maintaining a healthy eating habit, regular exercises and keeping your weight in check will reduced significantly your chance of having the disease. Join the fight against. diabetes today.

You may not know anyone who is diabetic now. But if we do nothing, that may not be the case in 2035.

Let us UNITE AGAINST DIABETES

 

References

IDF Diabetes Atlas 6th Edition 2013

IDF Prevention Consensus Alberti et. al 2007

www.who.int

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Join the Nigeria Diabetes Online Community on twitter @theNGdoc and visit our website and blog www.ngdoc.com and www.ngdocblog.com respectively for more information.

‘bolaji B. Dauda

DIET

DIET

A diabetes diet is simply a healthy eating plan that is high in  nutrients, low in bad fat and moderate in calories. It is a healthy diet for anyone! The only difference is the need to pay more attention to some of the food choices most notably the carbohydrates eaten.
Eating right is vital when trying to prevent or control diabetes. While exercise is also  important, what is eaten has the biggest impact when it comes to weight  loss. Its important to note that nutritional needs are virtually the same for  everyone else as for PWDs, no special foods or complicated diets are  necessary.
excercise

Speaking of carbohydrates being part of the notable choice we eat; Carbohydrates have a big impact on blood sugar levels more than fats and protein but its not always necessary to avoid them.

Its always good to be smart about what type of carbohydrate taken.  It is best to limit highly  refined carbohydrates like white bread, rice, snack foods, carbonated  drinks, candy e.t.c; focusing on high-fibre complex carbohydrates (also  known as slow-release carbohydrates) instead.
Slow-release carbohydrates  help keep blood sugar levels even because they are digested more slowly, thus preventing the body from producing too much insulin. They also provide lasting energy and help stay full longer.

 

FOOD TIPS FOR DIABETES DIET

1. Instead of of highly refined carbohydrates, try these high-fibre options:  Non-starchy vegetables, beans and fruits such as apple,pears, peaches, berries, bananas, mangoes e.t.c. Grains in the least processed state possible such as brown rice, white barley, millet, wheat berries e.t.c

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2. Limit concentrated sweets – including high calorie foods with a low  glycemic index, such as ice cream.  Reduce fruit juice to no more than  one cup a day.
Avoid sugar sweetened drinks.
3. Eat a healthful type of protein at most meals such as beans, fish, skinless chicken e.t.c.
4. Choose foods with healthy fats such as olive-oil, nuts (almond, walnuts and avocados).
Limit saturated fats from dairy and other animal products like cheese, yoghurt etc.
5. Completely avoid partially hydrogenated fats (Trans-fat), which are usually found in fast foods and many packaged foods.
6. Have complete three meals a day (do not skip breakfast).
7. Eat slowly and stop when full. Having Diabetes does not mean  eliminating sugar. If you have diabetes, you can still enjoy a small  serving of your favourite dessert now and then.
The key to it is MODERATION.
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But maybe you have a sweet tooth and the thought of cutting back on sweets sounds almost as bad as cutting them out together.

The good news about diet is that cravings do go away. The more your habits become healthier, the more the food you seem to love becomes too rich or too sweet and you may find yourself craving healthier options instead

This Article is written by Damilola Shobiye a Student of Nutrition and  Dietetics from Babcock University, Ilishan-Remo, Ogun State, Nigeria.
To be our Guest Blogger on the nigeria diabetes online community kindly  send your article to us on thengdoc@gmail.com, follow us on @theNGdoc and like our facebook page

HEALTH AND POLITICS

HEALTH AND POLITICS

Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person’s mind and body, usually meaning to be free from illness, injury or pain.

The World Health Organization (WHO) defined health in its broader sense in 1946 as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
World Health Organization
World Health Organization

 

Health is of major concern to nations of the world. WHO and the member states strive hard to ensure this is achieved across board.  A major WHO goal is to improve equity in health, reduce health risks, promote healthy lifestyles and settings, and respond to the underlying determinants of health.
This among others are the goals expected to be followed by member states and organizations.

A meeting with Prof. Cees Th. Smit Sibinga was a real eye opener as we discussed the problems faced by developing nations and africa as a continent.
Prof Sibinga is a WHO expert involved in international short term consulting missions; medium and long term projects focused on the development of Transfusion Medicine in economically restricted countries in Asia, Eastern Europe, Central Asia, Africa, Western Pacific and the Middle East.
Prof. Cees Th. Smit Sibinga and I
Prof. Cees Th. Smit Sibinga and I

A lot has been invested in terms of resource on health in the continent with little impact and Africa being a toast of many investors has to be self motivated towards adequate care especially in health for her citizens.

Our focus of discussion centered around blood transfusion practices in Africa (His area of expertise) and diabetes (my passion ),we realized that so much needs to be done to step our health practices up to conform to international standards especially in Nigeria.

Nigeria is a large country with great prospect and promising health policies but implementation has been a major hindrance to quality health care delivery.
The World Health Organization’s activities deals directly with member nations and organizations hence whatever agreement signed at the World Health Assembly is binding on all member nations and as such must be implemented, likewise any feedback given by the member nations must reflect the true state of health affairs in the member country as that would be the blue print guiding WHO activity in such country.

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So what happens inbetween agreements, implementation and feedback: The Politics of Health;

So many questions ranging from if the Member nations especially developing countries abide by the  agreements signed at the World Health Assembly; if they give the true state of health in their respective countries as a feedback to WHO?
These questions are endless but from the few minutes interaction with Prof Sibinga i realized that the problems are not as cumbersome as thought and the solution is within reach.

Prof Sibinga said: “When you vote, you exercise your authority not just to choose your favorite candidate to govern your affairs for a particular period but also to represent your interest within that same period’
So, it is not just in us as individuals or as a nation to vote for personalities we love or adore but we also need to vote for policies and adequate representation especially in health care delivery across board.

It is imperative to note that once we are misrepresented at the international level as against the true state of health affairs or when policies end only on the papers then we need not scream isolation by the international community when in real truth the world can only help those willing to help themselves.
Interesting to note is that topmost on the agenda at this year’s world health assembly is Non Communicable diseases (click here) among which is Diabetes which has affected over 347million people worldwide (about 50% of those with diabetes are yet to be diagnosed; More than 80% of diabetes deaths occur in low- and middle-income countries; WHO projects that diabetes will be the 7th leading cause of death in 2030)

With all these knowledge at our fingertips it is important for all stake holders and health advocates to rise to the challenge of ensuring that proper health care policies and delivery are achieved at all levels of governance.
This is a clarion call to all health advocates especially at community level to also encourage the people to in addition to voting for personalities also consider policies that will make their health better and more secured.

We believe all governmental administrative structures from the community to national heads must be filled with people who stand for policies that will better the health and lives of the people
With this evolutionary mind set in view and in place we believe the African health care system will become more proactive.