DO YOU KNOW ANYONE WHO IS DIABETIC?
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.
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.
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.
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.
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.
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
IDF Diabetes Atlas 6th Edition 2013
IDF Prevention Consensus Alberti et. al 2007
Contact us on firstname.lastname@example.org
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