Diabetes- More worries for health experts as new type sets in

Sep 20, 2009

AS a child, you were flogged for licking sugar. For adults, “don’t eat a lot of sugary and oily stuff, or you will catch diabetes,” is a common phrase. For ages, diabetes has been associated with lifestyle.

By Joel Ogwang
AS a child, you were flogged for licking sugar. For adults, “don’t eat a lot of sugary and oily stuff, or you will catch diabetes,” is a common phrase. For ages, diabetes has been associated with lifestyle.

And until recently, it has been a ‘rich-person’s disease’ because it is they that regularly afford ‘junk’ foods that lead to obesity.

According to Prof. Andrew Otim, the Uganda Diabetes Association chief.
“When a person gets a fairly well paying job, they start eating ‘well’ to compensate for the lost time, Otim says.

Statistics in Uganda
Diabetes has taken a sky rise over the years. In 1972, only 254 people were diagnosed. They all sought treatment and counselling from Mulago Hospital.

But according to World Health Organisation (WHO), the number had risen to 80,000 people in 2000.

This figure then rose to 560,000 people by 2006, while another 560,000 patients did not know they were diabetic.

Currently, there are 1.5 million diabetic Ugandans. Consequently, the number of centres handling diabetic cases countrywide have risen from one to over 10.

A total of 18 million people, suffer from the disease in Africa, according to WHO.

Dr. Meredith Hawkins, the global diabetes initiative director at Albert Einstein College of Medicine, New York, says 170 million people are suffering from diabetes globally.

“This figure is set to climb to 370 million by 2050 if it (diabetes) is not granted the attention it deserves,” Hawkins says.

But what is diabetes?
Diabetes means one’s blood glucose, or blood sugar is high. Diabetes mellitus, though, is a group of metabolic diseases characterised by chronic high blood sugar, resulting from defects in insulin secretion, insulin action or both.

It is associated with acute complications. The disease occurs when small blood vessels leak, affecting the eyes, kidneys, feet, nerves brains and blood vessels.

It occurs when the pancreas fails to make insulin, a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in the blood.

Over time, high blood glucose can seriously affect the heart, eyes, kidneys, nerves, gums and teeth.
It blocks or bursts the large blood vessels, affecting the normal functioning of the brain, heart and legs.

Categories of diabetes
There are three types. Type 1, 2 and gestational diabetes that affects youngsters and teens, adults and women expecting respectively.

Type I results from destruction of the pancreatic beta cells. Here, insulin is required for survival. Type 2, also called adult-onset that accounts for 90% of diabetes cases, results largely from too much sugars in the body that may accrue from eating fatty foods and less active lifestyles.

“About 70% of people who suffer from Type 2 are either overweight or obese,” says Hawkins.

Obesity, a major component of the metabolic syndrome, increases morbidity and mortality from type 2.

Type 3 is recognised for the first time in pregnancy. Otim says: “If left untreated, diabetes can lead to loss of sight, amputations, impotence and eventual death.”

New type is worse
While type 2 diabetes has high morbidity, it is type 3 that is worrying.
The disease, also called malnutrition diabetes, is predominant in sub-Saharan Africa.

Hawkins says: “I thought only overweight people suffer from diabetes, it is prevalent even in skinny poor people.

It presents itself much like type 1. Its cause is still unclear, but stress and poverty have been pointed out as factors for its cause.

This has raised concern among local health gurus, considering that 31% (9.3 million) of Ugandans live below the poverty line.

Dr. Fred Nakwagala, an endocrinologist at Mulago Hospital, says type 3 results from destruction of the pancreas due to drugs, cancer, HIV/AIDS and trauma: “People who have high cassava diet and protein deficiency are likely to suffer from it.”

Signs of diabetes
Being very thirsty
Urinating often
Feeling very hungry or tired
Weight loss
Slow healing sores
Dry, itchy skin
Having tingling feet
Blurry eyesight

In Uganda, 100 doctors and nurses from 20 clinics recently converged to deliberate on growing diabetes cases, its social and economic impact, treatment options and behavioural changes patients need to undertake.

The clinical diabetes conference that took place at Mukono Zonal Agricultural Research and Development Institute attracted local and international health gurus.

The International Diabetes Federation chief, Dr. Silver Bahendeka, says diabetes was growing at 93% up to 2010.

Managing diabetes
Eat three meals a day, with the diet based on traditional eating habits

Avoid animal fat, salt, ‘diabetic foods,’ pure sugars in foods and drinks

Food quantities must be measured in volumes using available household items like cups

Avoid alcohol. Sweeteners are not essential but may be used without concern for their safety

Do regular physical activity like jogging and skipping. It improves metabolic control, increases insulin sensitivity, cardiovascular health and weight loss.

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