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18.11.2009 Health

Diabetes Reaching Epidemic Proportions — WHO

By Daily Graphic
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The World Health Organisation (WHO) maintains that diabetes is reaching epidemic proportions worldwide.

The disease currently affects 246 million people worldwide and is expected to increase to 380 million in the next 20 years. According to the International Diabetes Federation (IDF), the largest increases are expected to be in developing countries.

The disease, which was virtually unknown in Africa during the beginning of the 20th century, has however become devastatingly endemic in Africa today.

Anecdotal evidence suggest that many people die from diabetes complications before having the opportunity to be diagnosed, yet, there is a lot of undisputed evidence supporting the fact that with relatively small investments both from governmental and individual levels, diabetes can be controlled and even prevented through simple interventions.

The Greater Accra Regional Director of Health Services, Dr Irene Agyapong-Amarteyfio, in 2008, reportedly told the Ghana News Agency (GNA) that diabetes and hypertension had become public health problems in the region and have been ranked as the third most frequently reported disease in most district hospitals across the region.

This clearly demonstrates the need for tighter data collection within the health system to help target people with diabetes with interventions and monitoring to reduce or delay onset of complications and also to direct resources effectively.

The theme marking this year's Diabetes Awareness Day is “Diabetes Prevention and Education”, which involves a five-year campaign programme that calls on people with diabetes, as well as those responsible for its care to understand what the disease is and take control.

According to the IDF, for people with diabetes, this is a message about empowerment through education.

For governments, it is a call to implement effective strategies and policies for the prevention and management of diabetes to safeguard the health of their citizens.

For healthcare professionals, it is a call to improve knowledge so that evidence-based recommendations are put into practice.

For the general public, it is a call to understand the serious impact of diabetes and to know how to avoid diabetes and complications with delays.

All these link into the key areas of diabetes management: Self care, monitoring, effective treatment guidelines and education.

According to the WHO, there are two types of diabetes that is type one and two. In type one, the body's immune system attacks the insulin producing cells in the pancreas, so the pancreas cannot produce insulin. Insulin is the treatment of choice.

In type two, either the pancreas does not produce enough insulin or whatever it produces, the body cannot use it properly or a combination of both.

The type two on the other hand, is becoming more common due to the growing number of younger and older people who are overweight and do not exercise enough and eat unhealthy foods.

High levels of glucose in the blood is what gives the symptoms of diabetes. These are tiredness, thirst, weight loss, passing lots of urine day and night and infections such as boils, thrush that keeps recurring.

Although the disease cannot be cured, it can be controlled and according to the UK Department of Health, if controlled poorly, the high glucose levels can cause serious complications such as kidney damage, blindness, heart problems and poor circulation to the legs.

It, is therefore, very important that people who have diabetes make a serious and particular effort to keep their glucose levels (sugar levels) within the recommended targets.

Health education is a key tool for supporting people with diabetes to be able to manage their condition. However, studies had identified that communication between healthcare professionals and people with diabetes is poor.

Health professionals should therefore, use communication tools specific for individuals to help them understand the seriousness and potential complications of diabetes.

The type two on the other hand and its complications are largely preventable. With good management from health professionals and increase level of involvement from people, there is no reason why people with diabetes cannot live a normal life, albeit a little restrictive.

Exercise can regulate blood glucose levels, help with weight reduction and help your body to use the insulin it produces effectively.

It can also help to reduce ones blood pressure and cholesterol levels. Evidence suggests that cumulative exercise is beneficial and every little counts.

Walking briskly, doing housework, dancing, taking up a sport such as tennis, football, basketball and any activity that will increase your heart rate are all innovative exercise that promotes healthy living in diabetic patients.

Due to westernisation, adulteration of culture and improvement in income generation levels, the trend of eating 'posh' foods, which are usually saturated with fats, salt and sugars are on the increase.

Fast foods and eating out is also on the increase and in some of these food avenues, providing healthy meals may not be their priority. There needs to be education on food, their caloric values and the recommended intake, as part of dietary education.

Access to oral medication is improving with the introduction of the National Health Insurance Scheme but there is limited choice of insulin types and devices to administer them.

Having access to devices and self monitoring equipment and knowing how to use them, will help to improve compliance with medication prescribed.

People should be given explanation on how their medication works and what to do if they have side effects such as low blood sugar levels. It is important that all medication prescribed are taken as directed.

People should be encouraged not to stop taking their medication, unless they have checked with their doctors.

It is also very important to educate people to tell doctors if they are taking any native medicines as a lot of the time, these can interfere with orthodox medication.

Many people with type two diabetes may start with tablets but as the disease progresses; some people might need insulin.

Careful explanation need to be given to people on why they need to have insulin and preparation should be started when there is an indication of poor control with maximum oral therapy.

This will give people time to ask questions and to express any anxieties. There are a lot of misconceptions about insulin and this can stop people engaging with their care.

The incidence of type two diabetes is increasing due to increased levels of obesity, reduced physical activity, a lack of awareness of the disease, its progression and severe complications.

People with the disease need knowledge and information about their condition, treatment and lifestyle changes that will help control or delay complications.

There is the need for sufferers to engage stakeholders in devising strategies for prevention and management of diabetes.

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