Diabetes: Rising epidemiological transformation
ACCORDING to International Diabetes Federation, Diabetes Mellitus (DM) is a metabolic disorder involving raised blood sugar level. Currently, it is turning out to be a major health problem prevalent all over the world, equally affecting both urban and non-urban population. However, an increased prevalence of Diabetes has been observed in most of the Asian, African and developing countries, due to lack of awareness, poor health facilities and unhealthy lifestyle. This could result in long-term negative consequences for any country’s health and economy. Therefore, diabetes is becoming more common across the world at an alarming rate.
Worldwide, it has affected 425 million people aged 20-80 years, and 451 million aged 30-90 years as reported in a study of 2017. It has been generally observed that 60% of the masses have inadequate knowledge of diabetes while 50% of them have a family history. The most concerning trend is the recent shift in the age group of diabetics at younger age, over the last three decades and anticipated to climb further by 2025, unless immediate preventive measures are not taken by the population., as it is the driving factor behind the diabetic epidemic through improper and disorderly lifestyle.
There are many factors like increased urbanization, sedentary lifestyles, lack of exercise, nutritional transition from simple home-made to junk foods, high in sugar and saturated fats, referred as western-style diet. Certain other risk factors are also associated like genetics, family history, obesity and hypertension. Today, the medical profession fears that the global number of diabetes may increase by 48% from 2023 to 2045. The International Diabetes Federation (IDF) has currently observed that there were 4.0 million deaths worldwide. However, diabetes is not a curable or a reversible disease, found 8.8 % in the world population and it is feared that the incidence is likely to rise in future especially in low and middle-income countries, where mortality results from unmanaged blood glucose, increased complications from cardiovascular and kidney diseases.
The classic symptoms are weight loss, increased urination, thirst and hunger. Symptoms may develop rapidly in type 1 diabetes, and slowly in type 2 diabetes. St. Vincent Declaration was adopted in 1989 to improve the care of diabetics and quality of life expectancy. Many people with type 2 diabetes have evidence of being pre-diabetic and the progression can be slowed or reversed through improved insulin sensitivity and liver function for glucose. Formerly, it was thought that diabetes is a benign condition affecting the elderly only, but now it has been proved that diabetes is a leading illness and mortality equally amongst the young and old.
DM has several categories, including type 1 (Juvenile Diabetes) and type 2 in adults (metabolic or hormonal disorders). The commonest treatment for type 1 diabetes is insulin replacement therapy and medication in both types, with lifestyle modifications, with strict professional advice by your family doctor. Diabetics are advised to completely follow the guidelines regularly and should not use any medication at his/her own, or by some other diabetic patient, may be a friend or a relative as there is every possibility he/she may land into complications. It is most ethical that only a professional medical man is authorized to treat a diabetic patient. However, gestational diabetes in pregnancy normally resolves shortly after delivery.
In fact, diabetes is a most challenging disorder and simple control of blood sugar will prevent this debilitating condition, otherwise it may progress to full blown complications leading to gangrene of the extremities, which needs amputation in some cases. However, it can be easily prevented by changing lifestyle and using diabetic diet, rich in whole grains and fibers, using good fats, found in nuts, vegetable oils, fish, and avoiding tobacco smoking. It will certainly reduce the risk of developing diabetes, especially with the genetic family history (gestational diabetes. Hence, awareness and prevention are the only measures to be enforced by the communities, which is an important part of the healthcare system. Today, the rapid epidemiological transformation is strongly linked with the changes in eating habits.
In summary, it is important to detect diabetes in humans through regular blood and urine examination in order to avoid or delay the onset of diabetes in young and old, especially in children. The purpose of these guidelines is to advise the family physician and the patients, how to manage the treatment. Avoiding a rich diet, full of fats and nutrients, with lack of exercise, reduced sleeping periods, over-eating, smoking, increased alcohol consumption, and indiscriminate use of drugs without medical guidance is the key to obviate the dis-orderly way of life.
For the interest of our readers, even the animals suffer from diabetes, most commonly in dogs and cats, especially in females. All breeds are equally affected, particularly the small breeds, such as Miniature Poodles, Burmese, Russian Blue, Abyssinian, and Norwegian Forest cat breeds are at a higher risk than other breeds, strikingly similar to human type 2 diabetes. Overweight cats are specially at higher risk, but the long-term complications as recognized in humans are much rarer in animals. The American Diabetes Association released guidelines in case of acute illness of domestic animals in the absence of classic symptoms.
—The writer is a former Registrar of Pakistan Nursing Council, Islamabad and specialized in the field of Nursing Care, especially in diabetics.
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