World
Diabetes Day is celebrated every year on November 14. The Day was created in
1991 by the International Diabetes Federation and the World Health Organization
in response to growing concerns about the escalating health threat that
diabetes poses. It became an official United Nations Day in 2007 with the
passage of United Nation Resolution 61/225. The campaign draws attention to
issues of paramount importance to the diabetes world and keeps diabetes firmly
in the public spotlight. World Diabetes Day is celebrated worldwide by the over
200 member associations of the International Diabetes Federation in more than
160 countries and territories, all Member States of the United Nations, as well
as by other associations and organizations, companies, healthcare professionals
and people living with diabetes and their families.
The World Diabetes Day campaign is led by the International Diabetes Federation
(IDF) and its member associations. It engages millions of people worldwide in
diabetes advocacy and awareness. The International Diabetes Federation chooses
new theme by each year to address issues facing the global diabetes community.
Diabetes Education and Prevention is the World Diabetes Day theme for the
period 2009-2013. Activities organized each year include, Radio and television
programmes, jingles and promos, Sports events, Free screenings for diabetes and
its complications, Public information meetings, Poster and leaflet campaigns,
Diabetes workshops and exhibitions, Press conferences, Newspaper and magazine
articles, Events for children and adolescents, etc.
Diabetes is a group of
metabolic diseases in which a person has high blood sugar,
either because the pancreas does not produce enough insulin,
or because cells do not respond to the insulin that is produced. This high
blood sugar produces the classical symptoms of polyuria
(frequent urination), polydipsia (increased thirst) and polyphagia
(increased hunger). Basically, there are three main types of diabetes. The
first results from the body's failure to produce insulin, and requires the
person to inject insulin or wear an insulin pump. The second results from insulin resistance, a condition in which cells
fail to use insulin properly, sometimes combined with an absolute insulin
deficiency. And the third form, occurs when pregnant women without a previous
diagnosis of diabetes develop a high blood glucose level.
All forms of
diabetes increase the risk of long-term complications. These typically develop
after many years (10–20), but may be the first symptom in those who have
otherwise not received a diagnosis before that time. The major long-term
complications relate to damage to blood vessels.
Diabetes could also double the risk of health complications, which include
affecting blood vessel formation in the retina of the
eye that can lead to visual symptoms, reduced vision, and potentially blindness.
Diabetes also has impact on the kidneys,
which can lead to scarring changes in the kidney tissue, loss of small
or progressively larger amounts of protein in the urine, and
eventually chronic kidney disease that may lead to dialysis.
It also impacts the nervous system, most commonly causing
numbness, tingling and pain in the feet and also increasing the risk of skin
damage due to altered sensation. Together with vascular disease in the legs,
neuropathy contributes to the risk of diabetes-related
foot problems (such as diabetic foot ulcers) that can be difficult to
treat and occasionally require amputation.
Causes of diabetes are partly inherited or due to lifestyle factors. The
inherited diabetes is usually triggered by certain infections. A genetic
element in individual susceptibility to some of these triggers has been traced
to particular genotypes
which are described as self" identifiers relied upon by the immune system.
However, even in those who have inherited the susceptibility, the disease seems
to require an environmental trigger. The second type is unrelated to genes but lifestyle
factors due to obesity,
diet, physical inactivity among others.
In recent years,
there has been a dramatic increase in diabetic cases around the world, despite
the intensified effort on education and preventive measures regularly promoted
by the relevant associations to mitigate the scourge of the disease. According
to Williams Textbook
of Endocrinology survey, globally as of 2010, an estimated
285 million people had diabetes, with type 2 making up about 90% of
the cases. Its incidence is increasing rapidly, and by 2030, this number is
estimated to almost double, based on research findings released by Wild S, Roglic G, Green A, Sicree R, King H in 2004 in their
research titled "Global Prevalence of Diabetes: Estimates for the year
2000 and projections for 2030”. Even though this projection may pose some technical
questions, but the fact remains that the global prevalence of Diabetes is on the increase. As at
the end of 2011, the International Diabetes Federation (IDF) published that 366
million persons are living with this disorder and that if nothing is done, this
figure could rise to 540 million in the near future.
The
menace of Diabetes is more common
and prevalent in the more developed countries. According to a survey in 2010, almost
one Chinese adult in ten has diabetes. The study estimated that more than 92
million Chinese adults have the disease, with another 150 million showing early
symptoms, based on a report broadcasted by BBC on March 25th, 2010.
Similarly, the report indicated that the incidence of the disease is increasing
rapidly; a 2009 study found a 30% increase in 7 years. For at least 20 years,
diabetes rates in North America have been increasing substantially. In 2010,
nearly 26 million people have diabetes in the United States, of whom
7 million people remain undiagnosed. Another 57 million people are
estimated to have prediabetes, based on a survey by the Centers for Disease Control and
Prevention(CDCP).
According to other
researches, the greatest increase in prevalence is, however, expected to occur
in Asia and Africa, where most patients will probably be found by 2030. A
research conducted by Gale, Jason in November, 2010 titled
"India’s
Diabetes Epidemic Cuts Down Millions Who Escape Poverty" and
taken on Bloomberg, the
disease affects more than 50 million Indians, equivalent to 7.1% of the
nation's adults, and that the disease kills about 1 million Indians a year. The
increase in incidence in developing countries may not be unconnected to the
trend of urbanization and lifestyle changes, perhaps most importantly a
"Western-style" diet.
In
Nigeria, Six million Nigerians are estimated to be living with diabetes while
deaths associated with the disease are projected to increase by 52% by the year
2015. This statistics was revealed by Erdoo Apeh, who is the Brand Development
Manager of DeeDoo Nigeria, Pharm. on Sunday 15th November at a news
conference, as part of the organization’s activities to mark this year’s World
Diabetes Day Awareness Campaign. Apeh added that The World Health Organization
(WHO) has estimated that about 6 million people are reported to be affected
with diabetes while six in every 10 Nigerians are at risk of having the disease
because of their life style, eating habits and nonchalant attitude towards
comprehensive and routine medical checkups. Corroborating Mr., Apeh’s statistics, the Health Reform Foundation of
Nigeria (HERFON), had also declared that diabetes is likely to cause more
deaths than imagined in Nigeria. The body said it is a major cause of deaths
arising from non-communicable diseases (NCDs). The foundation also declared in
a projection that death through diabetes in Nigeria will account for 52 percent
in 2015.
The good news however, is that all forms of diabetes have been treatable
since insulin
became available in 1921, and type 2 diabetes may be controlled with
medications. But both types 1 and 2 are determined as chronic, which cannot be cured except in very
specific situations. Management concentrates on keeping blood sugar levels as
close to normal as possible, without causing hypoglycemia is another form of
treating the disease. This can usually be accomplished with diet, exercise, and
use of appropriate medications (insulin in the case of type 1 diabetes,
oral medications, as well as possibly insulin, in type 2 diabetes).
To be able to tackle the dangerous trend of this killer disease, patient
education, understanding, and participation is very vital, since the
complications of diabetes are far less common and less severe in people who
have well-managed blood sugar levels. Attention should also be paid to other
health problems that may accelerate the deleterious effects of diabetes. These
include smoking, elevated cholesterol levels, obesity,
high blood
pressure, and lack of regular exercise.
According to The Diabetes
Prevention Program (DPP), a major federally funded study of
3,234 people at high risk for diabetes, showed that people can delay and
possibly prevent the disease by losing a small amount of weight (5 to 7 percent
of total body weight) through 30 minutes of physical activity 5 days a week and
healthier eating.
As a preventive measure
it is advised that anyone aged 45 years or older should consider getting tested
for diabetes, especially if you are overweight. If you are younger than 45, but
are overweight and have one or more additional risk factors
(see below), you should consider getting tested. To reduce the
spread of the disease, there are roles for patient education, dietetic support,
sensible exercise, with the goal of keeping both short-term and long-term blood
glucose levels within acceptable bounds. It is therefore
important to intensify awareness creation among the public that every person should see it as a
duty on their part to ensure responsible living and lifestyle
modifications. This is a
huge responsibility on the part of Government and individuals involved in
Diabetes work to double effort.
Apart from awareness creation, governments and instituted authorities have other
crucial roles to play in reducing the risk of the spread of diabetes in the
world. Countries that are concerned about their citizens already have
programmes and policies to that effect. For instance The United Kingdom has
predicted that the National Health Service could be spending
as much as 16.9 billion pounds on diabetes mellitus by 2035, a figure that
means the NHS could be spending as much as 17% of its budget on diabetes
treatment by 2035. Therefore, Nigeria among other countries should take cue
from UK’s effort.
It would be recalled that in September of 2011, there was an extra ordinary meeting of the United
Nations General Assembly where Diabetes was considered along with other non
communicable diseases as a global challenge. The President of Nigeria was in
attendance, but since then, we have not noticed any action being coordinated by
the Government to address the challenges of diabetes in Nigeria.
Therefore, it is
imperative for the government through the Ministry of Health to immediately
collaborate with Diabetes Association of Nigeria (the umbrella body of all
groups handling Diabetes) to implement some modern techniques introduced by
International Diabetes Federation like Diabetes Conversation Map Education
Program, which is currently in use in over 160 countries of the World who are
members of IDF. Introduce Guidelines for Diabetes management to public and
private hospitals in Nigeria in order to have uniform standards of
practice and care. It is also important that all non-governmental
organizations working in the area of Diabetes to complement such efforts so as
to have documented evidence for statistical records, awareness creation, as
well as bringing about effective networking among healthcare providers and
persons living with Diabetes in Nigeria. The work ahead for everyone involved
in Diabetes care and advocacy in Nigeria is enormous. Other Countries have gone
far, we seem not to have started, but it is possible to still create an impact
before the year 2020, to reduce our estimated prevalence rate.