Afoke Isiavwe
7 November 2009
Lagos — On the 14th of November the world will be celebrating the world diabetes day. This date was set aside by the United Nations and marks the birthday of Frederick Grant Banting, the man who in 1921 discovered insulin - a medication used for treating diabetes, along with his assistant medical student Charles Best. It is important to note that this landmark discovery forever positively changed the outcome of people living with diabetes.
The world diabetes day is the primary global awareness campaign for diabetes. Diabetes Education and Prevention is the World Diabetes Day theme for the period 2009-2013. The campaign slogan for 2009 is "Understand Diabetes and Take Control". Simply defined diabetes mellitus (DM) is a condition in which the body cannot properly handle glucose. This results in abnormally high blood levels of glucose (hyperglycaemia).
There are 4 main types of diabetes; type 1, type 2, gestational diabetes and other specific types. Over 85% of people with diabetes have type 2 diabetes. The epidemic of type 2 DM is fueled by obesity, inactivity and ageing. If not properly managed, diabetes can give rise to several complications, both immediate and long-term complications. The warning signs of diabetes include frequent urination, excessive thirst, weight loss, tiredness, increased hunger, lack of interest and concentration, vomiting and stomach pain, blurred vision, frequent infections e.g. recurrent boils, slow wound healing, numbness or tingling sensation in the feet or hands.
It is however important to note that these signs can be mild or absent in people with diabetes leading to delay in diagnosis. For now type 1 DM is not preventable, but type 2 DM can be prevented by a healthy diet and lifestyle, an appropriate body weight and increased physical activity. Studies in the US, Finland and China have demonstrated that these lifestyle changes are more effective in preventing type 2 diabetes in at risk people compared to the use of medications. According to the International Diabetes Federation (IDF) the last thirty years have seen a rapid increase in type 2 diabetes. In 1985, an estimated 30 million people worldwide had diabetes, a little over a decade later; the figure had risen to over 150 million.
According to latest IDF figures, Some 285 million people worldwide will live with diabetes in 2010. Unless action is taken to implement effective prevention and control programmes, IDF predicts that the total number of people with diabetes will reach 380 million by 2025. Worse still it is estimated that the majority of new cases of type 2 diabetes will be in the developing world and this is of major concern for Africa and Nigeria The increase in type 2 diabetes can be attributed to changing lifestyles in developing countries due to adoption of an unhealthy eating pattern, rising rates of physical inactivity, obesity and urbanization.
At the heels of the rise in prevalence of diabetes are its complications; kidney failure, heart attack, amputations, blindness, stroke etc. The great health and socio-economic impact of this rise in prevalence of diabetes mellitus combined with the burden of infectious diseases like HIV/AIDS must be taken seriously. The importance of primary prevention of type 2 diabetes, early diagnosis and management of its complications cannot be over emphasized. No longer considered to be a condition of primarily adult onset, type 2 diabetes has become increasingly common among children and adolescents, this is because of increasing prevalence of overweight and obesity and inactivity in them. As in adults, it may be that many childhood cases also go unrecognized, resulting in the possibility of a substantial number of children and adolescents with undiagnosed type 2 diabetes.
A positive family history of diabetes also is also a major risk factor for the development of type 2 diabetes. In the USA, there is increased incidence of obesity and type 2 DM in children of Native American, Hispanics, and African ancestries, although no race or socio-economic class is spared. The prevalence of hypertension among this group of children is also increasing; this has subsequently increased their risk for developing cardiovascular disease. Looking at children in urban schools like in Lagos, there are more overweight and obese children than in previous years.
The reason for this is not far fetched; children of today have more access to high-energy foods and drinks and often do very little physical activities. Most play indoors and physical education in many schools has been reduced to copying of notes with very little practical sessions. Often times, sports is done once a week in the schools. The World Health Organization (WHO) recommends 60 minutes of moderate- to vigorous-intensity physical activity each day that is developmentally appropriate and involves a variety of activities for young people (age five to 18 years).
It is important to know that type 2 DM can be prevented in at risk individuals by adopting healthy lifestyle changes, and when already present it can be properly managed to prevent complications of diabetes. It is time for us to start formulating policies that would safeguard Nigerian children from the coming diabetes pandemic.
Isiavwe wrote from Lagos
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