Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Hyperglycemia is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.
The most common is type 2 diabetes, usually in adults, which occur when the body becomes resistant to insulin or doesn’t make enough insulin. In the past three decades, the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes once known as juvenile diabetes or insulin dependent diabetes, is a chronic condition in which the pancreas produce little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025.
Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputations. Poorly controlled diabetes increases the chances of these complications and premature mortality. In addition, people with diabetes are at higher risk of presenting with cardiovascular disease and tuberculosis, especially those with poor glycemic control. A healthy diet, regular physical activities, maintaining normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes. Diabetes can be treated and its consequences avoided or delayed with diet, physical exercises, medication and regular screening and treatment for complications.
The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014 with the prevalence rising more rapidly in low and middle income countries than in high income countries. In 2019, diabetes was the direct cause of 1.5 million deaths worldwide, 48% of which occurred prematurely, before the age of 70 years. In Africa, therewere 24 million people living with diabetes in 2021 and this figure is projected to increase to 55 million by 2045, an increase of 129%, the highest increase of all regions.
According to the international diabetes foundation, in 2021, an estimated 716,000 adults in Uganda had diabetes. About 89% of Ugandans with diabetes are neither on medication nor aware of their status and, therefore, present to the health system with difficult to treat complications. In recognition of the increasing burden of diabetes and other non-communicable diseases as a major socio-economic challenge, government of Uganda is scaling up critical care pathways for managing chronic diseases, including diabetes up to primary health care level, as it was addressed by Hon. Margret Muhanga, the Minister of State for Primary Health Care during the spotlight meeting on diabetes in Uganda.
Type 1 diabetes mellitus.
Previously called insulin-dependent, juvenile or childhood onset DM, it is characterized by deficient insulin production and requires daily administration of insulin. Neither its cause nor the means to prevent it is known. It’s known to be an autoimmune disease and involvement of an environmental component.
During an autoimmune reaction, there is destruction of the cells in the pancreas that, make insulin i.e. beta cells. This process can go on for months or years. Presence of the susceptible genes HLA DR3 AND HLA DR4 may trigger an exaggerated immune response and production of auto antibodies against the pancreatic beta cells following the inversion of organisms like viruses.
Both reactions lead to the destruction of beta cells affecting insulin production. Although it’s often diagnosed in childhood, people can develop type 1 diabetes at any age. You are at a slightly higher risk of type 1 diabetes if your mother, father, brother or sister has it. There is currently no cure for type 1 diabetes, but a lot of research is undertaken to help find new treatments and a cure. Insulin is the main treatment for type 1 diabetes. You cannot live without insulin injections or using the insulin pump. Checking and managing your blood sugar levels is important to help you reduce your risk of serious short or long-term health problems.
Type 2 diabetes mellitus.
This affects how your body uses sugar (glucose) for energy. It stops the body from using insulin properly, which can lead to high levels of blood sugar if not treated. Over time, type 2 diabetes can cause serious damage to the body, especially nerves and blood vessels. Type 2 diabetes is often preventable. The best way to detect diabetes early is to get regular check-ups and blood tests with a healthcare provider.
Type 2 diabetes can go undiagnosed for years if symptoms are missed. Left untreated, high blood sugar levels can cause serious health problems. Anyone can develop type 2 diabetes but it mostly affects people over 25 years often with a family history. This type doesn’t just affect people living with overweight or obesity, although this is one of the risk factors, along with ethnicity.
There is no cure for type 2 diabetes but some people with this type can put their diabetes into remission by losing a significant amount of weight. Hence the main causes of type 2 diabetes are; living with obesity or over weight, unhealthy waist measurements, and too much fat 2stored in or around your liver and pancreas. Type 2 diabetes in children is less common than it is in adults but the causes are the same. Living with obesity or overweight is the main factor along with ethnicity and family history.
There are now more young people (under 18) being diagnosed with type 2 diabetes. Eating certain food cannot cause type 2 diabetes, but there are some foods that increase your risk of developing type 2 diabetes which include; sugar drinks, refined carbohydrates like white bread, white rice and sugar breakfast cereals, red and processed meats like sausages, salts, particularly in processed food. Some types of food can help reduce your risk of type 2 diabetes. They include some types of fruits and vegetables, unsweetened yoghurt, milk, cheese and oily fish.
Gestation diabetes
This is a condition in which one’s blood sugar levels become high during pregnancy. There two classes of gestational diabetes. Those of class A1 can manage it through diet and exercise. Those who have class A2 need to take insulin or other medication. This type of diabetes goes away after giving birth. However, it raises the risk of a mother getting type 2 diabetes later in life. Diabetes is a rapidly growing chronic and multifactorial disease with a worldwide projection of 324 million diabetics by the year 2025.
In Africa, the prevalence of diabetes is expected to rise by 98%, from 13.6 million in 2003 to 26.9 million in 2025 and a similar increase of 97% is expected in the Middle East. In May 2022, WHO member states set global targets for diabetes, as part of the recommendations to strengthen and monitor responses within the non-communicable disease programs.
To help achieve these global targets for diabetes, WHO and the world diabetes foundation (WDF) agreed to implement a joint integrated project on diabetes prevention and control in Ghana and Uganda and this kick-started with a spotlight meeting held in march.
This article is written by DR.MATOVU RICHARD (Email:matoxrich2@gmail.com) and Content sponsored by Specialist Doctors International
