According to the Global report on diabetes, World Health Organization, Geneva, 2016, the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. In 2012, an estimated 1.5 million deaths were directly caused by diabetes and another 2.2 million deaths were attributable to high blood glucose.More than 80% of diabetes deaths occur in low and middle-income countries.Type 2 diabetes accounts for around 90% of all diabetes worldwide. Reports of type 2 diabetes in children have increased worldwide.
With diabetes gaining epidemic proportions worldwide, WHO is marking World Health Day, April 7, 2016, by calling for immediate action on diabetes.In its first “Global report on diabetes”, WHO highlights the need to step up prevention and treatment of the disease.
WHO’s new report urges governments to warrant that people are able to make healthy choices and that health systems are able to identify, treat and care for people with diabetes. It encourages us all as individuals to eat healthy, be physically active, and avoid excessive weight gain.
Control the causes
The first WHO Global report on diabetes establishes that the number of adults living with diabetes has almost quadrupled since 1980 and factors driving this dramatic rise include overweight and obesity . Dr Anirban Chakraborty, consultant physician and diabetologist, elaborates on three main factors leading to diabetes. “Diet, weight control and exercise can help in effective diabetes management. Indians should ideally maintain a Body Mass Index (BMI) of under 23.The waist circumference is another crucial index.Indian males should have a waist circumference of less than 35 inches and for females it should be less than 31.5 inches.” He says that though Type 1 diabetes cannot be controlled, Type 2 diabetes can be prevented and regulated with lifestyle and dietary modifications.Referring to the Eatwell Guide that shows the different types of food we should eat -and in what proportions -to have a healthy, balanced diet, Dr Chakraborty advises, “The total number of carbohydrates consumed in a day should roughly equal the volume of fruits and vegetables consumed. One should make it a habit to look at food labels stating nutritional information so as to keep a check on the calorie intake.” Regular physical activity is a key part of managing diabetes along with proper meal planning, taking medications as prescribed, and stress management.
The importance of regular physical activity for diabetes prevention and treatment cannot be overstated.According to the American Diabetes Association, when physically active, the cells in our body become more sensitive to insulin so that it can work more efficiently .
The cells also remove glucose from the blood using a mechanism totally separate from insulin during exercise. Dr Chakraborty adds, “Incorporate exercise as a part of your daily regime; a minimum of 150 minutes of exercise every week is a must. One needn’t necessarily hit the gym, brisk walking, household chores etc also are good ways of getting the much needed quanta of physical activity .”
Cause for concern
According to the Diabetes Foundation (India), about 50.9 million people in India suffer from diabetes, and this figure is likely to go up to 80 million by 2025, making it the `Diabetes Capital’ of the world. Dr Sameer Dasgupta, consultant diabetologist, opines that what’s more alarming is the fact that “for each diagnosed diabetic in India, there is one that goes undiagnosed. This automatically doubles the figure.” He adds, “There are about 380 million people worldwide with pre-diabetes, a condition where the blood glucose level (blood sugar level) is higher than normal, but not high enough to be considered diabetes.”
Pre-diabetes patients also develop similar cardiac complications as diabetics, but more often than not, they don’t adopt necessary corrective lifestyle modifications to remedy the situation.
The frequency of diabetes is escalating around the world, and studies indicate that children are at increasing risk of developing the disease. Over time, diabetes can damage the heart, blood vessels, eyes, kidneys and nerves -causing chronic problems and early death. According to WHO, many countries are recording higher numbers of newly diagnosed cases of Type 1 diabetes, particularly in younger children. Recently, Type 2 diabetes has progressively been reported in children and adolescents, so much so that in some parts of the world type 2 diabetes has become the main type of diabetes in children. Growing incidence of childhood obesity and physical sedentariness are widely believed to play a crucial role. Dr Dasgupta mentions the “coordinated efforts of the International Diabetes Federation (IDF), WHO and the UN, who have sent a set of guidelines to governments to adopt legislation against the sale of high sugar content food and drinks to children and in schools, ban vendors selling such items in schools and workplaces and to ensure safe and clean drinking water in schools and workplaces.”
New age medicines
Even though diabetes can initially be managed by just eating well and being active, one will need medication at some point or the other. We have come a long way since the 1920s when insulin was first used to treat diabetes. There is no magic pill yet, but there are numerous options to help control blood sugar levels. And more are going to make an appearance making life a little easier for diabetics. Dr Debkripa Banerjee, diabetologist, says, “These newer drugs prevent the degradation of the cells as opposed to traditional oral hypoglycemic agents. The drugs, called SGLT2 inhibitors, target the kidneys to block the reabsorption of sugar, increase sugar excretion, thereby reducing blood sugar levels. They, however, are not recommended for patients who have severe kidney impairment, end-stage renal disease, or are on dialysis.”
Healing the alernate way
In Ayurveda, diabetes is known as Madhumeha and is classified as a kapha type of disorder. In view of the various side effects of traditional as well as New Age diabetes drugs, many are turning to Ayurveda for natural, holistic management of the disease. Dr Debasish Pahari, Ayurvedic expert, says, “There are several herbs that have been found to be very effective in treating diabetes and reducing blood sugar levels. The biggest advantage of these herbal diabetes medicine supplements is that they have no side effects.”
“Many cases of diabetes can be prevented, and measures exist to detect and manage the condition, improving the odds that people with diabetes live long and healthy lives,” says Dr Oleg Chestnov, WHO’s assistant directorgeneral for NCDs and Mental Health.”But change greatly depends on governments doing more, including by implementing global commitments to address diabetes and other NCDs.”
This World Health Day, let us take a pledge to work together to promote healthier lifestyles and increase awareness for battling this disease that affects millions around the world, silently killing both young and old.
Did you know?
– Diabetes is one of the leading causes of death in the world
– In 2012, diabetes was the direct cause of 1.5 million deaths. An additional 2.2 million deaths were caused in the same year by higher-than-optimal levels of blood glucose, through an increased risk of cardiovascular and other diseases.
– Even when blood glucose levels are not high enough to warrant a diagnosis of diabetes, damage can occur to the body.
Gestational diabetes is characterised by hyperglycemia, or raised blood sugar, with values above normal but below those diagnostic of diabetes, during pregnancy.
Women with gestational diabetes are at an increased risk of complications during pregnancy and delivery.
Adults with diabetes have a 2-3-fold increased risk of heart attacks and strokes.
Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation.
Diabetic retinopathy is an important cause of blindness, and occurs as a result of longterm accumulated damage to the small blood vessels in the retina. 2.6% of global blindness can be attributed to diabetes.
Diabetes is among the leading causes of kidney failure.
Treat it right
Interventions that are both cost-saving and feasible in developing countries include:
Blood glucose control, particularly in type 1 diabetes.
Blood pressure control and and foot care.Other cost-saving interventions include: