Preventing the common, silent, and serious diabetes

By Shailendree Wickrama Adittiya

Suwa Diviya by Sunshine Foundation for Good is an initiative that goes beyond creating great places to work, and instead, works towards a future where they are also healthy places to work. This is done by tackling a common, silent, but preventable health condition that continues to increase in Sri Lanka: Diabetes.

The Morning Brunch had the opportunity to chat with Suwa Diviya Project Head Dr. Kayathri Periyasamy in order to learn more about the initiative as well as its importance.

Dr. Periyasamy began by explaining that the tagline of Suwa Diviya is “Life without Diabetes”, which sums up what its programmes revolve around. It is a non-profit initiative by Sunshine Foundation for Good, the CSR arm of Sunshine Holdings, which operates under the theme “Bringing Good Things to Life”. Its CSR projects cover two important subjects – health and education.

 

Why diabetes?

According to Dr. Periyasamy, the reason Suwa Diviya focuses on diabetes is because there is a continuous increase of the condition in Sri Lanka, as studies carried out in the last 10 years show that the number of cases is doubling. She added that the number of younger people, especially in the urban sectors, who are becoming pre-diabetic, which is the stage before becoming diabetic, has tripled between 2008 and 2019. 

“Anyone with pre-diabetes will become a diabetic in the future. In fact, 70% will convert within five years,” Dr. Periyasamy shared.

It is thus a common problem in Sri Lanka, but it is also a silent one. According to Dr. Periyasamy, one in three people don’t even realise that they have the condition until quite late. 

“Most of the time, they only present after they develop some complications, so we miss out on picking them up early and preventing problems. So it’s common, it’s silent, and it’s also a serious disease.”

She went on to say that there are enough numbers in literature that highlight the complications that diabetes can cause. For instance, diabetes is the leading cause of non-traumatic blindness in people. It is also the top cause of lower limb amputation. Dr. Periyasamy added that it’s a huge factor in heart attacks and strokes, and also the leading cause of kidney disease in Sri Lanka.

“It seems to be the number-one cause of massive problems, but a lot of people don’t think about diabetes. They only think about the end problem, but we need to tackle the beginning of the problem,” she said, adding that this is why they have chosen this particular health condition as the focus of Suwa Diviya.

 

Focus areas

While diabetes is common, silent, and serious, it is also preventable. Dr. Periyasamy said that 60% of diabetes and related disorders are preventable if one knows what to do, especially looking at the information available. However, misinformation is a serious issue, as there is more misinformation being spread than information. This is why Suwa Diviya places a strong emphasis on diabetes awareness and education. 

“It’s a platform where we bring together a whole group of medical specialists as well as paramedical specialists who are involved in diabetes care and are dealing with diabetes – it could be people who are dealing with diabetic food or providing exercise. We try to bring them all to this platform where we provide proper evidence-based information, keeping away from any unnecessary myths or misinformation.”

With Suwa Diviya, people can gain a basic idea of the condition and learn about measures to prevent or manage diabetes that are easy to follow. 

“If you take our programmes, we are focused on four main aspects of diabetes. Why we picked those four aspects is purely because those are four aspects through which we can make some change, and it will give us some impact,” Dr. Periyasamy said.

 

  1. Preventing diabetes

Dr. Periyasamy kept highlighting the fact that diabetes is a preventable condition, and that it can be avoided through five lifestyle factors: Healthy nutrition, physical activity, weight management, quitting smoking, and moderate drinking.

Talking about the second step, for instance, Dr. Periyasamy said it is important to avoid being sedentary and instead be very physically active, the steps for which Suwa Diviya talks about in a very practical, easy-to-follow manner. 

“Preventing diabetes is also about maintaining weight. We have lost sight of what is a good weight for most of us, and one in four people are obese in Sri Lanka, so we need to change that. When we reduce our weight, we can prevent diabetes very easily.”

 

  1. Early diagnosis of diabetes
Suwa Diviya Project Head Dr. Kayathri Periyasamy

According to Dr. Periyasamy, many people don’t want to know they are diabetic, and thus it is often picked up during screening, and not because people present with symptoms. This is due to the silent nature of the disease.

She went on to say that Suwa Diviya emphasises the importance of picking it up early, as one can then stop it from progressing further. “A lot of people present with symptoms only after they develop complications, so you have lost that opportunity to stop kidney failure, for instance.”

“When you pick it up early, you can then control it to the best of your ability. The most recent evidence has shown that for those who control their blood sugar very early on very well, even if their sugar is high later in life, it doesn’t really lead to a lot of complications. This is called a legacy effect of diabetes.”

 

  1. Managing diabetes adequately

The third focus of Suwa Diviya is managing diabetes adequately. Dr. Periyasamy said that a lot of people who are diabetic see a doctor and take their medicine, but leave it at that. They don’t check their blood sugar regularly and don’t control it to be within the target blood sugar level. She explained that when a patient is halfway better, they feel good, and fail to manage the condition, as they don’t realise that they still have diabetes.

“This is what accumulates to cause complications in the future. If your sugar is not within the target range for a long period of time, say three or six months, then you start developing eye issues, kidney issues, etc. All of these occur very silently, and that’s the crux of diabetes.”

 

  1. Preventing complications

With regard to the fourth focus of Suwa Diviya, Dr. Periyasamy said: “Diabetes per se does not kill, it is the complications that cause you a huge amount of agony and death finally. It’s a lot of suffering, and it is also a huge financial burden.” 

The programme thus focuses on how people can live with diabetes without letting it progress to such complications.

 

Implementation

Having focus areas and objectives is one thing, but implementing them is another matter altogether. Dr. Periyasamy thus gave us a clear image of how Suwa Diviya reaches people. The initiative began in 2020, amidst the Covid-19 pandemic, which made physical gatherings a challenge. However, since they wanted to get information out to the people, Suwa Diviya turned to the internet, and now maintains a considerable social media presence.

“Then we moved on to doing webinars for companies, associations, and groups of people, and now we do a four-hour in-person workshop – and that’s where we like to focus our attention, rather than just a quick webinar,” she said, explaining that this is because at the workshop, they can give the attendees a lot of take-home information on preventing and managing diabetes.

The programme is practical and informative, providing participants with techniques to change their lifestyles.

“We try to empower them with enough for the individual to take on the task of changing their lifestyle. In the future, we would like to talk to bigger organisations so we can actually help them change organisational structures and improve them.”

Dr. Periyasamy went on to say: “In the future, it’s not only going to be about creating a great place to work. It’s going to be about a healthy place to work; it’s going to nurture health.”