The World Health Organisation (WHO) stated that there was a 3% increase in diabetes mortality rates by age between 2000 and 2019. In 2019, diabetes and kidney disease due to diabetes caused an estimated two million deaths. In Sri Lanka, the 2016 demographic and health survey found that 5.7% of the total population had diabetes. Given the prevalence of the condition, the WHO commemorates World Diabetes Day on 14 November annually.
The day is an ideal opportunity to raise awareness of diabetes as a global public health issue, shedding light on what needs to be done, collectively and individually, for better prevention, diagnosis, and management of the condition.
The theme this year is “Access to diabetes education”, and underpins the larger multi-year theme of “access to care”. WHO states that their World Diabetes Day activities will cover issues ranging from championing the priorities of people living with diabetes in advocacy to the Global Diabetes Compact, which drives efforts globally to reduce the risk of diabetes and ensure access to treatment and care.
What is diabetes?
Diabetes is a chronic health condition that affects how the body turns food into energy. According to the Centre for Disease Control and Prevention (CDC) of the US, the body breaks down most of the food consumed into sugar (glucose) and releases it into your bloodstream. When the body’s blood sugar goes up, it signals the pancreas to release insulin. Insulin acts as a key to letting the blood sugar into your body’s cells for use as energy.
However, with diabetes, the body doesn’t make enough insulin or can’t use it as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.
Unfortunately, there isn’t a cure for diabetes, but losing weight, eating healthy food, and being active can help. The CDC adds that the following can also help:
- Taking medicine as prescribed
- Getting diabetes self-management education and support
- Making and keeping healthcare appointments
There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes during pregnancy). Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake) and the CDC states that approximately 5-10% of the people who have diabetes have type 1. With type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. About 90-95% of people with diabetes have type 2. Gestational diabetes develops in pregnant women who have never had diabetes. If you have gestational diabetes, your baby could be at higher risk for health problems.
Prediabetes is also a condition one must be aware of. With prediabetes, blood sugar levels are higher than normal, but not high enough for a type 2 diabetes diagnosis. Prediabetes raises your risk for type 2 diabetes, heart disease, and stroke.
Who is at risk?
The Sri Lanka Diabetes Federation lists a number of risk factors and symptoms but adds that many people with diabetes do not display any symptoms.
The symptoms and signs of diabetes include weight change (gain or loss) with polyphagia (increased hunger), increased thirst (polydipsia), frequent urination (polyuria), extreme fatigue or lack of energy, blurred vision, frequent or recurring infections (especially urine, genital, and skin infections), cuts and bruises which are slow to heal, tingling sensation or numbness in the hands or feet, and trouble getting or maintaining an erection.
“It is important for you to know your risk for diabetes. Being Asian, we are at high risk for diabetes despite our age, sex, and body build. If you are at risk, get checked with no delay,” the Sri Lanka Diabetes Federation states.
Screening is recommended for the following persons:
- Anyone more than 40 years of age should get screened for diabetes and every three years thereafter
- A person with any of the following risk factors should start early and check more frequently:
- Sedentary lifestyle/lack of exercise
- Hypertension (high blood pressure)
- High cholesterol and lipids
- Family history: Having a relative (parent/sibling/child) with diabetes
- History of gestational diabetes (diabetes during pregnancy)
- Polycystic ovary syndrome (obesity-related menstrual disorder in women)
- Acanthosis nigricans (dark, thick, velvety skin over the neck and armpits)
According to the WHO, over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves. “Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes,” WHO states, adding: “Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and the eventual need for limb amputation.”
In addition to this, diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. Close to one million people are blind due to diabetes.
Diabetes is also among the leading causes of kidney failure.
People with diabetes are also more likely to have poor outcomes for several infectious diseases, including Covid-19.