Living well with diabetes

Diabetes has reached epidemic proportions in many populations
Living well with diabetes
"Blood glucose is your primary source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into our cells for energy."Wikimedia Commons/ Ofek Abuhazira

What is Diabetes

Diabetes (Diabetes mellitus) is a chronic (long-lasting) health condition that affects how your body turns food into energy. Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. When the blood sugar goes up, it signals the pancreas to release insulin. Blood glucose is your primary source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into our cells for energy. Typically, your blood glucose levels are below 100 mg/dl in the fasting state and always remain below 140 mg/dl in the post-prandial state (after meals).

When glucose levels are too high in the blood, it is called hyperglycemia. We call it Prediabetes when the fasting glucose levels are between 100 and 125 or post-meal levels are between 140-190 mg/dl. When the fasting glucose levels are 126 or above, or post-meal levels are 200 or above, it is called diabetes. There are two main types of diabetes: type 1 and type 2. People with type 1 diabetes don’t produce insulin, whereas People with type 2 diabetes don’t respond to insulin as well as they should. As often happens, people with type 2 diabetes don’t make enough insulin later in the course of the disease.

Magnitude of the Problem

Diabetes has reached epidemic proportions in many populations. As per International Diabetes Federation (IDF), approximately 463 million adults (20-79 years) were living with diabetes in 2019; the number is expected to rise to 700 million (70 crores) by 2045. Whereas the proportion of people with type 2 diabetes is increasing in most countries, 79% of adults with diabetes are living in low- and middle-income countries. On the other hand, more than 1.1 million children and adolescents were living with type 1 diabetes in 2019. In addition, more than 20 million live births (1 in 6 live births) are affected by diabetes during pregnancy. The latter is called gestational diabetes mellitus (GDM).

Out of 463 million adults estimated to have diabetes in 2019, one in two (232 million) people with diabetes were undiagnosed. The scenario is worst in developing countries. For example, the studies carried out at our department reveal that three out of 4 Kashmiri adults aged 40 or more and 9 out of 10 young adults aged between 20 and 40 years remain undiagnosed unless you check their blood glucose levels. In fact, most people with diabetes are not aware of their disease till they have high blood sugar levels and probably have had it for quite some time. People remain undiagnosed because the tell-tale signs of type 2 diabetes, such as frequent urination and excessive thirst, are often subtle, especially early on. It is estimated that diabetes caused 4.2 million deaths in 2019 alone. During the COVID-19 pandemic, people with pre-existing medical conditions, particularly, diabetes appeared to be more vulnerable to becoming severely ill with the virus. Diabetic patients with COVID-19 are associated with a two-fold increase in mortality and the severity of COVID-19 compared to non-diabetic patients.

World Diabetes Day (WDD)

WDD was created in 1991 by the IDF and the World Health Organization (WHO) in response to growing concerns about the escalating health threat posed by diabetes. WDD became an official United Nations Day in 2006 with the passage of United Nations Resolution 61/225. The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public and political spotlight. WDD is marked every year on the 14th of November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922.

Theme of WDD 2021

The theme for World Diabetes Day 2021-23 is “Access to Diabetes Care.” Even after 100 years of the discovery of insulin, millions of people with diabetes worldwide cannot access the care they need. People with diabetes require ongoing care and support to manage their condition and avoid complications.

WDD 2021 at SKIMS Srinagar

THIS YEAR, the WDD program at SKIMS is being organised on the 13th of November at the SKIMS auditorium. Given the COVID-19 Pandemic, the conference is held in a hybrid mode wherein a limited number of participants are invited to the venue. The rest of the interested participants are being asked to join the conference (streamed live) virtually. Highlights of the SKIMS WDD program include a Diabetes workshop on self-monitoring of blood glucose (SMBG), Carbohydrate Counting and insulin injection technique, besides many talks and a panel discussion on Lifestyle management and Pharmacotherapy of Diabetes.

Improvements in diabetes management have resulted in a greater number of people living longer with the disease. For this reason, diabetes prevention and self-management education efforts need to be bolstered to facilitate the knowledge, skill, and ability necessary for diabetes self-care. Diabetes, particularly when you need insulin to control it, is viewed as a task master in that the requirements of daily living with the disease are extensive. People with diabetes need to continually juggle with dietary regimens and other lifestyle modifications to learn to live well with diabetes.

Wide-scale adoption of healthy eating habits, sufficient physical activity, screen-time reduction, non-smoking, stress reduction, and regular medical check-ups could prevent an enormous number of chronic disease–related deaths each year. However, individual behavior change happens within a multifaceted sociocultural context, and, thus, programs that effectively promote behavior change are those that adequately address social context and account for cultural nuances. Diabetes prevention and self-management programs that accomplish this include group visits for minority and disadvantaged patients with diabetes to improve self-management and promote greater trust in medical providers, home health care interventions for vulnerable populations, and peer coaches from similar economic circumstances. Similarly, programs employing community health workers, family health advocates, or cultural health brokers have improved diabetes self-management and patient-physician relationships.

Prof. Shariq R. Masoodi, Senior Consultant, Department of Endocrinology, SKIMS Soura, Srinagar

Disclaimer: The views and opinions expressed in this article are the personal opinions of the author. The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK

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