Diabetes is one of the fastest rising public health issues and causing a number of serious health complications. The prevalence of diabetes is growing globally due to multiple factors like growing age, family history, hypertension, obesity and most influential are lifestyle behaviours commonly associated with urbanization. The International Diabetes Federation (IDF), Diabetes Atlas, 9th edition, reports that in 2019, approximately 463 million adults were living with diabetes; by 2045 this will rise to 700 million. 79% of adults with diabetes were in low- and middle-income countries. Over19 million adults in Pakistan are estimated to be living with diabetes. Unfortunately, many people yet do not know that they have diabetes. And of those who are diagnosed, many do not have access to medicines nor health services that they need.
Diabetes mellitus, commonly known as diabetes, is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into cells to be stored or used for energy. With diabetes, body either doesn’t make enough insulin or can’t effectively use the insulin it does make.
There are two main types of Diabetes: Type 1, diabetes & Type 2 diabetes.
Type 1, diabetes can develop at any age, though it often appears during childhood or adolescence. Researchers don’t know why the immune system sometimes attacks the body’s own cells. In type 1 diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. After that the body is unable to produce insulin. People with type 1 diabetes need daily insulin to control their blood glucose levels. Insulin is commonly delivered with a syringe, insulin pen or insulin pump. Around 10% of all people with diabetes have type 1 diabetes.
Type 2 diabetes, the more common type, can develop at any age, but more common in people older than 40. Type 2 diabetes (formerly called non-insulin-dependent,) results from the body’s ineffective use of insulin. Type 2 diabetes is the most common type of diabetes, accounting for around 90% of all diabetes cases. This type of diabetes is largely the result of excess body weight and physical inactivity.
Symptoms of Diabetes include: Increased thirst, frequent urination, extreme hunger, weight loss, fatigue. slow-healing sores, frequent infections, such as gums or skin infections, irritability, blurred vision.
Although many of the symptoms of type 1 and type 2 diabetes are similar, they present in very different ways. Many people with type 2 diabetes won’t have symptoms for many years, and their symptoms often develop slowly after complications have already arisen. The symptoms of type 1 diabetes develop quickly.
People with diabetes who require insulin need to check their blood glucose or blood sugar levels regularly. Self-monitoring of blood glucose helps people with diabetes and their health care providers understand how their blood glucose levels vary during the day so that their treatment can be adjusted accordingly.
Sometimes medication is an option as well. Oral diabetes drugs may reduce the risk of type 2 diabetes but healthy lifestyle choices remain essential. Physical activity also helps to control blood sugar levels and lowers risk of heart disease and nerve damage. The American Diabetes Association (ADA) recommends that adults with diabetes get at least 150 minutes of moderate to vigorous aerobic exercise a week. In addition, adequate sleep, stress-relieving strategies, can be helpful to stabilize the patient.
People with diabetes are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defences. In addition, some diabetes-related health issues, such as nerve damage and reduced blood flow to the extremities, increase the body's vulnerability to infection.
The pandemic of COVID-19 has shown that people with diabetes are at higher risk than people without diabetes of having a severe illness and death due to COVID. The pandemic and the measures to contain are quite a challenge for people with diabetes. The people with diabetes have to plan about how to manage to continue the recommended physical activity and a healthy diet within the constraints posed due to COVID. They should be more conscious to adopt all measures such as hand washing, wearing masks, ventilating indoor habitats, socializing with people preferably outdoors whenever possible, and keeping the safe physical distance. Vaccinations are encouraged for people with diabetes as a priority group for vaccinating.
Long-term complications of diabetes develop gradually. Eventually, diabetes complications may be disabling or even life-threatening. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. According to WHO, in 2019 an estimated 1.5 million deaths were directly caused by diabetes,
No effective and safe intervention currently exists to prevent type 1 diabetes. It can be managed through the control of blood glucose with a combination of insulin therapy and healthy life style.
The cornerstone of managing type 2 diabetes is a healthy diet, regular physical activity, avoiding tobacco use and maintaining a normal body weight.