World Diabetes Day 2020

Dr Th Premchand Singh *

Diabetes is manifested by high blood sugar level in the body. It is caused when the pancreas, an organ in our body is not able to secrete adequate amount of insulin and when the body cannot make good use of the insulin it produces. Insulin acts like a key to let glucose from the food we eat pass from the blood stream into the cells in the body to produce energy.

A long-term high glucose in the blood levels are associated with damage to the body and failure of various organs and tissues. Diabetes is a global problem with devastating human, social and economic impact. There are 463 million adults (1-in-11) living with diabetes in 2019 in the world and it is expected to rise to 578 million by 2030 the majority of them type 2 diabetes.

And it has been seen that 1 in 2 adults with diabetes remain undiagnosed which is around 232 million more diabetics. It is observed that 80% of people with diabetes live in low and middle income countries like Asia, the Middle East, Oceania and the Caribbean where diabetes affects up to 20% of the adult population.

These countries bear the brunt of the major increase in diabetes prevalence and the burden of the costs. India has 77 million people with diabetes according to International Diabetes Federation with an overall prevalence of 8.9%. Southern States of India have the highest prevalence with 10.5% and Manipur has 7% in a survey done in 2016.

This high incidence is because of increased urbanization, high rates of obesity, sedentary lifestyles and mental stress. Indigenous populations face genetic genocide because of their high genetic predisposition for type 2 diabetes. Worldwide, it is assumed that more than 50% of adults over the age of 35 in indigenous communities have diabetes, the example being the American Indians.

Diabetes is more common among those people having a family history of diabetes, overweight people, who take high calorie unhealthy diet, lack of physical activity and having high blood pressure. The symptoms of diabetes are excessive thirst, dry mouth, frequent urination, lack of energy, tiredness, slow healing wounds, recurrent infections in the skin.

Blurred vision and tingling or numbness in hands and feet are also commonly seen in diabetes. The cornerstone of type 2 diabetes management is a healthy balanced diet, increased physical activity and maintaining a healthy body weight. There is enough evidence that lifestyle changes achieving a healthy body weight and moderate physical activity can help prevent the development of type 2 diabetes.

A balanced low fat nutritious diet has been found to reduce risk of developing diabetes as well as heart diseases. Obesity, particularly abdominal obesity, is linked to the development of type 2 diabetes.

Increased physical activity is important in maintaining weight loss and is linked to reduced blood pressure, reduced resting heart rate, increased insulin sensitivity thereby decreasing blood sugar, improved body composition and psychological well-being.

In view of the rapidly increasing prevalence of diabetes, International Diabetes Federation (IDF) and World Health Organization (WHO) observed World Diabetes Day on the 14th November every year from the year 1991. It marks the birthday of Frederick Banting, who, along with Charles Best, had the idea that the pancreas’ internal secretion holds the key to the treatment of diabetes and discovered insulin in 1922.

In recognition of his great discovery, World Diabetes Day became an official United Nations Day in 2007 with the passage of United Nation Resolution 61/225. The campaign draws attention to issues of paramount importance of diabetes in the world and keeps diabetes firmly in the public spotlight.

Every year, the World Diabetes Day campaign focuses on a dedicated theme that runs for one or more years. The theme of World Diabetes Day 2020 is “Nurse and Diabetes”. The campaign aims to raise awareness around the crucial role that nurses play in supporting people living with diabetes. Nurses do outstanding work to support people living with a wide range of health concerns, specially diabetes mellitus.

People who are with diabetes or are at risk of developing diabetes need their support. Nurses are an integral part in the management of diabetes. In the management of diabetes, persons with diabetes need to take a big role in the treatment. They face a number of challenges, a different lifestyle regarding diabetic diet, exercise and medicines.

Nurses apprise them the importance of diet and nutrition as well as regular physical exercise in diabetes. They are taught about the balanced diet containing all the macronutrients like carbohydrate, protein, fat in appropriate amounts and micronutrients like vitamins and minerals. Exercise, aerobic and anaerobic should be part and parcel of their daily routine.

Nurses help to understand their medications used for diabetes, be it oral or injectable, when and how to take them. All diabetics are taught to examine their extremities regularly, especially the feet, for wounds, lacerations, and ulcers as diabetes can affect healing. Regular blood and urine tests are a must for all diabetics.

People with diabetes should be aware of symptoms of high and low blood sugar levels and nurses will teach them how to manage these situations. They need to get routine eye exams to check for retinopathy. Diabetics need to understand these concepts to remain compliant with treatment and follow up.

International Diabetes Federation is working world wide to facilitate opportunities for nurses to learn more about diabetes and receive training so that they can make a difference for people with diabetes.