World Diabetes Day- "Eyes on Diabetes"

Dr Th Premchand Singh *

World Diabetes Day observed at Lamphel by Directorate of Health Services, Manipur on Nov 14 2016 :: Pix - TSE

World Diabetes Day is observed every year on Nov 14. 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.

World Diabetes Day was launched in 1991 by the International Diabetes Federation (IDF) and World Health Organization (WHO) in response to concerns about the escalating health threat from diabetes. 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.

Diabetes is one of the major health problems in the world. There are currently 415 million people living with diabetes all over the world and by 2040 this will rise to 642 million, and one adult in ten will be a diabetic in 2040. About half of this population with known diagnosed diabetes will be there undiagnosed, and these people may present with diabetic complications.

International Diabetes Federation (IDF) has estimated that globally as many as 193 million people or close to half of the people living with diabetes in 2015 were unaware of their disease.

The increase in diabetic population is more so in the under developed countries like Africa and South East Asian countries which comprises India, Bangladesh, Nepal, Sri Lanka, Mauritius, Bhutan and Maldives. This has been because of the shift from agricultural and rural societies to the industrial and urban societies.

More than 80% of the global burden of diabetes is borne by underdeveloped and developing countries. India is now the diabetes capital of the world with 69 million people with diabetes with a prevalence of 8.7% in 2015, which is projected to at least to double in 2030.

Previously diabetes specially type 2 diabetes is known to be a disease of the older people, however recently with increasing intake of fatty, unhealthy high calories food and physical inactivity, diabetes has been increasingly seen among the children all over the world, which ultimately will become a global health issue.

Now, India is home to the second largest number of children with type 1 diabetes in the world (70,200), after the USA, and accounts for the majority of the children with type 1 diabetes among the south East Asian Countries. Manipur is no exception, there is increasing number of diabetes among the adults as well as children.

An ICMR project, “Registry of People with Diabetes in India with Young Age” is going on in Regional Institute of Medical Sciences, which shows high number of diabetics at younger age.

The theme of the World Diabetes Day 2016 is “Eyes on diabetes”. The main focus of this year is promoting two messages, (1) Screening for diabetes – important to modify its course and reduce the risk of complications and (2) Screening for diabetes complications – an essential part of managing diabetes and its complications.

The earlier a person is diagnosed of diabetes, the earlier treatment can be initiated in order to reduce the risk of harmful and costly complications. All diabetics should be advised lifestyle modification, which is the first treatment of diabetes comprising nutritious, healthy diet and physical activity.

There is enough evidence that upto 70% of diabetes can be prevented or delayed by achieving a healthy body weight and moderate physical activity combined with a balanced high fiber low fat diet. Obesity, particularly abdominal obesity, is linked to the development of type 2 diabetes. Weight loss improves insulin resistance, controls high blood glucose and also reduces blood pressure.

People who are overweight or obese should therefore be encouraged to achieve and maintain a healthy body weight. Physical activity is one of the main pillars in the prevention and management of diabetes. Increased physical activity is important in maintaining weight loss and is linked to reduced blood pressure, reduced resting heart rate, increased insulin sensitivity, improved body composition and psychological well-being.

Diabetes if not controlled leads to a number of complications involving all organs of the body. Complications of diabetes range from acute life threatening complications like – (1) hyperglycaemia, severe high blood glucose level in blood because of neglecting the diabetes drugs or when associated with infections and (2) hypoglycaemia, very low blood glucose level leading to drowsiness and even loss of consciousness from overzealous treatment.

Both conditions are dangerous and life threatening. Late complications or chronic complications of diabetes affects specially heart, kidney, nerves and eyes. The most common cause of blindness and kidney failure and heart attack is because of poorly controlled diabetes. Diabetic retinopathy is the most common cause of vision loss among people with diabetes and a leading cause of blindness among working age adults.

However, a number of studies have shown that all these complications can be prevented with strict blood glucose control. International Diabetes Federation advises screening for diabetic complications every year to prevent from these deadly complications.

The International Diabetes Federation and other diabetic associations wish to give the message that diabetes and its complications are preventable with proven and affordable interventions. There is an urgent need to screen, diagnose and provide appropriate treatment to people with diabetes.

This will help to identify people with undiagnosed diabetes and those at risk of developing it in future. In this campaign every association and organization, companies, healthcare professionals and people living with diabetes and their families has a role to play.