World Diabetes Day 2020: A Message of Hope for People Living with Diabetes
Diabetes mellitus is a chronic and widespread disease affecting people of all races and countries at an increasingly disturbing rate and its major feature is the elevation of blood sugar level. This disease has been in existence since ancient times and its features were first described by the Egyptians more than 3000 years ago. There are two major types of diabetes; Type 1 or insulin dependent diabetes mellitus (IDDM) which is manifested by complete insulin deficiency and accounts for about 10% of all cases of diabetes. Type 2 diabetes also known as non-insulin dependent diabetes mellitus (NIDDM) which is characterized by a relative deficiency of insulin or impairment of its actions and accounts for about 90% of all cases of diabetes.
According to the International Diabetes Federation (IDF, 2019), people living with diabetes globally have been estimated to be about 463 million and this alarming figure is expected to rise to approximately 578 million by the year 2030. Unfortunately, Nigeria has the highest number of people suffering from diabetes in Africa with an estimated 5 million people affected. Persistent or uncontrolled blood glucose level has been shown to be a major factor in the deterioration of diabetes, development of life-threatening complications, poor treatment outcomes and deaths. Diabetes is the main cause of coma, blindness, kidney failure, hypertension, stroke, sexual dysfunction, genito-urinary tract infections and limb amputations.
The World Health Organization and the International Diabetes Federation instituted the World Diabetes Day on the 14th of November, 1991 in reaction to the rising global apprehension about the worsening risks associated with diabetes and its numerous life-threatening complications. This date was adopted to honour the birth anniversary of Sir Frederick Banting who co-discovered insulin with Charles Best and John J.R. Macleod in 1922. Insulin is the drug used in the management of type 1 diabetes and also utilized by one third of individuals with type 2 diabetes. The discovery of insulin revolutionized and changed the story of diabetes for good which made the scientists to win the Nobel Prize for Physiology and Medicine in 1923.
Even though insulin and other antidiabetic drugs remain the cornerstone in the treatment of diabetes, the primary goals of management are; to ameliorate symptoms, reduce the risk of complications, improve the quality of life and reduce mortality. Calorie-restricted diets and exercise are also other modalities that have proved effective with better outcomes in diabetes care. A good number of people with type 2 diabetes are overweight or obese which is a major factor in insulin resistance. Exercise plays an important role in the control of blood glucose, improvement of insulin action, beneficial to the cardiovascular system and enhances the life expectancy of diabetic patients. Studies have revealed that if totally sedentary or inactive people partake in adequate physical activity for half an hour in a day, they will attain almost 30% decrease in the risk developing type 2 diabetes and other protracted medical conditions like hypertension, stroke and colon cancer.
Dietary and lifestyle approaches also play an integral role in the management of diabetes and they encompass lower calorie intake for overweight patients, intake of dietary fibres, avoidance of tobacco and alcohol. Researchers have suggested that Mediterranean diet is the best for diabetic subjects and it is composed of olive oil as the main source of fats, fruits, vegetables, legumes, cereals and fish. Furthermore, the westernized diets like processed foods and meat, fried foods, candy and sweets, carbonated drinks, refined grains and many more have been implicated in the development of diabetes. Individuals suffering from diabetes need to be educated about the value of right nutritional conduct which is vital in the control of blood glucose.
In ancient and medieval times, diabetes was a death sentence before people resorted to the use of herbs, ‘starvation’ diet and exercise. These non-drug strategies are still valuable today and should be fully explored by people suffering from diabetes. In conclusion, the Greek philosopher and scientist Hippocrates talked about the importance of eating healthy foods by saying- ’’Let thy food be thy medicine and medicine be thy food’’. People are also encouraged to imbibe the culture of periodic medical checkups as most diabetic individuals in this part of the world are discovered when the condition has deteriorated.
Pharm. (Dr.) Abdulhakim Abubakar (Pharm. D.)
Editor in Chief, Pharmaceutical Society of Nigeria (Kaduna State Branch)