The number of people worldwide suffering from diabetes is a “staggering” 366 million, according to The International Diabetes Federation. This was made known by officials during a recent meeting in Lisbon, Portugal. They estimate that 4.6 million people die annually from the disease and it cost governments about $465 billion every year to fight the disease.
In the same vein, Centers for Disease Control and Prevention (CDC) report estimates that about 26 million Americans have diabetes. It also says about 79 million Americans have prediabetes. According to the National Diabetes Fact Sheet for 2011 diabetes affects 8.3% of Americans of all ages and 11.3% of adults 20 years and older.
Here, 6 million Nigerians live with diabetes, according to Diabetes Association of Nigeria (DAN). One out of every five adult Nigerians die before their 50th birthday, and three out of five with childhood diabetes die before 20th birthday. In Africa at least 80% of people with diabetes are undiagnosed.
Diabetes is the leading cause of nontraumatic lower limb amputations. It also increases the risk for coronary heart disease 2-4 times more than in nondiabetic. Approximately two thirds of people with diabetes die of heart disease or stroke. There is also the risk of Diabetic Ketoacidosis (DKA), a very life-threatening complication, this especially in type I diabetes also known as Insulin Dependent Diabetes Mellitus. It used to be thought that type II diabetes also known as Non-Insulin Dependent Diabetes Mellitus was less common in non-Western countries, but now as people in those countries adopt Western diet and lifestyles it is now also seen more. Other complications of diabetes are kidney failure, blindness, infertility, miscarriages, stillbirths, sudden death, and reduced life expectancy.
The diabetes challenge is tripartite - and threefold. To the individual it is about knowing that you have a disease that is debilitating and lifelong. There is no cure but it can be managed. The individual has to learn to control their diet, reduce their weight and change their lifestyle. In other words a hedonic learns to become anhedonic, couch potatoes learn to break sweat. For older people a leopard would have to learn how to change its spots. They may need to change friends to stay alive. The individual will keep regular appointments with the doctor, to monitor compliance and to detect complications early, but more than anything every appointment helps make it fresh and gives them zeal to carry on. Those who stay away from appointments are more likely to die from complications of diabetes.
It is important to know that the so called diabetic diets are actually the ideal diet for any one above the age of 25, that is, for all of us. Telling the patient to cut down calories is not enough. There should be objectivity. I always say for carbohydrates a fixed-size portion is enough. This is one case where one-size-fits-all works. The ideal size is the size of the person’s fist. Whether full or not, the patient gets up, they won’t die. One thing is sure: those who take fewer calories live longer. Science has proven it. It is more “satisfying” to eat with bowls instead of dishes. That way your brain will not tell you that you are missing something. Food is like sex, it is pleasurable. So it can be abstained from and quantity taken controlled with discipline. It is still amazing that patients find it easy to take vitamins, but difficult for them to take their blood sugar lowering drugs. But patients should see these drugs for what they are – life-prolonging drugs.
For governments, especially with the global recession, there will be other things crying for attention. Health budgets may be cut. But whatever happens there must be money for treatment and research. And the political will for positive and purposeful research, through the road less travelled, apologies to Morgan Scott Peck. The next paragraph sheds more light on this.
But perhaps the greatest challenge is for medical scientists. For long the world has been presented with this disease among others where patients have to pop pills or injections all their lives to stay alive. It is almost always the same reaction from patients when as a doctor I break the bad news: “you mean I have to take these drugs everyday?” Some push their luck: “doctor, you mean maybe for a while.” Some go philosophical, “It is not my portion!” I feel compassion for them. My answer: “In this wicked world, there is no absolute health.” But research should strive to move from the frontier of “management” to “cure”. And perhaps the hope lies in stem cells. This part of medical research has been over politicized and there is a need for conservatives, especially religious bodies, to look far ahead to see the big picture.
November 14 of every year is Word Diabetes Day. For one day diabetes stays in our consciousness. For non-diabetics and non-stakeholders, after that day, it is forgotten. Diabetes and all its problems need to stay longer in the consciousness of all the players, and indeed all of us.
Dr Cosmas Odoemena
Thursday, 31 December 2015
THE SCOURGE OF DIABETES
The number of people worldwide suffering from diabetes is a “staggering” 366 million, according to The International Diabetes Federation. This was made known by officials during a recent meeting in Lisbon, Portugal. They estimate that 4.6 million people die annually from the disease and it cost governments about $465 billion every year to fight the disease.
In the same vein, Centers for Disease Control and Prevention (CDC) report estimates that about 26 million Americans have diabetes. It also says about 79 million Americans have prediabetes. According to the National Diabetes Fact Sheet for 2011 diabetes affects 8.3% of Americans of all ages and 11.3% of adults 20 years and older.
Here, 6 million Nigerians live with diabetes, according to Diabetes Association of Nigeria (DAN). One out of every five adult Nigerians die before their 50th birthday, and three out of five with childhood diabetes die before 20th birthday. In Africa at least 80% of people with diabetes are undiagnosed.
Diabetes is the leading cause of nontraumatic lower limb amputations. It also increases the risk for coronary heart disease 2-4 times more than in nondiabetic. Approximately two thirds of people with diabetes die of heart disease or stroke. There is also the risk of Diabetic Ketoacidosis (DKA), a very life-threatening complication, this especially in type I diabetes also known as Insulin Dependent Diabetes Mellitus. It used to be thought that type II diabetes also known as Non-Insulin Dependent Diabetes Mellitus was less common in non-Western countries, but now as people in those countries adopt Western diet and lifestyles it is now also seen more. Other complications of diabetes are kidney failure, blindness, infertility, miscarriages, stillbirths, sudden death, and reduced life expectancy.
The diabetes challenge is tripartite - and threefold. To the individual it is about knowing that you have a disease that is debilitating and lifelong. There is no cure but it can be managed. The individual has to learn to control their diet, reduce their weight and change their lifestyle. In other words a hedonic learns to become anhedonic, couch potatoes learn to break sweat. For older people a leopard would have to learn how to change its spots. They may need to change friends to stay alive. The individual will keep regular appointments with the doctor, to monitor compliance and to detect complications early, but more than anything every appointment helps make it fresh and gives them zeal to carry on. Those who stay away from appointments are more likely to die from complications of diabetes.
It is important to know that the so called diabetic diets are actually the ideal diet for any one above the age of 25, that is, for all of us. Telling the patient to cut down calories is not enough. There should be objectivity. I always say for carbohydrates a fixed-size portion is enough. This is one case where one-size-fits-all works. The ideal size is the size of the person’s fist. Whether full or not, the patient gets up, they won’t die. One thing is sure: those who take fewer calories live longer. Science has proven it. It is more “satisfying” to eat with bowls instead of dishes. That way your brain will not tell you that you are missing something. Food is like sex, it is pleasurable. So it can be abstained from and quantity taken controlled with discipline. It is still amazing that patients find it easy to take vitamins, but difficult for them to take their blood sugar lowering drugs. But patients should see these drugs for what they are – life-prolonging drugs.
For governments, especially with the global recession, there will be other things crying for attention. Health budgets may be cut. But whatever happens there must be money for treatment and research. And the political will for positive and purposeful research, through the road less travelled, apologies to Morgan Scott Peck. The next paragraph sheds more light on this.
But perhaps the greatest challenge is for medical scientists. For long the world has been presented with this disease among others where patients have to pop pills or injections all their lives to stay alive. It is almost always the same reaction from patients when as a doctor I break the bad news: “you mean I have to take these drugs everyday?” Some push their luck: “doctor, you mean maybe for a while.” Some go philosophical, “It is not my portion!” I feel compassion for them. My answer: “In this wicked world, there is no absolute health.” But research should strive to move from the frontier of “management” to “cure”. And perhaps the hope lies in stem cells. This part of medical research has been over politicized and there is a need for conservatives, especially religious bodies, to look far ahead to see the big picture.
November 14 of every year is Word Diabetes Day. For one day diabetes stays in our consciousness. For non-diabetics and non-stakeholders, after that day, it is forgotten. Diabetes and all its problems need to stay longer in the consciousness of all the players, and indeed all of us.
Dr Cosmas Odoemena
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment