Diabetes News!!

New International Diabetes  Federation (IDF)  Diabetes Atlas Released……

IDF Diabetes Atlas is a publication by International Diabetes Federation, published every two  years, to give  estimates of facts and figures about diabetes  around the world. Last IDF Diabetes Atlas was in 2015 before  this  latest one (the 8th) which has just  been  released early December 2017 to mark this year’s World Diabetes Day celebration.

Highlights of the  8th IDF Diabetes Atlas are as follows:

1. About 425 million people in the  world are currently living with diabetes; and this translates to 1 out of 11 adults in the  world. Again,  2/3 of people with diabetes (279 million diabetic patients) live in urban areas..

2. About 212 million people have diabetes mellitus but are not yet diagnosed. This translates to 1 in 2 adults currently living with diabetes.

3. About 327 million people in the world living with diabetes are of working age and this figure is roughly 2/3 of adults living with diabetes..  Eight (8) million people in the world living with diabetes are elderly (more than 65 years).

4. Over 200 million women in the world are currently living with diabetes mellitus. Again,  1 in 6 births is affected by hyperglycemia in pregnancy.

5. There is a projection that 700 million people will be living with diabetes mellitus by 2045.

6. Finally,  over 1 million children and adolescents are living with type 1 diabetes mellitus…..

This is the global situation report…. Nigeria and other countries of the sub-Saharan Africa are part of this mess.

Inspiring story……

Critical place of physical exercise in PREVENTING type 2 DM….

I joined the fatherless club many years ago courtesy of DM. About 2013, my half-brother, in his early 30s, was diagnosed with T2DM – he was admitted in the hospital where I work with a random blood glucose of more than 540mg/dl.

After discharge, I worked on him to start a regular physical exercise program. He started and has continued till date. He stopped sulphonylurea few weeks after hospitalization and metformin 2 – 3 months later. He has had normal blood glucose control ( FBG and A1C) for the past 3 years.

It made sense! In the primitive days when man was a hunter, farmer and was not sure where the next meal would come from, they lived long. The likes of Abraham, Isaac and Jacob in the Bible lived more than 100 years.

Insulin resistance is an important component of T2DM. Exercise increases insulin sensitivity, and when exercise is regular like meals, your guess is as good as mine!

So, with regular physical exercise T2DM can be controlled without medications (??reversed), it’s emergence can be delayed or prevented. My half-brother’s case provides a ready testimony.

In my practice (as a diabetologist/endocrinologist), the critical contribution of physical exercise to the management of persons living with T2DM is obvious.
Your own stories  can inspire someone somewhere…..tell yours in the comments box.

Top 10 common chronic complications that could result from suffering diabetes mellitus

People living with diabetes  mellitus are  prone to many chronic  complications which  can involve virtually all parts of the body from head to toe. Most of the  complications are consequences of persistent high blood sugar over a long time. The complications may be the reason for seeing a doctor leading to the  diagnosis of the condition or may manifest several years after one is found to have diabetes mellitus. In no particular order, the top 10 chronic  complications of diabetes mellitus include:

1. Stroke – people living with diabetes are more likely to suffer stroke than the normal population. This is because diabetes mellitus is often associated with other factors that increase risks of one  suffering stroke such as hypertension, obesity, lipids abnormality, increasing age and their blood being more viscous. It’s also important to  note that increased blood sugar in someone who has suffered a stroke is associated with worse outcome/prognosis.

2. Heart attack and heart failure : Compared with  the normal persons, people living with diabetes are prone to have more heart attacks which may present classically with the  typical symptoms or as silent heart attacks. They also present with heart failure more than the rest population.

3. Blindness and poor vision : Diabetes mellitus is a leading cause of poor vision and blindness in the  world. Many a time,  diagnosis of diabetes mellitus is made in the office of the Eye doctor  because patient presented to the latter because of worsening vision: not knowing that the culprit is diabetes mellitus.

4. Kidney disease and failure : for people living with diabetes, kidney failure has become a major  consequence. Diabetes  mellitus has become a leading cause  of end-stage renal disease leading to renal replacement therapy such as  haemodialysis.

5. Impotence in men: Diabetes mellitus is commonly associated with impotence  or erectile dysfunction in men suffering from it. This is associated with lots of depression and psychological trauma especially in a  young patient.

6. Peripheral vascular disease and  or lower limb amputation: Diabetes mellitus  causes narrowing of blood supply to the lower limbs and heart; on the lower limbs, this results to  poor or nonhealing of foot ulcers. This  results to increasing lower limb amputation, of which diabetes mellitus is currently the leading medical cause of lower limb amputations.

7. Chronic infections: People living with diabetes are prone to bacterial and fungal infections more than the rest of the population. Such infections  as staphylococcus aureus, vulvovaginal candidiasis, tuberculosis, other chest and dental infections are very common among diabetic patients because of the high blood sugar they have which favours bacterial  and fungal growth /multiplications.

8. Peripheral neuropathy : people living with diabetes suffer all manner of disabling abnormal feelings especially on their feet and hands. Some feel numb, burning sensation, tingling sensation, crawling sensations, hot  sensations etc in those areas.  The worst is that once those  parasthesia become obvious,  their treatments are difficult  and expensive.

9. Infertility, increased miscarriages, increased rates of delivery by Caesarean section : There’s  high rates of infertility among men and women living with diabetes than the rest population.  For women, living with diabetes is associated with increased  miscarriages, having big babies weighing more than 4kg, therefore,  necessitating delivering by Caesarean sections. Maternal and baby deaths are also increased among  female diabetic patients than non diabetic women.

10. Depression, anxiety, psychological trauma and poverty: Diabetes mellitus is a disabling  disease which is  fraught with lots of complications. At a certain time in the  journey with diabetes, people living with diabetes are depressed, anxious and worried. Some without good social support soon get fed up with the situation and drift into a condition called diabetic burnout. Again,  diabetes mellitus is a strong pauperising illness that soon depletes one of his/ her wealth reserve. Multiple painful blood sugar monitoring in the care of persons living with diabetes goes  with some psychological trauma.

In conclusion,  there are other complications of diabetes mellitus not listed above. The point in showing these complications is to underlie the importance of regular follow up in a good  diabetes clinic where efforts  are made to prevent those complications or to ameliorate them.

Diabetes News Of The Week

November 14 of every year is celebrated all over the world as World’s Diabetes Day (WDD). WDD was  created  in 1991 by International Diabetes Federation, IDF, and World Health Organization in response to the growing concerns about the increasing health problems posed by diabetes mellitus.

Currently, at Abu Dhabi, Unitred Arab Emirates, the IDF is holding an international scientific symposium between 4 – 8th December 2017 where more than 200 scientists are brainstorming and talking about the challenges of living with diabetes

Breaking news from Abu Dhabi, UAE,  will be posted here while still hot….  Keep visiting,  and leave your comments

8 tips on how to live with diabetes and eat like anyone else

Yes,  you heard me well. In those days, we had what was the “diabetic diet”. All that has changed today. Someone living with diabetes can and should eat like anyone else. However,  these are the caveat:

  1. Someone living with diabetes should avoid eating food and taking drinks or beverages rich in refined sugar eg ice-cream, sugar rich sodas etc.

  2. People living with diabetes should eat whatever food other members of the family are eating.  They should no longer have a separate pot of food. However,  the people living with diabetes should eat small – moderate quantities of food  spread over 5 – 6 meals per day. Their food should contain starch, protein, fat and vitamins/minerals like any other person.

  3. They should  take  most fruits and vegetables in moderate quantities; avoiding some with high glycaemic index such as pineapple and very ripe fruits.

  4. People living with diabetes should avoid alcohol and tobacco smoking….as both habits increase the  risks of  cardiovascular death to the diabetic patients.

  5. It’s erroneous to  deny people living with diabetes starchy or carbohydrate rich foods because of fear of the blood sugar rising. Such food types are energy giving food which diabetic patients need for their well-being and  day to day  activities. When denied such food,  they lose weight, are weak and tired most times.  The key word  as regards their diet is moderation……small but frequent meals.

  6. People living with diabetes who have other associated illnesses such as kidney diseases, hypertension or cholesterol abnormalities should reflect that in what they eat eg those that have hypertension should take low salt diet and those who have cholesterol issues should eat white meat (from chicken,  fish, turkey  etc)  in preference to red meat (from goat, cow, lamb, etc).

  7. People living with diabetes should avoid liquid or syrub medications eg blood tonics, cough syrups etc as much as possible because most of them are preserved with glucose and can cause high blood sugar levels.

  8. Finally, people living with diabetes who are on insulin  injections should always have some cubes of sugar or sugar rich soft drinks around them. Why?  To correct hypoglycemia (low blood sugar) which could result as a side effect of insulin injections. Making such provisions could be life saving. It is  not the physician’s intentions that a diabetic patient should have  hypoglycemia but this complication (potentially fatal)  can occur.

In conclusion,  the era of very  strict dietary restrictions for someone living with diabetes is gone. With the current  dietary recommendations, someone living with diabetes has a better quality of life as he/she goes about his/her daily activities.

5 facts people should know why diabetes mellitus is not curable

Some practictioners promise people living with diabetes  that after taking their treatments, they will have a cure for diabetes mellitus. This is bogus and  deceptive. Why is this so?

  1. In people that have type 1 diabetes mellitus, the beta cells of their pancreas have been totally destroyed by autoimmune disease process leading to  absolute insulin deficiency. But,  in type 2 diabetes mellitus patients, about 50-75 percent of their pancreatic beta cells are destroyed by the time they are diagnosed with diabetes mellitus  resulting in  relative insulin deficiency. In the  latter, with time, the remaining beta cells will be depleted of insulin.  Because no medication – orthodox, herbal etc can revive a dead pancreas,  it’s obvious that  diabetes mellitus is not curable.

  2. Inability of the  target cells in the body (mainly liver, fat cells and skeletal muscle) to respond appropriately  to  circulating insulin (referred to as insulin  resistance) is another  means by which type 2 diabetes mellitus results.  Currently,  there are drugs  targetting this insulin  resistance but they don’t completely reverse it. Thus, one  can’t talk of cure for  diabetes mellitus.

  3. There’s some  disorders involving the  satiety center in the  brain resulting in disorders of appetite and resultant obesity. This is not easily corrected.

  4. Abnormal high production of glucose by the  liver cells is, also,  central to onset of  type 2 diabetes. This process is not curable.

  5. Finally, there are, also,  disorders of gut hormones and kidney reabsorption disturbances which have been found to contribute to type 2 diabetes developing in a person.

Because the above processes involved in diabetes mellitus development cannot be totally reversed by herbs, nutritional products  or drugs ,  one  cannot  talk of a cure for diabetes mellitus. At least  for now!  One has to live with it all the days of his/ her life.

However, there are promising developments in the  care of  people living with diabetes mellitus. The future is obviously bright.

A choice in the medical ward….

Mr Zack (not real name), aged 49,  has lived with diabetes for 10 years.

He matched on a stick stump and had a minor wound. Neighborhood nurse cared for the wound.

Three weeks later, whole foot got  swollen and painful

He consulted a herbal healer who said it was a type of poison called “acha ere” in local parlance. Antidote was commenced.

Four weeks later,  story did not change. He left the herbalist and presented at a private general practitioner’s office.

One week later, he was  referred to a Federal Medical Center where he was  reviewed by the  endocrinologist, plastic surgeon and orthopedic surgeon.

Verdict. He has gangrene of the  affected foot and would  need  amputation.

Time to take decision!! Zack chose to be discharged home against medical advice. He chose to  die instead of losing a part of his body. And, he died, at 49.

Choice made. End of  my story….. Leave your  comments.