Mrs Bukky, a 65 year old grandma, has lived with diabetes for more than 22 years but she is relatively free from most of the chronic complications of diabetes mellitus. She looked like any other woman of her age; going about her daily activities with grace and is fully involved in her petty trading, social and church activities.
What’s the secret, one may ask?
Or is she just lucky?
Has she paid some prices to be enjoying her present state of health?
Can one eat his cake and have it?
Opportunities and luck favor the prepared mind! Five tips to increasing one’s chances of preventing the chronic complications of diabetes mellitus are discussed below:
1. Good control of blood glucose – good control of one’s blood glucose within the normal range over a long time goes a long way to minimizing development of the chronic complications of diabetes. Most of the chronic complications of diabetes mellitus have been associated with chronic hyperglycemia (ie raised blood glucose). Target blood glucose for each person living with diabetes is personalized now based on age of patient, life expectancy, presence of other illnesses, motivation and support. But, it has been shown from landmark studies /researches that good blood glucose control over a long time helps a lot to prevent the chronic complications. With a certain disciplined lifestyle (diet and exercise) and medications, one can achieve a persistent good blood glucose level.
There is the concept of legacy effects with regards to diabetes control in which it is known that good glucose control or otherwise from the time of diagnosis of diabetes mellitus affects the complications the patients may or may not develop several years later. Bearing this in mind, every person living with diabetes should strive to achieve good glucose control from the onset of diagnosis. One reaps what he/she sows!
2. Chronic complications of diabetes mellitus can be minimized by addressing adequately the other illnesses that are oftentimes associated with diabetes. For example, people living with diabetes often, also, are afflicted by hypertension and disorders of lipids. These associated illnesses must be treated at the same time that glucose control is taking place. Good diabetes care is not only about blood glucose control.
3. To prevent the chronic complications of diabetes mellitus, a diabetic patient who is overweight or obese must strive to lose weight and those that engage in tobacco smoking should stop such. This is because tobacco smoking and obesity are strong risk factors for cardiovascular diseases which have been shown to be the major causes of death in diabetic patients.
4. Good foot care practices, regular diabetes clinic visits and patient’s participation in diabetes self management education are important measures to prevent chronic complications of diabetes. Diabetic foot ulcer and lower limb amputations are preventable and are very expensive to treat. Self care is an important component of diabetes care and the skills for self care are imparted via diabetes self management education.
5. Finally, people diagnosed with diabetes mellitus should register and attend specialized diabetes clinics run by most tertiary hospitals. If one has access to a diabetologist/endocrinologist to take care of him or her, the better for the person. There are several practictioners out there with questionable competencies promising people living with diabetes are cure for diabetes. Most of them are quacks and will end up causing more harm than good.
When these tips are implemented, persons living with diabetes will reap the benefits in form of diabetes free of chronic complications. From the above, person’s living with diabetes are not at the mercy of diabetes per se. They can do something to help themselves minimize or prevent the chronic complications of diabetes.
The statistics are not heart-warming. According to the latest (8th) IDF Diabetes Atlas, 425 million people are living with diabetes currently and the projection is that by 2045, 700 million people will have diabetes mellitus. The question is: what can and should we do to ensure the 2045 projection does not become a reality?
All of us have one role or the other to play. If we do our bits, then as a team, the results can be amazing. It’s a popular saying in my community that it is only a tree that just stays where it is when a man is coming to cut it down. Most other beings will run away or attack the predator.
Diabetes mellitus is on our trail. We’re not trees and should not stand still like a tree. Lifestyle changes (diet and exercise) have a lot to do with type 2 diabetes.
Someone living with diabetes can make his/her kids wealthy. He/she does this by influencing the lifestyles of their children such that they do not develop obesity and type 2 diabetes. Childhood and youth obesity is on the increase globally. Many of such children with obesity are the children of those who are currently living with type 2 diabetes. Be a mentor to our children so they don’t make the same mistakes you made. Diabetes mellitus is a strong pauperizing disease….. Enrich your kids and facilitate their being wealthy by helping them live without type 2 diabetes. Yes, if you mentor your kids well while living with diabetes such that they do not develop type 2 diabetes, you have effectively removed a strong poverty – inducer in their lives. Catch them young; tell them what is afflicting you and the place of diets, physical exercise, tobacco smoking, alcohol, obesity etc in the big picture. Health care professionals are already overwhelmed by the enormity of the diabetes assignments. But, together we can make the necessary impact.
In conclusion, the choice is ours….to make the day brighter. We can make it!
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.
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.
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.
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