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Diabetes is a leading cause of morbidity and mortality in Africa. It is estimated that 15.9 million people are living with Diabetes in Africa.
Africa also has the greatest proportion of undiagnosed Diabetics; it is estimated that 60% of adults living with Diabetes do not know that they are Diabetic. (IDF,2019).
The prevalence of Diabetes is rapidly increasing owing to urbanisation, unhealthy lifestyle choices and obesity just to mention a few.
The prevalence of Diabetes in adults in South Africa is estimated to be at 12.8% having doubled since 2000 (IDF) while the prevalence of Diabetes in neighbouring Zimbabwe is currently estimated to be at 8.5% and it has doubled in the last 30 years (Mutowo et al, 2015).
The costs related to the management of diabetes complications which include hospitalisation are high and these high costs are burdening the health system.
Indirect costs are also high because the population mainly affected by Diabetes is the working class. If they are absent from work productivity decreases.
Diabetes has quickly become an epidemic and urgent action has to be taken so that we can halt the progression of it.
Diabetes is a condition where your body fails to regulate blood sugar levels. Our bodies release a hormone called insulin which plays a crucial role in maintaining normal blood sugar levels.
After having a meal, the food is digested in our stomach and within a few hours the products of digestion are ready to be absorbed into the bloodstream via the intestines.
One of the by-products of digestion is glucose which we sometimes refer to as “sugar”.
Once glucose is absorbed into the bloodstream the body is stimulated to release insulin, this hormone, as indicated earlier will ensure that the glucose levels (sugar levels) reduce to normal parameters.
If the body fails to release adequate insulin levels to lower the blood sugar or if it releases adequate amounts of insulin but the cells in the body fail to respond to the insulin released, this will result in high levels of glucose circulating in the blood stream.
High circulating glucose levels eventually lead to a condition which is called Diabetes. This failure in regulation of blood glucose either by a lack of insulin production or by a lack of response to the insulin released can occur to anyone and may present at any age.
There are different types of Diabetes conditions. This will depend on the underlying disease mechanism. Type 1 and Type 2 are the most known types of Diabetes and the other types include Gestational diabetes and a condition we call pre-Diabetes. I will explain these further.
Type 1 can occur at any age but commonly presents during childhood or adolescence. In Type 1 Diabetes your body fails to produce Insulin.
This means that when your blood glucose levels go up there is nothing in the circulation that will assist to bring the levels down. This is called Insulin deficiency.
Type 2 Diabetes may also occur at any age but commonly presents in adulthood. In Type 2 Diabetes your body is still able to produce insulin.
So, when your blood glucose levels go up after your meal, insulin is adequately released into the bloodstream however your body is not able to detect and respond to the insulin that has been released and that is circulating in the bloodstream. We call this insulin resistance.
This is the most common type of Diabetes.
This state of insulin resistance is associated with being overweight.
As an overweight diabetic patient loses weight, control of blood sugar improves as the body becomes better at detecting the insulin.
Prediabetes and gestational diabetes are potentially reversible diabetic conditions.
Pre-diabetes is a condition where your blood sugar levels are higher than normal but are not high enough for you to be initiated on treatment.
If preventive measures are not taken pre-diabetics progress to Type 2 Diabetics.
Gestational Diabetes occurs during pregnancy and often resolves after the pregnancy, but these individuals have a risk of developing Type 2 Diabetes.
Preventive measures mean that one has to make lifestyle changes and changes to their dietary habits and exercise habits with the goal to prevent development of Diabetes.
Risk factors for developing Diabetes include advanced age, a positive family history of diabetes, being overweight because the more fatty tissue you have the more resistant your cells become to insulin, inactivity, the less active you are greater your risk and poor dietary choices which means a lot of processed, refined sugary foods and eating less of wholegrains, fruits and vegetables.
To reduce your risk of developing Diabetes we advise you to work on reducing your weight if you are overweight, eating foods that are less sugary, less processed or refined, reducing your alcohol intake and opting for more fruits, vegetables, nuts and wholegrain foods and a healthy intake of moderate fat dairy products.
Symptoms of Diabetes include increased thirst, increased hunger, increased urination, rapid weight loss, weakness and blurred vision.
They may also include difficulty in concentration, slow healing wounds, recurrent oral thrush and vaginal thrush and sexual dysfunction.
All these symptoms are a result of high circulating blood sugar levels.
It is important to have yourself screened for Diabetes. It is even more important to have yourself screened now for Diabetes as we are faced with COVID 19.
As we might already know, people who suffer from moderate to severe disease and also those that require hospitalizations are individuals with underlying chronic conditions.
We are seeing that patients who are presenting with moderate to severe disease are presenting as newly diagnosed diabetics or known Diabetics who are poorly controlled.
I advise you to continue to observe the COVID 19 safety practices, mask up, practice handwashing and sanitise your hands, observe social distancing and get screened for Diabetes.
If you are a Diabetic strive to control your blood sugar levels by taking treatment as advised by the doctor, exercising at least 5 times per week for at least 30 minutes, and opting for healthier food choices.
Follow this column as we continue to talk about Diabetes and other health topics.
Contact All In 4 Health for General Medical Consultation, health screening, medical check-up, health education and promotion. The Glen Marais Shopping Centre, 57 Veld Street, Glen Marais, Kempton Park 1619
References: Mutowo M et al. Prevalence of diabetes in Zimbabwe: a systematic review with meta-analysis, Int J Public Health.2015, International Diabetes Federation, 2019, World Health Organisation.
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