Tuesday, April 10, 2012

Shut out diabetes with healthy living

A sedentary lifestyle, fatty fast-food and lack of exercise are contributing to more and more people falling victim to lifestyle ailments such as diabetes and obesity. Not a week goes by without reports on the high numbers in the UAE.

Diabetes is a pandemic in the Middle East and North Africa. While an estimated 24.5 million people are affected by diabetes, an equal number of people are on the threshold with Impaired Glucose Tolerance (IGT) or pre-diabetic stage. The figure is expected to double in the next 15 years.

This explosion of diabetes in the region is due primarily to the rapid economic growth, widespread urbanization as well as Westernized and sedentary lifestyles. Diabetes ranks top on the region’s healthcare concerns and diabetes education efforts are in full swing.

I am all too familiar with diabetes and its effects. My father, Esa, had diabetes. He developed Type 2 diabetes in his late forties. I don’t remember exactly when, but I was very young and it affected his lifestyle and the family’s.

Although not life-threatening and kept under control, it eventually contributed to his death. When he was admitted, unconscious, to hospital in Bahrain after being hit by a drunk driver, the doctors did not know he had diabetes. It seems wrong medicines were administered in the ER and…

Dad was a big sportsman and not obese. A lot of adjustments were made to the family’s diet and activities. We were brought up with very little sweets at home so as not to tempt him. Dishes were cooked in a healthy, non-greasy way, and the beach was a great outlet for sports. It taught us very young to eat healthy and try and always exercise.

The World Health Organization (WHO) estimates more than 346 million people worldwide have diabetes. Without intervention, this number is likely to more than double by 2030. It says 80% of diabetes deaths occur in low- and middle-income countries.
WHO explains:

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels.

Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. The cause of Type 1 diabetes is not known and it is not preventable with current knowledge.

Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes and fatigue. These symptoms may occur suddenly.

Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body’s ineffective use of insulin. Type 2 diabetes comprises 90% of people with diabetes around the world, and is largely the result of excess bodyweight and physical inactivity.
Symptoms may be similar to those of Type 1 diabetes, but are often less marked. As a result, the disease may be diagnosed several years after onset, once complications have already arisen. Until recently, this type of diabetes was seen only in adults but it is now also occurring in children.

Gestational diabetes is Hyperglycaemia with onset or first recognition during pregnancy. Symptoms are similar to Type 2 diabetes. It is usually diagnosed through prenatal screening, rather than reported symptoms.

Impaired Glucose Tolerance (IGT) and Impaired Fasting Glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to Type 2 diabetes, although this is not inevitable.

Last World Diabetes Day (November 14, 2011), the International Diabetes Federation developed five key messages on the disease:
  • Diabetes kills: 1 person every 8 seconds, 4 million people a year
  • Diabetes does not discriminate: all ages, rich and poor, all countries
  • Diabetes can no longer be ignored: 4 million lives lost a year, 1 million amputations a year, millions lost in income and productivity
  • Life-saving care, a right not a privilege: education, medicines, technologies
  • Choose Health: demand healthy food and environments, keep active, eat well.

The warning signs of diabetes include (these can be mild or absent in people with Type 2 diabetes):
  • Frequent urination
  • Excessive thirst
  • Increased hunger
  • Weight loss
  • Tiredness
  • Lack of interest and concentration
  • Vomiting and stomach pain (often mistaken as the flu)
  • A tingling sensation or numbness in the hands or feet
  • Blurred vision
  • Frequent infections
  • Slow-healing wounds

There are many risk factors for Type 2 diabetes. They include:
  • Obesity and overweight
  • Lack of exercise
  • Previously identified glucose intolerance
  • Unhealthy diet
  • Increased age
  • High blood pressure and high cholesterol
  • A family history of diabetes
  • A history of gestational diabetes

About 19.5 per cent of the UAE's population is now living with diabetes according to statistics released by the Imperial College London Diabetes Center. Figures show that 40 per cent of residents over 60 have diabetes and the number is expected to increase over the coming years.

Chart from Gulf News
A study by United Health Group titled “Diabetes in the United Arab Emirates: Crisis or Opportunity?” finds the prevalence of Type 2 diabetes in the Emirates is amongst the highest in the world.

By 2020, an estimated 32 percent of the adult population (aged 20-79), including nationals and expatriates, may have diabetes or pre-diabetes at a possible cost of $8.52 billion (AED 31.27 billion) over the next decade if current trends continue. This means that one in three adults from all levels of UAE society will be affected. Yet, the vast majority of cases of pre-diabetes and about 35 percent of cases of diabetes in the UAE remain undiagnosed, representing lost opportunities to avoid the costs and complications of a largely preventable disease.

Healthy snacks for diabetes
Weight is at the heart of the problem. Obesity, pre-diabetes and diabetes are related conditions that create a dangerous, yet preventable, cascade of health and economic impacts. According to WHO, about 73 percent of adult women and 66 percent of men are overweight or obese in the UAE, placing the country in the top five worldwide in the obesity stakes.  And women in the UAE are more likely to have pre-diabetes than men.
With children as young as 10 being diagnosed with the illness -- again due to obesity, coupled with physical inactivity, an unhealthy diet and hypertension – it is a warning bell for parents to take action.

The above figures are quite frightening and it might be time to cut down on fast food and fizzy drinks and take a walk. It’s never too early to heed an SOS on health.