Eyes on diabetes: Knowing and managing it
As the Dietetics department of the National Orthopaedic Hospital, Igbobi, Lagos, joined the rest of the world to celebrate the 2016 World Diabetes Day, some issues concerning the health condition were brought to the fore.
Highlighting the fact that many people are unaware that they are diabetic, Dr. Olurotimi. O. Odunubi, Medical Director, Orthopaedic Hospital Igbobi said: “It’s in the process of assessing some patients brought in from road accidents or who come for the treatment of arthritis that we discover they have diabetes mellitus. Other patients come as a result of complications of the problem, especially gangrene of the lower limb, which is a complication of poorly managed diabetes mellitus. The incidence of patients that have had amputation from diabetes seems to be higher than amputation from trauma.
“It is a concern to the hospital that patients with diabetes are poorly managed before they are presented to us, which presents a big challenge.”
He explained that as opposed to the treatment of patients of road accidents and arthritis, the hospital is lucky to have physicians and consultants that can help manage diabetes. The addition of an endocrinology to the hospital team, he said, will be highly welcome.
This year’s theme for the World Diabetes Day was “Eyes on Diabetes.’’ The event kicked off with a free sugar and blood pressure test for all, which lasted through out the day.
Dr. Okobi, a consultant physician at the National Orthopaedic Hospital defined diabetes as a metabolic disorder.
“When an individual eats a meal, the body releases insulin because the meal is broken down into smaller molecules called glucose, which is what the body needs to build up itself.
“So, as soon as we eat a meal and our blood sugar goes up, the normal response is that our pancreas are stimulated. This causes increase of insulin, which drives sugar in the blood through the cell. But in diabetes, this process does not take place. Instead, when a person eats and the body breaks it down, the blood sugar increases, but the sugar remains in the blood, as there is no insulin to drive it into the cell, which is the reason people refer to diabetes as ‘Starvation in the midst of plenty, as sadly, the cells do not have access.’
“The cells become starved of glucose, despite the fact that there is a lot of glucose in the blood. It is a metabolic disorder in which there is absolute insulin deficiency.”
Okobi explained that there are different types of diabetes. Type 1, also called juvenile diabetes, occurs when the pancreas don’t produce insulin. The treatment involves giving insulin to the patients. Persons less than 30 years are more likely to have the type 1 diabetes
Patients with type 2 diabetes have insulin, but this may not be adequate. This condition usually affects people who are overweight. The consequence is that their cells are affected, which don’t allow them to grow properly.
Gestational diabetes mellitus occurs during pregnancy and usually goes away after the baby is born. It is diagnosed, when higher than normal blood glucose levels first appear during pregnancy.
“In 1984 in Jos, 3.1 per cent of the population had diabetes, but there was an increase of 10.3 per cent in 2004, Okobi said. “Diabetes can also be silently present in the system for up to 10 years before its presence is detected. So, the only way out is to go for regular screening.”
So, what are the symptoms of diabetes?
“Some of the symptoms include, blurred vision, lack of energy, weight loss, excessive thirst, vaginal infection and frequent urination.
“Our aim is to let the public know that the condition can be managed and patients can live good life, even after being diagnosed. Non-communicable diseases are more common than that of the human immunodeficiency virus (HIV) and Tuberculosis (TB).”
Mrs. Babasola Foluso, a representative of the nutrition society of Nigeria, also explained that diabetic patients can still live a normal life style.
She said: “In 2015 alone, about 193 million people worldwide were diagnosed of diabetes and by the year 2040, one in 10 adults will have diabetes, if we do not fight it. A healthy sugar level should be between 90 to 125mg/dl (milligrams per deciliter).
Mrs. M.O. Obono, head of the Pharmacy department advised that every one should get tested regularly, regardless of age.
“Over time, high blood sugar can wreak havoc on every major organ system in the body, causing heart attacks, strokes, kidney failure, blindness, impotence and infections that can lead to amputations,” she said.
“But, properly treated, the impact of diabetes can be reduced. Even people with type 1 diabetes can live long and healthy lives, if they keep their blood sugars under tight control. Regular physical activity at least three times a week for 30 minutes, is advised so that the insulin can act.’’
Mrs. Umeche, a dietician, advised that a food diary should be planned, with food portions controlled. She encouraged people to go for a variety of food, which should include 50 per cent vegetables, 25 per cent protein, such as, fish and meat, while the remaining 25 percent should be carbohydrate.
She said the idea of diabetic patients avoiding fruits is unfounded, as diabetics can eat fruits.