Access to Diabetes Education

The statistics regarding diabetes are both alarming and troubling. The International Diabetes Federation IDF states that approximately 537 million adults (20-79 years) are living with diabetes. The total number of people living with diabetes is projected to rise to 643 million by 2030 and 783 million by 2045. World Diabetes Day (WDD) was created in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO) in response to growing concerns about the escalating health threat posed by diabetes. World Diabetes Day became an official United Nations Day in 2006 with the passage of United Nation Resolution 61/225. It is marked annually on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922. Like all United Nations days there is a particular message surrounding the day. World Diabetes Day provides an opportunity to raise awareness of diabetes as a global public health issue and what needs to be done, collectively and individually, for better prevention, diagnosis and management of the condition. The theme this year is Access to Diabetes Education. In what is arguably the world’s largest diabetes awareness campaign, WDD has a global audience of over 1 billion people in more than 160 countries. The global campaign is geared at drawing attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public and political spotlight. What is Diabetes? Cleveland Clinic states diabetes happens when your body is not able to take up sugar (glucose) into its cells and use it for energy. This results in extra sugar in your bloodstream. The mismanagement of diabetes can lead to serious consequences, causing damage to a wide range of your body's organs and tissues including your heart, kidneys, eyes and nerves. Different Types of Diabetes Type 1 Diabetes: This type is an autoimmune disease, meaning your body attacks itself. In this case, the insulin-producing cells in your pancreas are destroyed. Up to 10% of people who have diabetes have Type 1. It’s usually diagnosed in children and young adults (but can develop at any age). It was once better known as “juvenile” diabetes. People with Type 1 diabetes need to take insulin every day. This is why it is also called insulin-dependent diabetes. Type 2 Diabetes: With this type, your body either doesn’t make enough insulin or your body’s cells don’t respond normally to the insulin. This is the most common type of diabetes. Up to 95% of people with diabetes have Type 2. It usually occurs in middle-aged and older people. Other common names for Type 2 include adult-onset diabetes and insulin-resistant diabetes. Your parents or grandparents may have called it “having a touch of sugar.” Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes. Gestational Diabetes: This type develops in some women during their pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes you're at higher risk of developing Type 2 diabetes later on in life. Drug or Chemical-Induced Diabetes: Examples of this type happen after organ transplant, following HIV/AIDS treatment or are associated with glucocorticoid steroid use. Symptoms of Diabetes Symptoms of diabetes include: • Increased thirst. • Weak, tired feeling. • Blurred vision. • Numbness or tingling in the hands or feet. • Slow-healing sores or cuts. • Unplanned weight loss. • Frequent urination. • Frequent unexplained infections. • Dry mouth. • Women: dry and itchy skin, and frequent yeast infections or urinary tract infections. • Men: decreased sex drive, erectile dysfunction and decreased muscle strength. Complications According to the Mayo Clinic long-term complications of diabetes develop gradually. The longer you have diabetes and the less controlled your blood sugar the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. In fact, prediabetes can lead to type 2 diabetes. Possible complications include: • Heart and blood vessel (cardiovascular) disease. Diabetes majorly increases the risk of many heart problems. These can include coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you're more likely to have heart disease or stroke. • Nerve damage (neuropathy). Too much sugar can injure the walls of the tiny blood vessels (capillaries) that nourish the nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction. • Kidney damage (nephropathy). The kidneys hold millions of tiny blood vessel clusters (glomeruli) that filter waste from the blood. Diabetes can damage this delicate filtering system. • Eye damage (retinopathy). Diabetes can damage the blood vessels of the eye (diabetic retinopathy). This could lead to blindness. • Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of many foot complications. • Skin and mouth conditions. Diabetes may leave you more prone to skin problems, including bacterial and fungal infections. • Hearing impairment. Hearing problems are more common in people with diabetes. • Alzheimer's disease. Type 2 diabetes may increase the risk of dementia, such as Alzheimer's disease. • Depression. Depression symptoms are common in people with type 1 and type 2 diabetes. The Challenges of Diabetes Control According to the Pan American Health Organization (PAHO), the expansive increase in the diabetes epidemic goes hand in hand with the rise in its risk factors. The Americas is the most overweight/obese and physically inactive region in the world: 63 out of 100 adults are overweight or obese, and 39 out of 100 people have insufficient physical activity. The increase in risk factors for diabetes is alarming in children and adolescents. Thirty-two out of 100 adolescents and 36 out of 100 children are overweight or obese, while 81 out of 100 adolescents engage in insufficient physical activity. People living with diabetes face different barriers to accessing health care: treatment for diabetes and its complications can be costly and often requires high out-of-pocket expenses. Insulin is crucial to sustaining the lives of people living with Type 1 diabetes and many with type 2 diabetes. In many countries, diabetes care is not included in universal health coverage, and there are gaps in primary health care services and access to other care levels. The PAHO theorizes that The COVID-19 pandemic has seriously affected access to diabetes health services. Despite the association between diabetes and COVID-19 and the need for continuous and uninterrupted care for people living with the disease, in many countries, COVID-19 preparedness and response plans do not include services for diabetes. Living With a Non-Communicable Disease Non-communicable diseases are those diseases that are not transferrable by contact but rather developed through family genetics, degenerative changes or unhealthy lifestyle habits. Living with diabetes is not a walk in the park. Diabetes management and care requires vigilance and consistency. With diabetes there are no days off. It is critical that one learns how to test one’s blood glucose levels; this should be done on a daily basis and recorded for future reference. The overall treatment for diabetes is not cheap. One has to purchase the testing strips, the lancets and the needles especially for those with Type 1 diabetes which is Insulin dependent. Of course there is also the doctor’s visit. In many instances a visit to a private doctor can cost as much as $5,000. Quite often the diagnosis of diabetes is made in the prime of your life and as you retire your income levels decrease drastically. Approximately 11.9% (9% men, 14.6% women) or 236,200 of Jamaicans 15 years and older have diabetes. Unfortunately, many Jamaicans do not have health insurance. One also has to be vigilant in order not to have a medical situation where one goes into Hyperglycemia. This is high blood glucose which occurs when there is too much sugar in the blood. This happens when your body has too little insulin (the hormone that transports glucose into the blood), or if your body can't use insulin properly. On the other hand there is Hypoglycemia a condition in which your blood sugar (glucose) level is lower than the standard range. Treatment involves quickly getting your blood sugar back to within the standard range either with a high-sugar food or drink or with medication. Sadly, my dad who has Type 1 diabetes has experienced both hypercemia and hypogkycemia which led to him being hospitalized in December of 2018. Call to Action The international community is being encouraged to support the World Health Organization (WHO) established five diabetes coverage targets by 2030. These targets are: eighty percent (80%) of people living with diabetes are diagnosed, eighty percent (80%) of people with diagnosed diabetes of good control of glycaemia, eighty percent (80%) of people with diagnosed diabetes have good control of blood pressure, sixty percent (60%) of people with diabetes of 40 years or older receive Statins and finally, 100 percent of people with Type 1 diabetes have access to affordable Insulin and blood glucose self- monitoring. Both my parents have diabetes. The elderly are especially challenged without a caregiver regarding care for diabetes. There are numerous complications from diabetes. Diabetes is an awful disease that affects all of your organs. It is very important that one follows the advice by one’s doctor regarding the management of diabetes. There are those who will argue that the pharmaceutical drugs are not the best in managing diabetes and those persons often explore bush medicine in the management and treatment of their diabetes. It is imperative that we listen to our bodies; access information concerning diabetes education and consult and heed the advice of our primary health care provider surrounding the management of diabetes. At the end of the day each individual has to do what he/she thinks is best for them. As we commemorate World Diabetes Day, we need to redouble our efforts in ensuring access to diabetes education become universal. Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. waykam@yahoo.com @WayneCamo © #WorldDiabetesDay #Insuling #EducationToProtect