642 million people will live with Diabetes by 2040

415 million people currently live with diabetes, with this figure expected to grow to 642 million people by 2040 according to the International Diabetes Federation (IDF).  More distressingly, for the first time it is estimated there are now more than half a million children aged 14 and younger living with type 1 diabetes according to the 7^th IDF Diabetes Atlas.

A further 318 million adults are estimated to have impaired glucose tolerance which puts them at high risk of progressing to diabetes, a disease that has already killed more people than HIV/Aids, TB and Malaria combined.

“Of concern is that of the 415 million people living with diabetes, an estimated 193 million – almost half – are undiagnosed.  In support of this year’s IDF campaign themed “Eyes on Diabetes”, Lilly South Africa is encouraging South Africans to educate themselves about the risk factors for diabetes, and to proactively screen for type 2 diabetes in a bid to modify its course and reduce the risk of complications.   A person with type 2 diabetes can live for several years without showing any symptoms of this chronic disease, during which time high and uncontrolled blood glucose can cause significant damage in the body.  There is an urgent need to screen, diagnose and provide appropriate treatment to people with diabetes, as well as screen for complications as an essential part of managing both type 1 and type 2 diabetes,” explains Dr Ntsiki Molefe-Osman, Diabetes Medical Advisor at Lilly South Africa.

Diabetes is a leading cause of cardiovascular disease, blindness, renal failure and lower-limb amputation. More than a third of type 1 and type 2 diabetics will also develop some form of damage to their eyes that can lead to blindness. (Ref: https://www.idf.org/complications-diabetes )

“Fundamental to managing and preventing the complications of diabetes is diligent management of blood glucose, blood pressure and cholesterol levels to as close to normal levels as possible.  While diabetes can present with many complications, these can be picked up early through proactive screening so that they can be treated and managed, preventing them from becoming more severe and impacting health and quality of life. Whilst a diagnosis of diabetes may come as a shock and does require significant lifestyle adjustments, it’s important to remember that with consistent and good control, millions of people living with diabetes live full, active lives,” adds Dr Molefe Osman.

What is the difference between type 1 and type 2 diabetes?

Diabetes is a complex disorder of carbohydrate, fat and protein metabolism that is primarily a result of a deficiency or complete lack of insulin secretion by the pancreas, or resistance to insulin.

• Type 1 diabetes – usually begins in childhood or adolescence and is caused by a faulty autoimmune response that causes the body to destroy the pancreatic cells that produce insulin, which in turn leads to an insulin deficiency.
• Type 2 diabetes – approximately 90% of all cases of diabetes are type 2. In the case of type 2 diabetes, insulin is produced, but the body’s cells do not respond to it correctly. Instead, the body becomes resistant to insulin. It is most often but not always associated with obesity, poor diet, physical inactivity, advancing age, family history of diabetes, ethnicity and high blood glucose during pregnancy. It can go undiagnosed for years. Due to the progressive nature of the disease, a majority will eventually need insulin to be added to their treatment.   

(Ref: https://www.idf.org/about-diabetes )

Symptoms of type 2 diabetes: 

• Excessive thirst
• Frequent urination
• Persistently dry skin
• Always feeling hunger
• Blurred vision
• Drowsiness
• Nausea

There is no cure for diabetes – prevention is crucial

There’s no cure for type 1 diabetes although researchers are working on preventing the disease as well as the further destructive progression of the disease in people who are newly diagnosed. However, up to 80% of type 2 diabetes can be prevented by making simple changes in our everyday lives and knowing the risks.  The huge emphasis on prevention, or if you’re already living with diabetes, on strict control, is with good reason.  Diabetes is an exceptionally challenging disease to live with and manage, requiring the support of specialist doctors, and a huge amount of discipline on the part of the patient in managing the demanding diet, lifestyle and treatment regimen.  There are a number of health challenges that come with living with diabetes including:

• Diabetic retinopathy – diabetes can lead to eye disease (retinopathy), which can damage vision and even cause blindness.  
• Nerve damage – poorly controlled blood glucose and high blood pressure can lead to damage of the nerves throughout the body (neuropathy). This damage can lead to problems with digestion, urination, erectile dysfunction in men and other complications. Among the most commonly affected areas are the extremities, in particular the feet, where nerve damage can lead to pain, tingling, and loss of feeling. Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations.  
• Kidney failure – Kidney disease (nephropathy) is far more common in people with diabetes, a leading cause of chronic kidney disease.
• Heart Disease – 50% of people with diabetes die of cardiovascular disease – angina, heart attack, stroke, peripheral artery disease, and congestive heart failure.
• Depression – Diabetes can cause complications and health problems that worsen symptoms of depression, leading to poor lifestyle decisions, such as unhealthy eating, less exercise, smoking and weight gain. 
• Mortality risk – the risk of dying prematurely among people with diabetes is at least double the risk of people without diabetes.

How to reduce your risk

While some risk factors for diabetes such as age, ethnicity and family history can’t be changed, many other risk factors such as managing your weight, eating healthy foods in the right quantities and exercising regularly can be managed. According to Diabetes South Africa (Ref: https://www.diabetessa.org.za/are-you-at-risk/ ), there are various aspects to good diabetes management including:

• Education – Knowing about diabetes is an essential first step. All people with diabetes need to understand their condition in order to make healthy lifestyle choices and manage their diabetes well.
• Healthy eating – There is no such thing as a ‘diabetic diet’, only a healthy way of eating, which is recommended for everyone. However, what, when and how much you eat plays an important role in regulating how well your body manages blood glucose levels. It’s a good idea to visit a registered dietician who can help you work out a meal plan that is suitable for your lifestyle.
• Exercise – Regular exercise helps your body lower blood glucose levels, promotes weight loss, reduces stress and enhances overall fitness.
• Weight management – Maintaining a healthy weight is especially important in the control of type 2 diabetes.
• Medication – People with type 1 diabetes require daily insulin injections to survive. There are various types of insulin available in South Africa. Type 2 diabetes is controlled through exercise and meal planning and may require diabetes tablets and\or insulin to assist the body in making or using insulin more effectively. Talk to your doctor about the best treatment option for you, as well as the all-important cost considerations of different treatments.
• Lifestyle management – Learning to reduce stress levels in daily living can help people manage their blood glucose levels. Smoking is particularly dangerous for people with diabetes.