SCIENCE

THE DIABETES EPIDEMICS IN DEVELOPING COUNTRIES

Diabetes is a chronic condition that occurs when the body cannot produce enough insulin - as many people know it. Type I diabetes kills if not treated with insulin. Type II diabetes is more complex to understand. It is when the body cannot effectively use insulin that the pancreas produces. People with Type II diabetes can remain undiagnosed for many years and poorly managed diabetes leads to serious complications , among others heart attack and early death .

One laboratory criterion for diagnosis is fasting blood glucose levels above 7,0mmol/L .

PREVALENCE

In 2011, 14.7 million adults in the Africa-Region are estimated to have diabetes, with a regional prevalence of 3.8%. Some of Africas most populous countries also have the highest number of people with diabetes, with Nigeria having the largest number (3.0 million), followed by South Africa (1.9 million), Ethiopia (1.4 million)*, and Kenya (769,000).

The top six countries with the highest number of people with diabetes make up just over half of the total number in the region. It can easily be termed as an epidemic.

*When adding both Diabetes and Prediabetes, there are probably more than 4.5 Million patients in Ethiopia (11.7 % of those between ages of 20-79). It is possible that the IDF estimates may underestimate the real prevalence of the disease.

Children in the region with type 1 diabetes often go undiagnosed to certain death.

PREVENTION

Based on the findings of lifestyle prevention studies, it is recommended that: Everyone is encouraged to engage in at least 30 min of moderately intense physical activity (eg. brisk walking) most days of the week. Everyone should be encouraged to maintain a healthy diet and a healthy weight. Obesity, particularly abdominal obesity, is central to the development of Type II diabetes and other disorders. Stop smoking now! WARNING SIGNS OF DIABETES Most people know these signs: Excessive thirst and urination, weight loss, fatigue, abdominal pain, vomiting, blurred vision...... The onset of type 1 diabetes is usually sudden and dramatic so we do not have to dwell on that. Type II diabetes accounts for at least 90% of all cases of diabetes. With Type II, symptoms can often be mild or absent, making this type of diabetes gradual in onset and hard to detect and the diagnosis of Type II diabetes is usually delayed, sometimes presenting itself with complications already at diagnosis! It often occurs after the age of 40 but can occur earlier, especially in populations with high diabetes prevalence. It is characterized by insulin resistance and relative insulin deficiency, either of which may be present at the time that diabetes becomes clinically manifest. Type 2 diabetes can remain undetected for many years and the diagnosis is often made from associated complications or incidentally through an abnormal blood or urine glucose test. It is often, but not always, associated with obesity, which itself can cause insulin resistance and lead to elevated blood glucose levels. COMPLICATIONS OF DIABETES Type 1 and type 2 diabetes are life-long conditions that require careful monitoring to control both high and too low levels . Without proper management they can lead to very high blood sugar levels which can result in long term damage to various organs and tissues like: Cardiovascular disease: affects the heart and blood vessels and may cause fatal complications such as coronary heart disease (leading to heart attack) and stroke. Cardiovascular disease is the major cause of death in people with diabetes, accounting in most populations for 50% or more of all diabetes fatalities, and much disability. Kidney disease (diabetic nephropathy): can result in total kidney failure and the need for dialysis or kidney transplant. Diabetes is an increasingly important cause of renal failure, and indeed has now become the single most common cause of end stage renal disease, i.e. that which requires either dialysis or kidney transplantation. Nerve disease (diabetic neuropathy): can ultimately lead to ulceration and amputation of the toes, feet and lower limbs. Loss of feeling is a particular risk because it can allow foot injuries to escape notice and treatment, leading to major infections and amputation. Eye disease (diabetic retinopathy): characterized by damage to the retina of the eye which can lead to vision loss. //The E