Diabetes is increasingly becoming a public health problem in developing countries like The Gambia. Prevention of diabetes and appropriate management of the disease largely depends on correct knowledge of the risk factors and signs and symptoms of the condition.
The use of mass media and strengthening the education sector in The Gambia may be of importance in raising diabetes know
Diabetes prevalence has been rising more rapidly in middle- and low-income countries1,Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. WHO projects that diabetes will be the 7th leading cause of death in 2030.
Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.
Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.
What is diabetes?
Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It’s also the brain’s main source of fuel.
Diabetes is a group of conditions where the body cannot produce enough or any insulin, cannot properly use the insulin that is produced, or cannot do a combination of either, when any of these things happen, the body is unable to get sugar from the blood into your cells. This can lead to high blood sugar levels., Glucose, the form of sugar found in your blood, is one of your main energy sources. A lack of insulin or a resistance to insulin causes sugar to build up in your blood. This can lead to health problems.
The three main types of diabetes are:
o type 1 diabetes
o type 2 diabetes
o gestational diabetes
Type 1 diabetes
Type 1 diabetes is believed to be an autoimmune condition. This means your immune system mistakenly attacks and destroys the beta cells in your pancreas that produce insulin. The damage is permanent, what prompts the attacks is not clear. There may be both genetic and environmental reasons. Lifestyle factors are not believed to play a role.
Type 2 diabetes
Type 2 diabetes starts out as insulin resistance. This means your body cannot use insulin efficiently, which causes your pancreas to produce more insulin until it cannot keep up with demand. Insulin production then decreases, which causes high blood sugar, the exact cause of type 2 diabetes is unknown. Contributing factors may include:
Genetics, a more sedentary lifestyle, higher weight or obesity, there may also be other health factors and environmental reasons.
Gestational diabetes is caused by insulin-blocking hormones that are produced during pregnancy, this type of diabetes only happens during pregnancy. It is often seen in people with preexisting prediabetes and a family history of diabetes, About 50 percent Trusted Source of people diagnosed with gestational diabetes go on to develop type 2 diabetes.
The main cause of diabetes varies by type. But no matter what type of diabetes you have, it can lead to excess sugar in the blood. Too much sugar in the blood can lead to serious health problems.
Diabetes symptoms depend on how high your blood sugar is. Some people, especially if they have prediabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe, some of the symptoms of type 1 diabetes and type 2 diabetes are:
Feeling more thirsty than usual, urinating often, losing weight without trying.
Presence of ketones in the urine. Ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin, feeling tired and weak, feeling irritable or having other mood changes., Having blurry vision, having slow-healing sores, Getting a lot of infections, such as gum, skin and vaginal infections.
Type 1 diabetes can start at any age. But it often starts during childhood or teen years.
Type 2 diabetes, the more common type, can develop at any age. Type 2 diabetes is more common in people older than 40.
What is pre-diabetes
Many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes., This is sometimes known as pre-diabetes. If your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased., It’s very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated.
Causes of diabetes
The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach). When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it’s broken down to produce unshowier, if you have diabetes, your body is unable to break down glucose into energy. This is because there’s either not enough insulin to move the glucose, or the insulin produced does not work properly.
There are no lifestyle changes you can make to lower your risk of type 1 diabetes., You can help manage type 2 diabetes through healthy eating, regular exercise and achieving a healthy body weight.
Lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:
achieve and maintain a healthy body weight; be physically active – doing at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control; eat a healthy diet, avoiding sugar and saturated fats; and, avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease.
Diagnosis and treatment
Early diagnosis can be accomplished through relatively inexpensive testing of blood glucose. Treatment of diabetes involves diet and physical activity along with lowering of blood glucose and the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications. Interventions that are both cost-saving and feasible in low- and middle-income countries include:
blood glucose control, particularly in type 1 diabetes. People with type 1 diabetes require insulin, people with type 2 diabetes can be treated with oral medication, but may also require insulin;
blood pressure control; and
foot care (patient self-care by maintaining foot hygiene; wearing appropriate footwear; seeking professional care for ulcer management; and regular examination of feet by health professionals).
Diabetes during pregnancy (gestational diabetes)
Gestational diabetes is high blood sugar (glucose) that develops during pregnancy and usually disappears after giving birth. It can happen at any stage of pregnancy, but is more common in the second or third trimester. It happens when your body cannot produce enough insulin – a hormone that helps control blood sugar levels – to meet your extra needs in pregnancy.
Gestational diabetes can cause problems for you and your baby during pregnancy and after birth. But the risks can be reduced if the condition is detected early and well managed.
Who’s at risk of gestational diabetes?
Any woman can develop gestational diabetes during pregnancy, but you’re at an increased risk if: your body mass index (BMI) is above 30 – use the BMI healthy weight calculator to work out your BMI you previously had a baby who weighed 4.5kg (10lb) or more at birth you had gestational diabetes in a previous pregnancy1 of your parents or siblings has diabetes.
Symptoms of gestational diabetes
Gestational diabetes does not usually cause any symptoms.
Most cases are only discovered when your blood sugar levels are tested during screening for gestational diabetes.
Some women may develop symptoms if their blood sugar levels gets too high, such as:, increased thirst, needing to pee more often than usual, a dry mouth, tiredness, But some of these symptoms are common during pregnancy and are not necessarily a sign of gestational diabetes. Speak to your midwife or doctor if you’re worried about any symptoms you’re experiencing.
How gestational diabetes can affect your pregnancy
Most women with gestational diabetes have otherwise normal pregnancies with healthy babies., However, gestational diabetes can cause problems such as:
your baby growing larger than usual – this may lead to difficulties during the delivery and increases the likelihood of needing induced labour or a caesarean section
polyhydramnios – too much amniotic fluid (the fluid that surrounds the baby) in the womb, which can cause premature labour or problems at delivery
premature birth – giving birth before the 37th week of pregnancies – a condition that causes high blood pressure during pregnancy and can lead to pregnancy complications if not treated ,your baby developing low blood sugar or yellowing of the skin and eyes (jaundice) after he or she is born, which may require treatment in hospital, the loss of your baby (stillbirth) – though this is rare, Having gestational diabetes also means you’re at an increased risk of developing type 2 diabetes in the future.
Screening for gestational diabetes, During your first antenatal appointment (also called a booking appointment) at around week 8 to 12 of your pregnancy, your midwife or doctor will ask you some questions to determine whether you’re at an increased risk of gestational diabetes.
If you have 1 or more risk factors for gestational diabetes you should be offered a screening test., The screening test is called an oral glucose tolerance test (OGTT), which takes about 2 hours.
It involves having a blood test in the morning, when you have not had any food or drink for 8 to 10 hours (though you can usually drink water, but check with the hospital if you’re unsure). You’re then given a glucose drink., After resting for 2 hours, another blood sample is taken to see how your body is dealing with the glucose.
The Test is done when you’re between 24 and 28 weeks pregnant. If you’ve had gestational diabetes before, you’ll be offered a test earlier in your pregnancy, soon after your booking appointment, then another test at 24 to 28 weeks if the first test is normal.
For further information check with Gambian diabetes agency website, WHO website, email to Dr H. Azadeh on [email protected], text only on WhatsApp from 3PM to 6PM on +2207774469.
Dr H. Azadeh, senior lecturer at the University of The Gambia, Clinical Director at Medicare Health Services.