Fast facts: Diabetes, its dangers and complications

Jotham Angatia being injected with insulin by his wife, Electine, at their Ibokolo home in Butere, Kakamega County. He has battled diabetes for 39 years. [Nanjinia Wamuswa, Standard].

Every November 14, World Diabetes Day is marked to raise awareness on the disease whose prevalence experts warn will shoot past projections if rising trends of obesity are not controlled.

Diabetes -- a chronic, incurable, costly and increasingly but largely preventable non-communicable disease -- is responsible for millions of deaths annually.

It affects about one in every 11 adults worldwide and increases the risk of heart attack, stroke, blindness, kidney failure and limb amputation.

In Kenya, the prevalence of diabetes mellitus is reported at 2.7 per cent (rural) and 10.7 per cent (urban), with over 3.3 per cent of the population affected and an additional 7 per cent un-diagnosed.

According to a Ministry of Health official, there are about 468,000 adults with diabetes in Kenya.

Below are some key facts on diabetes:

What is diabetes

It occurs in two ways; either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.

Insulin is the hormone in our body that regulates blood sugar.

In essence, the insulin allows glucose from the food we eat to pass from the bloodstream into the cells in the body to produce energy.

Illustrated vector diagram of how insulin works. [Getty Images]

Types of diabetes

Type 1 diabetes

Previously known as insulin-dependent, juvenile or childhood-onset.

Patients cannot produce insulin and have to depend on a daily injection of the hormone.

Its cause is not known and it largely affects children and young adults.

There is no known way to prevent type 1 diabetes which is characterised by excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue.

Type 2 diabetes

Formerly called non-insulin-dependent, or adult-onset and occurs when your body can not effectively use the insulin it produces.

It is associated with age, overweight, hypertension, abnormal cholesterol levels, an inactive lifestyle, stroke and genetic factors. 

It accounts for up to 95 per cent of all diagnosed cases of diabetes.

Symptoms may be similar to those of type 1 diabetes but are often less marked.

Women who have had four or more pregnancies are at increased risk of developing Type 2 diabetes later in life. 

Gestational diabetes

It is a form of hyperglycaemia (too much glucose in the blood) in which blood glucose values are above normal but below those diagnostic of diabetes.

Scientists say it is a form of glucose intolerance diagnosed in some women during pregnancy.

Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery.

They have up to 50 per cent chance of developing diabetes in the next 5 to 10 years.

Who is most affected?

Those in low- and middle-income countries, who are middle-aged (45-64) and not elderly (65+).

Morbidity and Complications

It can lead to heart disease and strokes, high blood pressure, blindness, and damage to the kidneys. It also causes infections and gum disease.

The overall risk of dying among people with diabetes is at least double that for non-sufferers.

Treatment

There is no cure for diabetes and treatment involves lowering blood glucose and other known risk factors.

How to manage diabetes

Nakuru residents undergo diabetics screening. Managing the disease in Kenya is a huge challenge owing to a lack of general awareness about diabetes and its complications, and scarcity of healthcare personnel, monitoring equipment and even drugs. [Mercy Kahenda, Standard]

Some of the options but not limited to those listed include:

• Keeping blood glucose level under control to prevent urological and other diabetes-related problems
• Balancing your meals with the right amounts of starches, fruits and vegetables, fats and proteins
• Taking meals in small portions spread across many meals in a day
• Avoiding excess sugar, especially in carbonated drinks such as soda
• Avoiding stress

Treatment of diabetes in men involves options to treat erectile dysfunction including injections with hormones prescribed by health experts.Urologists and endocrinologist also prescribe treatment for low testosterone. Testosterone is the male sex hormone key in regulating fertility in men.

Facts and figures

In 2017:

• Approximately 425 million adults (20-79 years) were living with diabetes; by 2045 this will rise to 629 million.
• More than 1,106,500 children were living with type 1 diabetes
• 79 per cent of adults with diabetes were living in low- and middle-income countries
• The greatest number of people with diabetes were between 40 and 59 years of age
• Diabetes caused 4 million deaths
• 352 million people were at risk of developing type 2 diabetes

IDF Diabetes Atlas Eighth Edition 2017. [Courtesy, International Diabetes Foundation]

Five common myths on diabetes

Eating too much sugar causes diabetes. Fact: There is no one food or nutrient that causes diabetes.

If you are overweight or obese, you will eventually develop type 2 diabetes. Fact: Being overweight is a very important risk factor and the only modifiable one. The others like genetics, one has no control over them.

People with diabetes can't eat sweets or chocolate. Fact: Sweet foods, if eaten in small portions, can be eaten by people with diabetes. Everyone should endeavour to avoid empty calories (those without real food value).

If you have diabetes, you can’t eat any bread, potatoes. Fact: Starchy foods and fruit can be included in a meal plan for people with diabetes. It is the quantities that matter.

I'm skinny, so I can't get diabetes. Fact: In as much as people who are overweight stand a greater risk, 20 per cent of people who get it are slim.

Sources: World Health Organization, British National Health and Nutrition Examination Survey, International Diabetes Foundation