Preventing Effects of Diabetes in Our Population
Community-based Programmes Can Help to Reduce Chronic Disease
Aug 24, 2009 Sanjiva Wijesinha
Diabetes is a serious disease that affects millions of people throughout the world today. In many countries, it is one of the leading causes of blindness and end stage kidney failure - and also contributes to the vast majority of deaths due to heart attacks and strokes.
Throughout the world, the incidence of new cases of diabetes is steadily rising - and it is predicted that by 2030, Type 2 diabetes will affect about 366 million individuals - that is 4.4% of the world's population!
There are four areas that governments worldwide are focusing on today
- Prevention: reducing the number of new people developing diabetes
- Detection: diagnosing the condition early - and commencing appropriate treatment
- Motivation: ensuring long term care so patients with diabetes continue with their treatment
- Education: so patients know why they will benefit from self-management
Preventing Diabetes
Nine out of ten people who develop diabetes get Type II Diabetes. Doctors describe the aetiology as "Multifactorial" - which simply means that there are many factors that can contribute to a patient developing the condition. Genetic and ethnic factors play an important role - for example, Native Americans, Indigenous Australians and people from the Indian subcontinent are at greater risk of developing Diabetes as they get older compared to other ethnic groups. A family history of diabetes - in other words, if one or both of one's parents have the disease - puts one at greater risk. Environmental factors such as obesity and a sedentary lifestyle also increase the likelihood of developing this disease. It has been shown that improving one's lifestyle - such as reducing weight and increasing the amount of regular physical exercise that one does - can drastically cut the risk of developing Diabetes.
The 2003 Finnish Diabetes Prevention Study showed that an intensive lifestyle intervention produced long-term beneficial changes in diet, physical activity and reduced diabetes risk. This type of intervention is a feasible option to prevent type 2 diabetes and can with benefit be implemented in the primary health care system.
Early Detection and Treatment
Diabetes is not just a disease where there is too much sugar in the body - it is a condition which damages the large and small blood vessels of the body. Reducing these Macrovascular (large vessel) and Microvascular (small vessel) effects is critical - so early diagnosis and appropriate treatment are essential.
For patients with risk factors (a family history of the disease, being overweight, maintaining a sedentary lifestyle without any exercise), diligent screening for the onset of diabetes is important. Getting a blood test for blood sugar at least once a year is a good plan. If diagnosed with the disease, it is important that these new patients receive appropriate Diabetes Education and motivated to undertake appropriate treatment of what will be a lifelong condition.
Community health centres can play a valuable role in running group based programmes to teach patients about diet, regular blood sugar testing and motivating them to take their medications at the correct times.
Continuity of Care
Since Diabetes is a lifelong disease, there will inevitably be times when diabetic patients will lose motivation to continue with taking their medications every day and regularly pricking their fingers for blood testing. As a consequence, they inevitably suffer from setbacks and complications. This is having access to a good diabetes educator, dietitian or doctor can help. Diabetic patients are also liable to develop depression - and may benefit from counselling and psychological support.
Self Management
Diabetes is a lifelong disease that needs ongoing management - which ideally requires an informed and motivated patient as well as a proactive team of health professionals.
Self-management is the key to this ideal - since it involves the patient being disciplined - monitoring his blood glucose level, modifying his diet, undertaking adequate physical exercise and taking his medications at the correct dose and time.
All these skills require awareness of the disease, motivation to undertake behaviour change and discipline to stick to these changes so as to reduce complications and maximise health and wellbeing in the long term.
Fingerprick test for Diabetes
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