By:Thandiwe Kubere

As the world commemorates diabetes month every year in November, it is important to understand the risk factors associated with the disease, safe precautions to protecting one’s health as well as the appropriate treatment approach for those who are affected. Diabetes awareness’s criticalness comes with the globally agreed target to halt the rise of diabetes and obesity by 2025. Health care providers have constantly stressed on the importance of adopting a healthy diet, exercising, and avoiding obesity. One can suffer from diabetes at any age and stage of their lives.

Global Nutrition Report showed diabetes prevalence (% of population ages 20 to 79) in Lesotho was reported at 4.6 % in 2021, according to the World Bank collection of development indicators. Globally, the number of people with diabetes rose from 108 million in 1980 to 422 million in 2014, and has been rising more rapidly in low- and middle-income countries than in high-income countries.

Dr Molotsi Monyamane, also revealed that the disease’s prevalence continues to rise rapidly in recent years, because in more cases, people do not take heed of the disease and adopt healthy practices such as exercising and a good diet.

Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. Glucose is an important source of energy for the cells that make up the muscles and tissues. It is also the brain’s main source of fuel.

The main cause of diabetes varies by type. But no matter what type of diabetes one has, it can lead to excess sugar in the blood, which can lead to serious health problems. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Both type 1 and type 2 diabetes may be caused by a combination of genetic or environmental factors. Potentially reversible diabetes conditions include pre-diabetes and gestational diabetes.

According to WHO, the most common is type 2 diabetes, which is usually found in adults. In the past 3 decades, its prevalence has risen dramatically in countries of all income levels. It occurs when the body becomes resistant to insulin or doesn’t make enough insulin. Insulin is a hormone that comes from a gland behind and below the stomach (pancreas).The pancreas releases insulin into the bloodstream, which circulates, letting sugar enter the cells. Insulin lowers the amount of sugar in the bloodstream.

Contrariwise, type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. It is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

 In 2019, diabetes and kidney disease caused an estimated 2 million deaths. Another 460 000 kidney disease deaths were caused by diabetes, and raised blood glucose causes around 20% of cardiovascular deaths. The majority of people with diabetes live in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades.

Dr Monyamane declared a 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 also be treated and its consequences avoided with medication and regular screening and treatment for complications.

If any symptoms of diabetes start showing, it is important to contact health care providers, since the treatment is better and more effective when the condition is diagnosed early.

According to WHO, diabetes symptoms depend on how high the blood sugar is. Some people, especially if they have pre-diabetes, gestational diabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

They include, feeling more thirsty than usual, urinating often, and losing weight without trying, as well as the presence of ketones in the urine. Ketones are a by-product of the breakdown of muscle and fat that happens when there’s not enough available insulin. A person should also take heed when they usually feel tired and weak, feel 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

According to Mayo Clinic, risk factors for diabetes depend on the type of diabetes. Family history may play a part in all types. Environmental factors and geography can add to the risk of type 1 diabetes. In some cases, it is essential for family members of people with type 1 diabetes to be tested for the presence of diabetes immune system cells (autoantibodies), which increases the risk. But not everyone who has these autoantibodies develops diabetes.

Moreover, Prediabetes, type 2 diabetes and gestational diabetes are more common in people who are overweight or obese.

Long-term complications of diabetes develop gradually. The longer one has diabetes and less controlled blood sugar, the higher the risk of complications. Possible complications include: Heart and blood vessel (cardiovascular) disease. These can include coronary artery disease with chest pain heart attack, stroke and narrowing of arteries. Moreover, too much sugar can injure the walls of the tiny blood vessels that nourish the nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.

Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhoea or constipation. For men, it may lead to erectile dysfunction. Kidney damage can also result from diabetes because kidneys hold millions of tiny blood vessel clusters that filter waste from the blood. Diabetes can damage this delicate filtering system. It can also damage the blood vessels of the eye. This could lead to blindness.

Additionally, it can cause foot damage, Skin and mouth conditions, hearing impairment, Alzheimer’s disease, and depression related to diabetes.

Type 1 diabetes cannot be prevented because exact cause of this condition is not known and it mostly results from genetics. But there are healthy lifestyle choices that help treat prediabetes, type 2 diabetes and gestational diabetes.

Dr Monyamane encourages people to eat healthy foods which have low fat and calories and are high in fibre. It is important to have a plate with more fruits, vegetables and whole grains instead of meat and products with excess sugar, which as high cholesterol. Moreover, people should eat starch that is equal to their fist.

He also encouraged people to exercise and get more physical activity to avoid getting overweight or obese. Additionally it is important to keep the blood pressure in check and to take medicine as prescribed.

It would also help to get diabetes self-management education and support as well as making and keeping health care appointments.

Now, as the world fights to curb the rising rate of the disease, he noted it is important to have policies in the country, which supports the initiatives in the Health sector. He advised this can be achieved by making sugar tax laws which prevent excessive sugar foods, which are high in cholesterol, from coming into the country in large numbers. Furthermore, he highlighted on the need to have a health insurance which will be put in place for the low working class and the underprivileged who cannot afford medical aids because diabetes treatment and medication is expensive.