The latest global onslaught against diabetes

By Adeze Ojukwu

Diabetes is generally viewed as ‘a silent killer.’

It is a leading  cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

The facts are not only staggering, but disconcerting, according to latest reports from World Health Organization(WHO) and other notable authorities.

‘One in 10 persons is living with  diabetes, with the number of patients escalating, from 108 million in 1980 to 422 million in 2014.’

Sadly, prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries.

‘Between 2000 and 2016, there was a 5 percent increase in premature mortality from diabetes.’

‘In 2019, an estimated 1.5 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.’

The metabolic disorder, is one of the four major Non-Communicable Diseases(NCDs), affecting humanity.

Others include cardiovascular diseases, cancer and chronic respiratory conditions.

Experts are often worried about the chronic condition, which ‘occurs when the body either does not produce enough insulin or cannot effectively use the insulin it does produce.’

According to WHO, the infirmity, therefore results in raised blood sugar levels which, if not controlled, over time can  lead to serious damage to the body and its systems.

The situation is worse for patients dependent on insulin, which ‘is a hormone that regulates the blood sugar or glucose, which is  formed from the food consumed by a person,’ it noted.

Hence, the recent launch of a global initiative to improve the management of diabetes, especially among low and middle income countries is a welcome relief.

For millions of sufferers, across the Global South, including Nigeria, where access to insulin and other life-saving drugs is both negligible and exorbitant,  this intervention is quite heart-warming.

According to United States(US)-based Mayo Clinic, glucose is vital to  health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel. However it’s elevation poses serious health dangers.

Therefore new compact was  launched to address this disorder, at the recent Global Diabetes Summit.

The high-profile event was co-hosted by WHO and Canada, with the support of the University of Toronto.

During the launch, Director-General, WHO, Dr. Tedros Ghebreyesus, underscored ‘the need to take target action on diabetes is clearer than ever.’

In a statement, he said ‘the development comes as risk of early death from diabetes is increasing, underscoring why countries must tackle the disease and bring treatment to all who need it.’

He also highlighted various strategies on charting a new course in prevention and treatment of the deadly disease.

His words: ‘The number of people with diabetes has quadrupled in the last 40 years. It is the only major non communicable disease for which the risk of dying early is going up, rather than down. And a high proportion of people who are severely ill in hospital with COVID-19 have diabetes.’

‘More than 420 million people worldwide live with diabetes, a group of chronic diseases characterized by elevated blood sugar, which can cause damage to the heart, blood vessels, eyes, kidneys and nerves.’

‘The most common is type 2 diabetes, which occurs when the body becomes resistant to insulin, the hormone that regulates blood sugar.

‘But we cannot take on diabetes alone. We must each share knowledge and foster international collaboration to help people with diabetes live longer, healthier lives — in Canada and around the world.’

For now ‘the global compact focuses on several priorities. Among the most urgent is increasing access to diabetes diagnostic tools and medicines, particularly insulin, in low and middle-income countries.’

‘Roughly half of all adults with type 2 diabetes remain undiagnosed, according to WHO. Additionally, half of all people with the condition do not get the insulin they need, putting them at risk of irreversible complications such as early death, amputation and sight loss.’

‘The insulin market is currently dominated by three companies, but a pilot programme for WHO prequalification of the medication, introduced two years ago, could change the situation. The prequalification process ensures medicines meet global standards for quality, safety and efficacy.’

‘Prequalification of insulin produced by more manufacturers could help increase the availability of quality-assured insulin to countries that are currently not meeting demand.’

Meanwhile, ‘discussions are underway with manufacturers of insulin, and other diabetes medicines and diagnostic tools, which could help meet demand at prices that countries can afford.’

According to the initiators, another key aim is to set a ‘global price tag’ that quantifies the costs and benefits of meeting new targets for diabetes care.

‘Governments also will be encouraged to meet their commitments to include diabetes prevention and treatment in primary healthcare and universal health coverage packages.’

The Canadian  Minister of Health, Dr. Patty Hajdu, said ‘Canada has a proud history of diabetes research and innovation. From the discovery of insulin in 1921 to one hundred years later, we continue working to support people living with diabetes,’

Dr. Bente Mikkelsen, Director of the Department of NCDs, WHO, explained that ‘the compact seeks to rally key stakeholders, as well as people who live with diabetes, around a common agenda to generate new momentum and create solutions.’

‘The ‘all hands on deck’ approach to the COVID-19 response is showing us what can be achieved when different sectors work together to find solutions to an urgent public health problem,’ he added.

Generally, ‘chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes and gestational diabetes.’

‘Prediabetes occurs when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes.’

‘Prediabetes is often the precursor of diabetes unless appropriate measures are taken to prevent progression. Gestational diabetes occurs during pregnancy but may resolve after the baby is delivered.’

Diabetic symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may sometimes not experience symptoms.

 In type 1 diabetes, symptoms tend to come on quickly and are more severe.

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.

Medical science proves that ‘diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.’

Some of the signs and symptoms of type 1 diabetes and type 2 diabetes are ‘increased thirst, frequent urination, extreme hunger, unexplained weight loss.’

‘Presence of ketones in the urine, fatigue, irritability, blurred vision, slow-healing sores as well as frequent infections, such as gums or skin infections and vaginal infections can also occur in a patient.’

‘Type 1 diabetes can develop at any age, though it often appears during childhood or adolescence.’

‘Type 2 diabetes, the more common type, can develop at any age, though it is more common in people older than 40.’

.Ojukwu, is a Fellow of Hubert H Humphrey Fellowship, a  journalist and advocate for improved health and socio-economic services for all citizens, as articulated in the Sustainable Development Goals(SDGS).

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