By Aamir Amin Nowshahri
World Health Day is celebrated on April 7 every year. It is one of the eight official global public health campaigns marked by the World Health Organisation (WHO). The first World Health Assembly decided in 1948 to celebrate April 7 as the World Health Day with effect from 1950.
Each year, a theme is selected by WHO in line with global healthcare trends. The theme for 2016 is “Beat Diabetes”.
Diabetes is a chronic, non-communicable disease which occurs when the pancreas does not produce enough insulin in the body. It can also occur when the body cannot effectively use the insulin produced by the pancreas. Insulin is a hormone that regulates blood sugar and gives the body the energy that we need to live. If it cannot get into the cells to be burned as energy, sugar starts building up to harmful levels in the body.
Over a period of time, elevated levels of blood sugar can have serious effect on every major organ system in the body, which may result in heart attacks, strokes, nerve damage, kidney failure, blindness, impotence and infections that can lead to amputations.
Type 1 diabetes
Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset diabetes) is characterised by deficient insulin production. People suffering from this type of diabetes require daily administration of insulin. The cause of type 1 diabetes is not known and it is not preventable with current knowledge.
Symptoms of type 1 diabetes include excessive urination (polyuria), excessive thirst (polydipsia), constant hunger, weight loss, vision changes and fatigue. These symptoms may occur simultaneously.
Type 2 diabetes
Type 2 diabetes (formerly called non-insulin dependent of adult-onset diabetes) is caused when the body cannot utilise insulin effectively. A study conducted by the WHO in 1999 found that type 2 diabetes comprises 90 per cent of people with diabetes around the world. This type of diabetes is to a large extent caused by excess body weight and lack of physical activity.
The symptoms of type 2 diabetes are largely similar to those of type 1 diabetes, but are often less marked. As a result, the disease may be diagnosed several years after onset, once complications have already arisen.
In a worrying trend, type 2 diabetes was only being seen in adults until recently but has now also been reported to occur in children.
In gestational diabetes, pregnant women have blood glucose levels which are above normal but below those diagnostic of diabetes. Such women are at an increased risk of complications during pregnancy and the time of delivery. They are also at an increased risk of type 2 diabetes in the future.
Gestational diabetes is diagnosed through prenatal screening, rather than reported symptoms.
Impaired glucose tolerance and impaired fasting glycaemia
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are immediate conditions in the transition between normality and diabetes. People with IGT and IFG are at a high risk of progressing to type 2 diabetes, although it is not inevitable.
Consequences of diabetes
Diabetes can affect multiple organs and organ systems over a period of time.
- Adults with diabetes have a 2-3 fold increased risk of heart attacks and strokes.
- Diabetes causes reduced blood flow and neuropathy (nerve damage) in the feet. This increases the chances of foot ulcers, infection and eventual need for foot amputation.
- Diabetic retinopathy (damage to the tiny blood vessels in the back of the eye) is an important cause of blindness. This condition is responsible for 2.6 per cent of all blindness cases reported across the world.
- Diabetes is one of the leading causes of kidney failure.
Diabetes has been growing tremendously around the world in the recent past. A global study conducted by WHO in 2016 shows that the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years of age has risen from 4.7 percent in 1980 to 8.5 per cent over the same period. The report also points out that diabetes has been rising more rapidly in middle and low income countries.
According to the report, around 1.5 million deaths were directly caused by diabetes in the year 2012. Another 2.2 million deaths were attributable to high blood glucose levels for the same year. It has also been projected that diabetes will be the 7th largest cause of death in the year 2030.
Diabetes in India
A study conducted by The Lancet medical journal ranks India among the top 3 countries with diabetic population in the world. The study reveals a dramatic rise in the number of diabetes patients in India: from 11.9 million in 1980 to 64.5 million in 2014.
Diabetes in Kashmir
The diabetes scenario in Kashmir is also turning grave by the day. The Sher-i-Kashmir Institute of Medical Sciences, the leading medical institution of the state, reports around 25 to 30 new cases of diabetes every week. Over a period of one year, this sums up to around 1300 to 1500 people added to the list of those with diabetes.
Though no recent data is available, a study conducted by SKIMS in 2008 estimated that around 1.5 lakh Kashmiris could be suffering from the disease. Prevalence of diabetes in people aged over 40 years increased from 5.3 per cent in 1999 to 6 per cent in 2008, which is roughly an increase of 13 per cent over a decade.
The study revealed that 70 per cent of Kashmiri adults over the age of 40, and as high as 90 per cent of Kashmiri adults aged between 20 and 40 did not know that they already had diabetes.
(Aamir Amin Nowshahri is an Assistant Information Officer with PIB at Srinagar.)