SWEETENING THE PILL

BY Dr. Sanjiva Wijesinha

Recently, there was an important medical con­ference in Colombo hosted by the Sri Lanka College of Endocrinologists (SLCE).The meeting drew some 1,000 delegates (mainly endocrinologists who are medical doctors with specialisation in diabetes) from various countries.

Their goal was to discuss the growing problem of diabetes the world over.

Data from the International Diabetes Federation reveals that in 2017, some 425 million people on the planet had diabetes and this number is expected to increase to over 600 million by 2040.

And in South Asia alone, there are nearly eight million people living with diabetes and approximately 1.2 million deaths as a result of it each year.

This disease has an enormous impact on the patients, as well their families and communities. From an economic perspective, 12 percent of the world’s healthcare expenditure is expended on managing diabetes.

The President of the South Asian Federation of Endocrine Societies (SAFES) Dr. Noel Somasundaram – one of the key specialists behind the 2019 Colombo Declaration on Dia­betes – says: “A healthy diet, regular physical activity and maintaining normal body weight are the three key strategies to preventing or delaying the onset of Type 2 diabetes.”

Many people who are at risk of diabetes and even some of those who already have it aren’t aware that it can be treated, and its dangerous consequences avoided or delayed through healthy eating practices, physical activity and appropriate medication.

People with diabetes should monitor themselves regularly and consult a doctor at least once a year – or even once in six months – so that they can be screened for the complica­tions caused by diabetes. It isn’t simply a disease (as many people believe) that results in harmless high blood sugar -it’s a major cause of blindness, heart attacks, strokes, lower limb amputation and kidney failure.

So it’s essential for anyone who has diabetes to have an annual eye checkup (to screen for diabetic eye damage) in addition to six monthly blood pressure measurements, blood tests to make sure the body’s sugar level is under control, and checks for reduced blood circulation and nerve damage.

Initially, the prevention of diabetes can be considered under two categories: primary and secondary. It is possible to prevent the onset of diabetes in those who are obese, overweight or have an inherited risk of the disease through some key interventions – vigorous physical activity and the adoption of a reduced calorie diet, which is low in carbohydrates and rich in fibre. Weight reduction is crucial.

Also, it’s important for those at risk to undergo regular blood tests so that the presence of the disease can be identified early … before it develops further. The timely diagnosis of diabetes enables the early institution of both significant lifestyle changes and medication.

For those who have had diabetes for a few years, there are modem therapies that will help slow down and even reduce the narrowing of blood vessels (atherosclerosis) that’s associated with diabetes.

Medications that reduce cholesterol, improve heart function, control heart failure and reduce the risk of unwanted blood clots that could clog vital arteries are now available. In consultation with a competent and up-to-date doctor, these interventions can be utilised to improve the quality of life and reduce the risk of complications.