Education to protect tomorrow

World Diabetes Day was observed on Monday under the theme “Education to protect tomorrow”.
In his message for the day, Health Minister, Dr Frank Anthony made some revealing and more so worrying comments when he said that diabetes affects 1 in 10 adults. Diabetes is also one of the leading causes of premature death and illness. Another startling fact is that the Minister revealed that of the more than 60,000 living with diabetes in Guyana, a large number are young people with type 1.
To quote the Minister: “While diabetes and its complications are largely preventable, prevention and management strategies are crucial to reduce morbidity and mortality and improving patient outcomes. Therefore, early detection is essential for managing diabetes.”
He announced that the Health Ministry was working closely with several international partners to ensure that every person living in Guyana is provided with the best diabetes care. One such partner is the Mount Sinai Health System, to promote testing for diabetes status, and ensure world-class diabetes prevention and treatment are available at health centres nationwide.
Diabetes education is the cornerstone of diabetes management, because diabetes requires day-to-day knowledge of nutrition, exercise, monitoring, and medication.
Diabetes occurs when two processes are impaired – both connected to the body dealing with the transportation of glucose sugar to the cells of the body via the blood. All carbohydrates and sugars are digested to glucose – which is a small-molecule sugar for easier transportation to the cells that use it to produce energy for our activities. Too high a concentration of glucose in the blood, however, adversely affects several organs in the body, in addition to forcing the cells to break down other molecules – even our proteins – to obtain energy. The affected organs are the eyes, heart, kidney, and the feet, and cumulatively debilitate the patient in the early stages and can lead to death in the end. Diabetes, for instance, increases heart attack risk by up to three times for men and five times for women.
However, diabetes is one of the non-communicable diseases (NCDs) caused by the other three risk factors – unhealthy diet, physical inactivity, and harmful use of alcohol. A programme to reduce these risks is within the capabilities of the Health Ministry, since it involves primarily education. There are verbal questionnaires that can indicate a predisposition in persons towards developing type 2 diabetes. If these are conducted early enough, a change of lifestyle to incorporate the above-mentioned factors of regular exercise and controlled diet have been shown capable of averting the diabetic condition.
The body controls the level of glucose sugar in the blood at a safe, optimum level by secreting the hormone insulin from the pancreas whenever the level rises beyond that level. There are two types of diabetes: type 1, in which the body is unable to produce the hormone insulin; and type 2, in which the body is unable to use insulin effectively. Type 2 is the most common form, accounting for around 90 per cent of all diabetes cases worldwide. Type 1 is diagnosed very early on and affects mostly children while type 2 develops gradually and manifests its effects generally in adults approaching their 40s. In type 2 diabetes, the pancreas production of insulin could be impaired as well as the mechanisms by which glucose sugar is transmitted from the blood through the cell walls.
The treatments for diabetes attempt to positively assist the impaired processes. There can be the direct intake of insulin at prescribed times, which is the only path for type 1 patients and type 2 patients at an advanced stage. There are also medications that stimulate the pancreas to produce more insulin as well as some to assist in glucose transfer into the cells. It has been found that daily exercise also assists in the latter process and coupled with a diet that is low in sugars and easily digestible carbohydrates and high in leafy vegetables and lean protein, can significantly lower glucose levels in the blood.
Over the years, the Government has done a credible job of improving the facilities for dealing with diabetes-related medical complications. This must be continued and we commend the efforts that are being made to fight the NCD.