ALHAJI ALHASAN ABDULAI
ALHAJI ALHASAN ABDULAI

When I wrote a feature article on the need to limit our intake of sugar up to 50gms a day per person, I had some readers in Ghana who accepted my findings saying that they wish to also read my research on sugar in Ghana and not only a piece quoted from medical findings from the United States of America. But you all agree that issues regarding medical sciences are universally accepted just like ones in relation to sugar.

ALHAJI ALHASAN ABDULAI
ALHAJI ALHASAN ABDULAI

Some people who read the article have called to commend me and have promised to cut down on their intake of sugar. Sugar is a sweetener to our foods acceptable all over the world, and it is also true that it would be bad to overuse it in foods especially beverages in Ghana and all over the world.

My write up on sugar has led to another work on our lifestyles that lead to the upsurge of diabetes in the world including Ghana but with special emphasis on the United States of America and Saudi Arabia. A study has shown that Diabetes (otherwise known as diabetes mellitus, DM) is described as a metabolic disorder in which the body cannot properly store and use the energy found in food.

More specifically, diabetes is a condition that affects the body’s ability to use glucose (a type of sugar) as fuel. Glucose, is a form of carbohydrate that comes from foods such as breads, cereals, pasta, rice, potatoes, fruits and some vegetables. Glucose is also synthesized in the liver and is carried in the blood to the rest of the body to fuel cellular processes.

To use glucose as fuel, insulin is required to get the glucose into cells. Insulin is a hormone (a type of chemical messenger) made by specialized cells in the pancreas. Insulin regulates blood glucose by stimulating the removal of glucose from the blood and its uptake into muscle, liver and fat cells where it can be stored for energy.

Sometimes the body does not make enough insulin or the cells do not respond properly to insulin. Blood glucose levels can then become elevated while the cells are deprived of fuel. When blood glucose levels get too high (hyperglycemia) this can cause damage to the tiny blood vessels in the eyes, kidneys, heart and nervous system, which is why diabetes is associated with an increased risk of cardiovascular disease, kidney disease, loss of vision and neurological conditions.

Persistently elevated blood glucose may lead to a diagnosis of prediabetes or diabetes. Prediabetes describes the condition where blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.

There are three types of diabetes:
 Type 1 diabetes
 Type 2 diabetes
 Gestational diabetes.

Type 1 diabetes used to be known as insulin-dependent diabetes (IDDM), or juvenile-onset diabetes as it often begins in childhood. Type 1 diabetes is an autoimmune condition where the immune system wrongly identifies and subsequently attacks the pancreatic cells that produce insulin, leading to little or no insulin production.
Type 2 diabetes used to be known as non-insulin dependent diabetes (NIDDM) and adult onset diabetes, but it is increasingly common in children, largely due to children being more likely to be obese or overweight. In this condition, the body usually still produces some insulin, but this is not enough to meet demand and the body’s cells do not properly respond to the insulin. The latter effect is called insulin resistance, where persistently elevated blood glucose has caused cells to be overexposed to insulin, making them less responsive or unresponsive to the hormonal messenger.

Gestational diabetes occurs in pregnancy and typically resolves after childbirth. People who have experienced gestational diabetes do, however, have an increased risk of developing type 2 diabetes after pregnancy.
Contents of this article:

You will also see introductions at the end of some sections to any recent developments that have been covered by MNT’s news stories. Also look out for links to information about related conditions.
Fast facts on diabetes

 29.1 million children and adults in the United States – 9.3% of the population – have diabetes (21 million diagnosed, and an estimated 8.1 million undiagnosed).12

 1.7 million new cases of diabetes were diagnosed in people aged 20 years and older in 2012.

 15.5 million, or 13.6% of all men aged 20 years or older have diabetes.

 13.4 million, or 11.2% of all women aged 20 years or older have diabetes.

 37% of Americans aged 20 years or older have prediabetes.

 Diabetes is present in 15.9% of American Indians/Alaska Natives, 13.2% of non-Hispanic blacks, 12.8% of Hispanics, 9% of Asian Americans, and 7.6% of non-Hispanic whites.

 Diabetes contributed to 231,404 deaths in the US in 2007.2

 $245 billion: Total costs of diagnosed diabetes in the United States in 2012.2

 Only 5% of people with diabetes have type 1 diabetes, which is an autoimmune disease involving caused by genetic, environmental, and other factors.2

 Type 2 diabetes accounts for 95% of diabetes cases and is usually associated with older age, obesity and physical inactivity, family history of type 2 diabetes, or a personal history of gestational diabetes.2
 There is no known way to prevent diabetes type 1. Effective treatment requires the use of replacement insulin.

 Type 2 diabetes can be prevented through healthy food choices, physical activity, and weight management. It can also be managed through lifestyle and diet, although insulin or oral medication may be necessary for some people.

A medical research from Saudi Arabia’s Arab News indicates that Diabetes, also known as the “life style disease,” is rapidly turning into a modern-day epidemic. Due to a luxurious, sedentary life style and unhealthy food habits, thousands are joining its ranks every day.

Globally there are currently 336 million people who have diabetes. This figure is set to rise to over 550 million by 2030. The epidemic is causing the death of 4.6 million a year, or one victim in every 7 seconds. Diabetes is among top 10 causes for disability, resulting in life threatening complications such as heart disease, stroke, lower limb amputations and blindness. Ironically, 50 percent of people with diabetes are undiagnosed.

World Diabetes Day is tomorrow and the Ministry of Health is waging an awareness campaign.

There are two type of diabetes: type 1 and type 2. Type 2 diabetes represents 90 percent of diabetes cases in Saudi Arabia. Usually, the disease either resulted from or was exacerbated by unhealthy dietary habits, lack of exercise and the prevalence of obesity. These key factors have resulted in diabetes becoming a silent killer.
Saudi Arabia’s Ministry of Health is not only providing treatment to all those affected but also indulged in efforts for preventive measures and mass education. There still is a long way to go.

The prevalence of diabetes is in Kingdom is at an alarming level Over 25 percent of the adult population is suffering and that figure is expected to more than double by 2030. Half of the people over 30 years of age are prone to diabetes. Saudi Arabia has the second highest rate of diabetes in the Middle East and is seventh highest in the world, according to the World Health Organization (WHO).

Some reports suggest that the Kingdom spends approximately SR 30 billion every year on the treatment of diabetes. A patient’s treatment costs the government SR 5,000 per year, if there are no complications. Those would increase the cost considerably. The treatment of one common diabetes complication, renal failure, costs the government between SR 98 and 180 thousand per year for the dialysis of only one patient.

Adding to those costs are the indirect burden of diabetes, caused by lack of productivity as a result of disability or death. These expenditures and burdens are tremendously high and immeasurable.

Loss of vision is one of the primary concerns for persons with diabetes. Approximately two thirds of diabetics are likely experience loss of vision after 35 years of diabetes. Diabetic retinopathy very often results in impaired vision. Diabetes is 25 times more likely to lead to blindness than any other conditions. A person with impaired vision due to diabetic retinopathy usually experiences difficulty in daily life. They may see dark spots or have restricted side vision due to decreased contrast sensitivity.

Jahangir, a Pakistani expatriate in the Kingdom, has diabetes. He is unable to drive a vehicle at night hours due to poor vision. Several other diabetes patients had to return to their home countries as they had lost the ability to work. Poorly controlled diabetes may cause problems while driving, which may lead to traffic accidents, warns the Saudi Diabetes & Endocrine Association (SDEA). It said that low blood sugar (hypoglycemia) and visual impairment are the main problems diabetic drivers may experience.

The WHO estimates that every year more than one million limb amputations occur globally. Around 85 percent of those are believed to be avoidable if appropriate medical attention had been given at an earlier stage. Saudi Arabia has a high amputation rate, compared to other countries.

A condition known as the diabetic foot, involving a lack of feeling, ulcers that do not heal, bone softening, gangrene and other complications, is a result from nerve damage and constricted blood flow in the foot caused by diabetes.

People must act now to prevent the rapidly growing disease, said Khalid Abdul Rahman Tayeb, director of Diabetes and Endocrinology at Al-Nour Specialist Hospital in Makkah. He was chairman of the Ministry of Health committee on diabetes in Kingdom.

He said that one out of four adults in Jeddah are affected with the disease and all stakeholders should help prevent diabetes in the Kingdom.

The control of diabetes prior to surgery is particularly significant. Providing guidance to patients on how to take care of their feet and telling them what to do if complications develop will reduce the number of complications and prevent amputations.

Good diabetes management and regular foot care help prevent severe foot sores that are difficult to treat and may require amputation.

Diabetic patients measure glucose blood levels using a glucometer, small drop of blood from finger and a test strip.

Diabetes complications include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly and are difficult to treat.

The good news is that proper diabetes management and careful foot care can help prevent foot ulcers. In fact, better diabetes care is probably why the rates of lower limb amputations have gone down by more than 50 percent in the past 20 years.

When foot ulcers do develop, it’s important to get prompt care. A nonhealing ulcer that causes severe damage to tissues and bone may require surgical removal (amputation) of a toe, foot or part of a leg.

Here’s what you need to know to keep your feet healthy, and what happens if amputation is necessary.
Preventing foot ulcers

The best strategy for preventing complications of diabetes — including foot ulcers — is proper diabetes management with a healthy diet, regular exercise, blood sugar monitoring and adherence to a prescribed medication regimen.

Proper foot care will help prevent problems with your feet and ensure prompt medical care when problems occur.

Tips for proper foot care include the following:

• Inspect your feet daily. Check your feet once a day for blisters, cuts, cracks, sores, redness, tenderness or swelling. If you have trouble reaching your feet, use a hand mirror to see the bottoms of your feet. Place the mirror on the floor if it’s too difficult to hold, or ask someone to help you.

• Wash your feet daily. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes. Use a pumice stone to gently rub the skin over where calluses easily form. Sprinkle talcum powder or cornstarch between your toes to keep the skin dry. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft.

• Don’t remove calluses or other foot lesions yourself. To avoid injury to your skin, don’t use a nail file, nail clipper or scissors on calluses, corns, bunions or warts. Don’t use chemical wart removers. See your doctor or foot specialist (podiatrist) for removal of any of these lesions.

• Trim your toenails carefully. Trim your nails straight across. Carefully file sharp ends with an emery board. Ask for assistance from a caregiver if you are unable to trim your nails yourself.

• Don’t go barefoot. To prevent injury to your feet, don’t go barefoot, even around the house.

• Wear clean, dry socks. Wear socks made of fibers that pull sweat away from your skin, such as cotton and special acrylic fibers — not nylon. Avoid socks with tight elastic bands that reduce circulation, as well as thick bulky socks that often fit poorly and irritate your skin.

• Buy shoes that fit properly. Buy comfortable shoes that provide support and cushioning for the heel, arch and ball of the foot. Avoid tight-fitting shoes and high heels or narrow shoes that crowd your toes. If one foot is bigger than the other, buy shoes in the larger size. Your doctor may recommend specially designed shoes (orthopedic shoes) that fit the exact shape of your feet, cushion your feet and evenly distribute weight on your feet.

• Don’t smoke. Smoking impairs circulation and reduces the amount of oxygen in the blood. These circulatory problems can result in more-severe wounds and poor healing. Talk to your doctor if you need help to quit smoking.

• Schedule regular foot checkups. Your doctor or podiatrist can inspect your feet for early signs of nerve damage, poor circulation or other foot problems. Schedule foot exams at least once a year or more often if recommended by your doctor.

• Take foot injuries seriously. Contact your doctor if you have a foot sore that doesn’t quickly begin to heal or other persistent problems with your feet. Your doctor will inspect your foot to make a diagnosis and prescribe the appropriate course of treatment.

Insulin is like a key that opens up the locks on your body’s cells so that glucose (blood sugar) can get inside and be used for energy. If the glucose cannot get into your cells, it builds up in your blood stream. If left untreated, high blood glucose can cause long-term complications.

Alhaji Alhasan Abdulai
Executive Director
EANFOWORLD FOR SUSTAINABLE DEVELOPMENT
P.O.BOX 17070AN 233244370345/23327483710/ 233208844791
[email protected] /[email protected]

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