DIABETES is a chronic condition that occurs when your blood glucose (sugar) is too high. It can lead to serious health complications, especially if untreated, yet many people with diabetes are not receiving the necessary treatment.
According to the World Health Organisation about 830 million people worldwide have diabetes, more than 800 million of whom are adults, four times the number estimated in 1990, despite a globally agreed target to halt the rise in diabetes and obesity by 2025.
Diabetes is a growing health concern in Zimbabwe, according to Cimas Health Group doctor Tafadzwa Mungiria.
“The prevalence of diabetes in adults is around 1,5%, with approximately 106 400 cases reported in 2021,” he said.
Mungiria attributed the increase in diabetes cases largely to rising obesity rates due to a sedentary lifestyle, unhealthy diets, physical inactivity, and aging populations.
More than half of those living with diabetes are not receiving treatment, according to the World Health Organisation (WHO).
Mungiria said some people might not be receiving treatment because they are unaware that they have diabetes or may not understand the importance of managing the condition.
“Yet untreated diabetes can lead to severe complications such as heart disease, kidney failure, nerve damage, blindness and amputations,” he said.
Other reasons for some people with diabetes not receiving treatment could be the high cost of insulin and other diabetes medications, which could be prohibitive, especially in low and middle-income countries, and limited access to healthcare.
“Many people, particularly in rural or hard-to-reach areas, lack access to healthcare facilities and professionals, who can provide a proper diagnosis and treatment.
Inadequate healthcare infrastructure and insufficient training for healthcare providers can also contribute to the lack of treatment,” Mungiria said.
“Even when medications are available, some people may not adhere to their prescribed treatment regimen due to forgetfulness, fear of injections or perceived lack of benefit.”
Causes
Our pancreas produces insulin, which moves glucose from our bloodstream into cells all over our body. Diabetes occurs when the body either does not produce enough insulin to do this or cannot use the insulin it produces effectively, resulting in too much glucose in our bloodstream.
With Type 1 diabetes, which is commonest in children and young adults, the body’s immune system attacks insulin producing cells in the pancreas, leading to lack or low production of insulin, Mungiria explained.
“Type 2 diabetes is often linked to lifestyle factors such as obesity, excessive alcohol intake and physical inactivity, as well as genetic factors,” he said.
Gestational diabetes develops during pregnancy and usually goes away after childbirth.
Symptoms
Common symptoms include increased thirst, frequent urination, extreme hunger, unexplained weight loss, fatigue, blurred vision, slow-healing sores, recurrent abscesses, recurrent urinary tract infections, numbness of hands and feet and cataracts.
Risk factors
Mungiria said there were risk factors that were modifiable such as obesity physical inactivity and dietary habits, and non-modifiable factors, namely age, family history and certain ethnic backgrounds.
Prevention
“Type 2 diabetes can often be prevented changes such as maintaining a healthy weight, eating a balanced diet, reducing or stopping alcohol intake and engaging in regular physical activity,” he said.
Mungiria said diabetics should avoid sugary drinks, processed foods, high-fat foods and refined carbohydrates.
“Diabetics should focus on whole grains, vegetables, fruits, lean proteins and healthy fats.
Drinking water and unsweetened beverages is also recommended,” he said.
Through lifestyle avoid sugary drinks, processed foods, high-fat foods and refined carbohydrates.
“Diabetics should focus on whole grains, vegetables, fruits, lean proteins and healthy fats. Drinking water and unsweetened beverages is also recommended,” he said.
“Exercise helps manage blood sugar levels, improves cardiovascular health and aids in weight management. A mix of aerobic exercises such as walking or swimming and strength training is recommended, aiming for at least 150 minutes of moderate-intensity exercise per week.”
Mungiria said a healthy weight was one where your BMI was 18,5 to 24,9kg/m2.
Treatment
“Early detection is crucial as it allows for timely intervention, which can prevent or delay complications and improve quality of life. It also reduces the incidence of premature deaths,” Mungiria said.
Treatment for diabetes involves managing blood sugar levels through a combination of lifestyle changes, such as improved diet and more exercise, medication and insulin therapy, he said.
“Regular monitoring of blood sugar levels is also crucial,” Mungiria added.
Improving care, prevention
Mungiria said there have been efforts to improve diabetes care and prevention in Zimbabwe through various health initiatives and partnerships. He mentioned programmes operated by the Diabetes Association of Zimbabwe in particular.
Efforts had been made to improve health systems that provide prevention, early detection and treatment but challenges remained in terms of accessibility and resources, he said.
Cimas offers various health services to promote early detection and management of diabetes, including screenings and educational programmes, Mungiria pointed out.
“Cimas is involved in health promotion activities, including awareness campaigns and community health programmes through its iGo department,” he said.
“Currently Cimas has a Diabetes Outcomes Measurement dashboard, which the data analytics team and managed care use for decision making and policy formulation.
“Education and awareness are key. Understanding the condition, knowing the risk factors, and making informed lifestyle choices can significantly impact the management and prevention of diabetes.
“Support providers, family, and community can also play a vital role in managing the condition effectively. Together we can make a difference,” Mungiria said.
Asked what advice he would give to those who have diabetes, he said: “Regularly monitor blood sugar levels, follow a balanced diet, stay physically active, take medications as prescribed and attend regular medical check-ups.”
