Health

ACCESS TO DIABETES CARE: THE KEY TO DIABETES MANAGEMENT

 

Diabetes is one of the major chronic lifestyle diseases that continues to affect the overall global population. The World Health Organization (WHO) reports that 422 million people worldwide are suffering from diabetes and around 1.5 million deaths each year is directly linked to it.

Diabetes can occur primarily due to two major reasons, which are lack of insulin (Type I Diabetes, T1D) or due to ineffective use of insulin (Type 2 Diabetes, T2D). While T1D cannot be effectively prevented, T2D is certainly preventable.

Some interesting data as reported by the International Diabetes Federation are worth pondering:-

  • 1 in 2 adults with T2D remain undiagnosed
  • 75% of people with diabetes hail from low and middle-income group countries
  • 75% of people with diabetes belong to the age group of the working population
  • 20% of people suffering from diabetes are above 65 years of age
  • Diabetes accounted for 10% of the global health expenditure in the year 2019

These facts and figures are enough to substantiate the fact that the global community as a whole is still unable to access the primary components of diabetes care.

2021 marks the completion of 100 years of therapeutic insulin discovery which has significantly saved and enhanced the quality of life for many, but on the other hand, its access to the majority of the global population still remains a far cry. 14th November is observed worldwide as World Diabetes Day, marking the birth anniversary of Fredrick Banting, who co-discovered insulin with Charles Best.

On a pledge to improve the global scenario of this silent killer, the International Diabetes Federation has set the World Diabetes Day Theme for 2021-2023 as “Access to Diabetes Care, If Not Now, When?” It has outlined the following cardinal components for diabetes care which form the basic prerequisites for effective management of diabetes symptoms and complications:-

  1. Access to Insulin
  2. Access to Oral Medicines
  3. Access to Self-Monitoring
  4. Access to Education and Psychological Support
  5. Access to Healthy Food and a Safe Place to Exercise

As a health practitioner, in my opinion, the first and foremost step to wage war against this metabolic disorder is to raise one’s own awareness around diabetes.

One can initiate preventive healthcare around diabetes following simple measures as outlined below:-

Family History Does Matter:

Family History is a strong, independent, and easily assessed risk factor for T2D. Genetic predisposition raises the chances of an individual being prediabetic (where blood sugar levels are higher than normal but not high enough to be identified as diabetes) which may later develop into T2D. Research suggests that the chances of an individual getting T2D raises by almost 50% if both parents are diabetic. Acquiring proper know-how about family health history is probably the first step one should take as a preventive measure against diabetes. Appropriate diagnosis of prediabetes and taking suitable proactive measures can reverse, prevent and/or delay the onset of T2D.

Manage Body Weight:

Insulin resistance and dysfunction of the pancreatic β cells are the two major factors responsible for the progression towards T2D. When insulin secretion is not sufficient enough to compensate for the degree of insulin resistance, T2D develops. Obesity has a strong and direct correlation with the occurrence of diabetes as it leads to some form of insulin resistance. Body fat distribution is a critical determinant of insulin resistance, for instance, intra-abdominal fat is a major factor causing insulin resistance. Excess accumulation of adipose tissue in overweight and obese individuals leads to the increased secretion of non-esterified fatty acids (NEFAs) which is associated with insulin resistance. Prolonged exposure to NEFAs also causes loss of β cell function that leads to impaired insulin secretion pathways and decreased levels of insulin synthesis.

Don’t Starve, Eat Mindfully:

 

One of the common misconceptions that diabetics have in the context of managing their blood sugar levels is the drastic reduction of their food intake often leading to starvation at times. But on the contrary, proper dietary intervention strategies by a qualified nutritionist will effectively help an individual manage their blood sugar level often leading to reduced medicine dependence and even reversal, in some cases. Research has indicated that structured nutrition therapy can indeed improve glycaemic control.

 

Some effective dietary tips for blood sugar management are:-

 

  1. Having small frequent meals.
  2. Not starving for prolonged periods.
  3. Ensuring a rainbow-coloured platter for every meal with enough leafy greens, fibre-laden fruits and vegetables.
  4. Eating mindfully with a proper balance of macro and micro-nutrients depending upon your personal health history.
  5. Avoiding the intake of refined carbohydrates, ultra-processed and junk food.
  6. Going through food labels for making an informed choice.

 

Go for a Periodic Health Check-Up: Follow the ABC Rule:

 

A or A1c Control Glycemic Control

B or Blood Pressure Control

C or Cholesterol Control

 

Getting your HbA1c, blood pressure and cholesterol levels regularly monitored is another cardinal step for keeping a close watch on blood sugar levels. HbA1c is one of the best biomarkers to assess whether one is prediabetic. In a clinical trial involving obese and overweight patients with T2D, it was found that nutrition therapy led to a reduction of HbA1c levels up to 0.61%-0.66%, an observation similar to the outcome after using common diabetic medication. T2D increases the risk of cardiovascular mortality. Optimal glycaemic control along with control of high blood pressure and cholesterol levels are the key steps to reduce the cardiovascular risk associated with T2D.

 

Follow a Proper Lifestyle:

 

Both smoking and alcohol intake is detrimental for people with T2D as they lead to impaired insulin sensitivity and beta-cell function. Adopting an active lifestyle, indulging in light-freehand exercise, yoga and abstaining from alcohol intake and tobacco is important for effective diabetes management and its allied health risks. Lifestyle management is the key to delaying and/or preventing the onset of diabetes, especially for non-diabetic individuals who usually have the common misconception that only avoiding and/or limiting the intake of added sugar will prevent them from being diabetic.

 

As rightly quoted by the famous author Chris Prentiss, “Change Starts with Awareness”, this World Diabetes Day, let’s be the change and may we all come together to spread knowledge, create awareness and pledge to make diabetes care affordable and accessible for all.

 

Written by Eshani Bhaumik Barui, Senior Dietitian Head-Nutrition, Research & Operations YANA Diet Clinic, Food Technologist & Dietitian, Certified FSSC 22000 Lead Auditor Gold Medalist (JU)

 

 

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