Diabetes, it’s complications and treatment
Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. Diabetes care should be carried out in a qualified centre and by qualified health professionals.
The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn’t make enough insulin. In the past three decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025.
About 422 million people worldwide have diabetes, particularly in low-and middle-income countries, and 1.6 million deaths are directly attributed to diabetes each year. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades.
Diabetes of all types can lead to complications in many parts of the body and can increase the overall risk of dying prematurely. Possible complications include
- kidney failure
- leg amputation
- Vision loss
- Nerve damage.
Adults with diabetes also have two- to three-fold increased risk of heart attacks and strokes.
In pregnancy, poorly controlled diabetes increases the risk of fetal death and other complications.
These symptoms are seen in millions of cases around the world. Nearly 3% of global blindness can be attributed to diabetic retinopathy, which occurs as a result of long-term accumulated damage to the blood vessels in the retina. Diabetes is also among the leading causes of kidney failure. Reduced blood flow and nerve damage in the feet caused by diabetes can lead to foot ulcers, and the associated infections and complications can lead to the need for limb amputation, as well as severe and life-long health problems.
Type 1 diabetes cannot currently be prevented. Effective approaches are available to prevent type 2 diabetes and to prevent the complications and premature death that can result from all types of diabetes. These include policies and practices across whole populations and within specific settings (school, home, workplace) that contribute to good health for everyone, regardless of whether they have diabetes, such as
Controlling blood pressure and lipids.
The starting point for living well with diabetes is an early diagnosis – the longer a person lives with undiagnosed and untreated diabetes, the worse their health outcomes are likely to be. Easy access to basic diagnostics, such as blood glucose testing, should therefore be available in primary health care settings. Patients will need periodic specialist assessment or treatment for complications.
A series of cost-effective interventions can improve patient outcomes, regardless of what type of diabetes they may have. These interventions include blood glucose control, through a combination of diet, physical activity and, if necessary, medication; control of blood pressure and lipids to reduce cardiovascular risk and other complications; and regular screening for damage to the eyes, kidneys and feet, to facilitate early treatment.
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