Non-communicable diseases are the leading cause of death globally and diabetes mellitus is the 4th main contributor. According to WHO’s statistics about 2 million people die of diabetes annually. In Kenya, a quarter of the hospital admissions are diabetes cases, a report by Kenyatta National hospital revealed in 2013.
Summit Deshpande, 10 years old at the time of the interview in 2016 was an ordinary boy living an ordinary life having been diagnosed with diabetes type1 at the age of 7.
One Saturday afternoon, he goes into his routine activity before a meal. He pricks his finger, presses a drop of blood on the litmus paper on his sugar meter to measure his blood sugar levels, picks his insulin, unveils the needle and gently presses it on his stomach. Having boosted his insulin levels, he joins the sister at the dinning area to have lunch; wheat made ‘chapati’, beans, some salad on the side and some apple juice.
“There are no special diets for people with diabetes and they should not be ostracised,” says Mrs. Ranjen Patel a clinical and community nutritionist working with Diabetes Kenya, an organisation that assists people living with diabetes in the Country. “Taking the right portions of a balanced diet where half the plate is vegetables and the rest two halves should be for starch and protein."
Diabetes is a chronic disease that occurs either when the pancreas produces less insulin than what the body requires, or fails to produce it at all. The body's Inability to effectively use produced insulin is also a part of it. Insulin is a hormone that regulates blood sugar in the body.
Hyperglycaemia, or raised blood sugar on the other hand is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels.
Summit is among other 487 million people living with diabetes globally, and a representation of about three to 10 percent of the patients with type one diabetes in Kenya. According to WHO statistics, of all diabetes patients, over 85 percent have type two diabetes while five percent have gestational diabetes.
“Diabetes is a very complex disease with a complex hypo genesis or causative mechanism,” said Dr. Archarya a diabetes specialist who further explained the different types of diabetes; type one, two, gestation diabetes and diabetes due to other causes.
Type 1 diabetes
Type 1 diabetes previously known as insulin-dependent, juvenile or childhood-onset is characterised by deficient insulin production and requires daily administration of insulin. The patients in this case have no insulin at all a result of a failed pancreas.The cause of type 1 diabetes is not known and it is not preventable with current knowledge.
Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.
According to a report by South Sudan journal, Parents of children with type 1 diabetes have to spend about 220 USD each year on subsidised insulin that the Kenyan Government provides. However the insulin is scarce and many Parents end up buying it in privately owned pharmacies which are expensive. The burden therefore leads to inconsistencies for poor families and ill health for their children.
Type 2 diabetes
Type 2 diabetes formerly called non-insulin-dependent, or adult-onset results from the body’s ineffective use of insulin. Type 2 diabetes comprises the majority of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity. This is also diabetes that runs in families and is mostly inherited.
Symptoms may be similar to those of type 1 diabetes, but are often less marked. As a result, the disease may be diagnosed several years after onset, once complications have already arisen.
Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.
"We are now seeing type 2 diabetes in children and this is shocking.This is because there are more children who are obese. Children are taking junk and using drugs." Dr. Archarya said in her explanation on the new trend.
Gestational diabetes
Gestational diabetes a type that is diagnosed through prenatal screening, rather than reported symptoms, is diabetes where hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes, occurring during pregnancy.
Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. They and their children are also at increased risk of type 2 diabetes in the future. The relative risks of later Type 2 diabetes according to a report by Kenya's Ministry of health is between 7- 13 times high in women with gestational diabetes compared to normal glycemic ones. The pancreas an organ that helps control sugar could be affected by a virus or anything else which cripples the bitter part of the pancreas that produces insulin.
Diabetes due to other causes.
There are multiple causes of this type that range from use of steroids, alcohol and substance abuse as triggers to medical conditions that make the patients susceptible to diabetes as well as medical interventions like cancer treatment. For lifestyle triggered kinds, Identifying the bad habit causing it and putting a stop to it causes a reversal and is the cure. However continuation of the habit then subjects the Patient to type 2 diabetes intervention. On the other hand the other condition triggered situations like down syndrome, that are beyond a patients control are treated just like type 2.
“Life expectancy in the country is improving, while the country is developing at a rapid pace. This has resulted in people living for more years and at the time adopting lifestyles that have negative impacts on their health.” Said Beth Mugo Minister for health and sanitation, in the release of diabetes guide book by the Ministry of health in 2010.
At the time 70 percent of people with diabetes were obese or overweight a causative factor to the disease. A recent research by lancet indicated that 26 percent of Kenya’s population is obese or overweight. Urbanisation which has brought about the adoption of a western lifestyle is seen as a contributing factor due to consumption of alcohol, tobacco consumption among other dietary choices.
“The Guidelines are written for all Kenyans, though health workers may have to adapt information to meet local situation and specific needs for specific patients,” said Beth Mugo. “The successful implementation and strict adoption of these guidelines will require the partnership of the care providers and people living with diabetes mellitus” she added.
WHO reports that the complications of undetected and untreated diabetes are serious and cause huge human suffering and disability. They also have huge socio – economic costs resulting from premature morbidity and mortality. Diabetes is one of the leading causes of blindness, renal failure and lower limb amputation. It also triggers cardiovascular disease which is the leading cause of deaths in diabetes patients.
The Government, WHO and other non- governmental organisations have been active in creating and implementing policies that can help Kenya achieve Millenium development goals and its vision 2030 which includes a healthy workforce.
Comments