VOLUME 19 NUMBER 2 • November 2022 37 SA JOURNAL OF DIABETES & VASCULAR DISEASE diabetes news World Diabetes Day ‘Education to protect tomorrow’ South Africa is one of the 48 countries of the International Diabetes Federation (IDF) African region (AFR). According to the IDF, there are 24 million people living with diabetes within the AFR. This rate is expected to increase to 55 million by 2045. The proportion of undiagnosed diabetes is the highest in the AFR at 53.6%.1 Although diabetes can be treated and its consequences avoided or delayed with the correct diet, physical activity, medication and regular screening, monitoring and treatment, one in 10 adults (approximately 537 million adults) are currently living with diabetes, globally.6 These statistics make it imperative to acknowledge World Diabetes Day in the AFR to spread awareness and educate the population around the symptoms, early testing and diagnosis as well as the management and treatment of diabetes. Once a patient is diagnosed, it is important to enhance knowledge, attitude and patients’ behaviour to achieve glycaemic control and prevent the development of health complications associated with diabetes. What is diabetes? Diabetes is a chronic health condition that affects how your body turns food into energy. The body breaks down most of the food one eats into glucose and releases it into the bloodstream. When the blood sugar goes up, it signals the pancreas to release insulin. Insulin acts like a key to let the blood sugar into your body’s cells for use as energy. With diabetes, the body doesn’t produce enough insulin or can’t process it sufficiently. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in the bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss and kidney disease.2 This year Roche Diabetes Care, a frontrunner in personalised healthcare, is emphasising the theme of ‘Education to protect tomorrow’ through early awareness, education and personalised monitoring. Types of diabetes There are two main types of diabetes: type 1 and type 2. Type 1 diabetes (also known as insulin-dependent, juvenile or childhood onset) is an autoimmune disease characterised by deficient insulin production and requires daily administration of insulin. In type 1 diabetes, symptoms tend to come on quickly and can be more severe. Type 1 diabetes is generally diagnosed in children and young adults, although it can occur at any age.3 Type 2 diabetes (also called non-insulin-dependent or adult onset) results from the body’s ineffective use of insulin. More than 95% of people living with diabetes have type 2 diabetes and the symptoms tend to come on more gradually than type 1 diabetes. Type 2 diabetes can develop over the course of several years and is a result of a combination of different risk factors such as being over 45 years, being overweight, have a sedentary lifestyle, being a smoker, having a family history of diabetes, having high blood pressure and abnormal triglyceride or high-density lipoprotein (HDL) cholesterol levels.4 Some of the symptoms of type 1 and type 2 diabetes are:5 • feeling more thirsty than usual • urinating often • losing weight without trying • presence of ketones in the urine. Ketones are a by-product of the breakdown of muscle and fat that happens when there’s not enough available insulin • feeling tired and weak • feeling irritable or having other mood changes • having blurry vision • having slow-healing sores • getting a lot of infections, such as gum, skin and vaginal infections. Thankfully, diabetes can be easily managed through a practice called self-monitoring of blood glucose (SMBG). SMBG is an approach whereby people with diabetes measure their blood sugar (glycaemia) themselves using a glycaemic reader (glucose meter). Based on the reading, they can adjust or check the effect of their treatment (diet, exercise, insulin, antidiabetics, stress management) in consultation with their doctor therefore making it an integral part of one’s diabetes management routine. The readings obtained help patients with better understanding of their condition to modify their lifestyle with the support from their doctor for better therapy adjustment. However, an occasional once-a-week sugar test does not have any significance from a clinical perspective. Hence, it is crucial to practice regular and structured sugar testing to get clinically relevant data points to act upon. Structured SMBG is nothing but regular sugar checks at predefined times with a clear objective. Other key areas of how a patient can monitor their diabetes is by using the SELF method: S: Structured self-monitoring of blood glucose Set a regular schedule to monitor and record your blood glucose level. Most commonly, it is measured immediately after waking in the morning and two hours after lunch. Remember to re-confirm this routine with your doctor. E: Exercise The American Diabetes Association recommends that people with diabetes should exercise for 150 minutes or more per week and
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