World Diabetes Day
14th of November 2015
World Diabetes Day was established in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO), in order to contribute in addressing globally the increased cases of the disease.
World Diabetes Day is now officially a United Nations Organization (UN) World Day.
The General Assembly of the United Nations Organizations (UN) passed on the 20th of December 2006 the resolution 61/225, according to which the 14th of November, known as World Diabetes Day was officially designated as an official UN World Day, starting from the year 2007. In this resolution which can be considered as a milestone, diabetes is characterized as a chronic disease that exhausts the patient, entailing, in parallel, a substantial cost for them. Furthermore, the serious complications that are associated with the disease can possibly create hazards to human life, rendering the issue of Diabetes from a family problem, to a matter of national concern and subsequently to a worldwide plague.
It is the first time that a non-communicable disease is addressed as a threat to global health, as in the case of communicable epidemic diseases e.g. malaria, tuberculosis and A.I.D.S.
In 2015, World Diabetes Day is dedicated to the proper diet for the treatment of diabetes mellitus.
World Diabetes Day is celebrated around the world. Its goal is to mobilize millions of people in more than 160 countries, aiming at the best informing and diabetes awareness.
The campaign is addressed to everybody, including people with diabetes mellitus, children, adults, health professionals, political decision makers and Mass Media.
The logo of World Diabetes Day is the blue circle and has been established by the International Diabetes Federation in 2007 and symbolizes the unity in the global battle against Diabetes. The circle symbolizes life and health. The blue color symbolizes the sky, that unifies all nations and is the color of the UN flag. The blue circle symbolizes the unity of the Global Diabetes Community, as a response to the pandemic character of the disease.
What is Diabetes Mellitus?
It is a chronic condition that occurs when the pancreas does not produce enough insulin, or when the human body cannot make efficient use of the insulin that is produced. Insulin is a hormone that is secreted by the pancreas and allows cells to take up glucose from the blood and use it as energy. A poor function in the production or action of insulin or both of the above, lead to the increase of the blood glucose levels (hyperglycemia). This leads, in the long run, to complications that are divided into damages to small blood vessels, to the eyes, kidneys, nerves (microangiopathy) and damages to large vessels, myocardial infarction, cerebral infarction and angiopathy of the legs (macroangiopathy).
Some statistical data from the International Diabetes Federation (IDF) are listed in order to better understand the international problem that is called diabetes mellitus and its economic and social implications.
- In 2014, 387 million people have been recorded with diabetes mellitus and in 2035 this number will reach 592 million.
- The majority of people with diabetes mellitus are between 40 – 59 years old.
- For every two persons with diabetes there is a person with diabetes mellitus who is not aware of their condition, therefore the actual number is much higher (the global rate of diabetes mellitus is globally recorded at 8%). It is estimated that there are 179 million people with undiagnosed diabetes.
- Diabetes mellitus caused 4.9 million deaths in 2014.
- More than 79 million children developed type 1 diabetes mellitus in 2013.
More than 21 million women develop gestational diabetes mellitus.
- In Greece the rate is approximately 9%, which means approximately 1 million people with diabetes mellitus, of which 22,000 are children of less than 14 years of age with type 1 diabetes mellitus.
- In Crete, the rate is approximately 8%, and there are 55,000 people with diabetes mellitus, of which 450 are children with type 1, or juvenile diabetes mellitus; the rate has doubled, as it has been observed, in the last 10 years, and there still are 25,000 people with diabetes mellitus that are not aware of their condition.
Types of diabetes mellitus
Type 1
It is characterized by the destruction of β cells that produce insulin in the pancreas, and is due to an autoimmune mechanism. These people produce little or no insulin, which has the result that their survival is based on the intake of insulin. It is also known as juvenile or insulin dependent diabetes mellitus and occurs principally in children, young adults, but also at any age.
Type 2
It is characterized by a lack of insulin (smaller amounts of insulin are produced than the ones that are needed), as well as by the resistance to insulin (the produced insulin does not function properly). It regards 90% of diabetic patients and affects all ages, principally adults, as well as children. In Greece, in the last 10 years, the rate of type 2 diabetes mellitus in children increased from 3% to 40% due to obesity. We are the first country in child obesity in Europe.
Gestational diabetes mellitus
It is the condition where women without any previous history of diabetes mellitus, present high blood sugar levels, principally after the third trimester of pregnancy and its rate in Greece, according to the Hellenic Diabetes Association, is 18% of the pregnant women. It does not cause symptoms, however its diagnosis and treatment is urgent because there are effects both on the mother and on the foetus. A mother with gestational diabetes mellitus has a chance of 50% to develop diabetes mellitus within five years after childbirth.
Other types of diabetes
- Symptoms of Diabetes Mellitus.
- Frequent Urination – Polyuria
- Polydipsia
- Polyphagia
- Weight loss
- Weakness– fatigue
- Lack of interest and of concentration
- Vomiting and stomach ache (principally in type 1)
- Visual disturbances, frequent infections
- Itching in the external genital organs, balanoposthitis (in men), vulvovaginitis (in women).
- These symptoms may be mild or even absent in people with type 2 diabetes mellitus.
- Who have a high risk to develop type 2 diabetes mellitus?
- Obesity and overweight
- Lack of physical exercise
- Poor nutrition
- Age over 45 years
- High arterial pressure and cholesterol
- Family history of diabetes mellitus
- History of gestational diabetes mellitus
- Previous history of impaired fasting glycemia IFG (fasting blood sugar 100 – 125 mg/dl) or impaired glucose tolerance IGT (blood sugar, 2 hours after the intake of 75 grams of glucose, 140 – 199 mg/dl).
The prevention measures should principally focus on people at risk, so that the occurrence of type 2 diabetes mellitus is delayed or even fully prevented. Significant research has shown that maintaining normal body weight and a good physical condition can contribute to the prevention of type 2 diabetes mellitus.
The International Diabetes Federation (IDF) sets a target of at least 30 minutes daily exercise, such as, for example, brisk walking, swimming, cycling or dancing.
It has been proven that walking at normal pace, for at least 30 minutes daily, can decrease the risk of developing type 2 diabetes mellitus from 35 to 40%.
Diagnosis of diabetes mellitus.
ALWAYS CONFIRMED TWICE
- Fasting blood sugar >= 126 mg/dl
- Blood sugar >= 200 mg/dl in a random blood sample and symptoms of diabetes mellitus (polyuria, polydipsia, polyphagia, weight loss, etc.)
- Blood sugar >= 200 mg/dl 2 hours after the oral intake of 75 grams of glucose after having fasted all night (Oral Glucose Tolerance Test - OGTT)
We do not use blood glucose meters in order to diagnose diabetes mellitus.
Treatment of diabetes mellitus.
Type 1: The administration of insulin is a matter of survival and the beginning of its administration after the diagnosis is imperative, while a proper diet and physical exercise are equally important.
Type 2: The cornerstone is proper diet, physical exercise, followed by oral antidiabetic tablets and various other injectable drugs, and the administration of insulin when it is required. The administration of insulin does not mean that the person with diabetes mellitus is at a final stage. This takes place simply because the pancreas, the organ that produces insulin, seems not being capable to secrete the quantity of insulin that is required for the proper regulation of blood sugar.
Gestational diabetes mellitus: In 90% of the cases, only a proper diet is required and at a minor percentage of 10% insulin is also required, which is administered only during pregnancy and the administration stops after childbirth.
The treatment of diabetes mellitus is of great importance in order to avoid complications and is a responsibility both of the doctor and of the person with diabetes mellitus and both of them should assume their share of responsibility.
Every year the World Diabetes Day focuses on different agendas. This year the agenda is proper diet, an issue that regards all of the people, but especially diabetics.
There is no mild diabetes mellitus. There is diabetes mellitus that can be regulated, according to the goals set by the doctor aiming at the prevention of complications and there is the uncontrolled diabetes mellitus that has as consequence acute and chronic complications.
We must do something for this huge socioeconomic problem and the most important measure is PREVENTION.
We must prevent the occurrence of new cases or we must diagnose them early and regulate them perfectly from the beginning, as is stated in the message of the International Diabetes Federation for the World Diabetes Day.
References
1. Riley P, McClaughlyn K. Understand diabetes and take control : World Diabetes Day 2009. Diabetes Voice, June 2009
2. Metzger B, et al. New findings in gestational diabetes- the HAPO Study. Diabetes Voice, Special Issue : May 2009
3. McGill M, McGuire H. The IDF framework for diabetes education- current status and future prospects. Diabetes Voice. March 2009
4. International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabetic Medicine, 2007:24:451 – 463.
5. Patients Education and psychological care. Diabetes Voice, Supplement September 2066
6. Diabetes Atlas 3rd Edition, International Diabetes Federation, 2006