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Background Information
“Diabetes is a growing and massive silent epidemic that has the potential to cripple health services in all parts of the world.”
Quote of Dr. Robert Beaglehole, Director Chronic Diseases and Health Promotion, speaking at the launch of Diabetes Action Now, May 5, 2004
Diabetes is a serious global health problem and is becoming worse. It is a widespread metabolic disease affecting around 5-7% of the world’s population. Studies have shown that diabetes is a costly disease. Currently, 5 to 10% of the world’s healthcare budget is spent on diabetes and this figure will grow significantly over the next years.
Diabetes is not only a cost-intensive disease, it is also a serious health problem for the patient. High blood sugar levels over time can lead to long-term damage, dysfunction and failure of various organs and systems like cardio-vascular diseases (heart attack, stroke, lower limb amputation) and kidney and eye problems. Recent figures of the World Health Organization indicate that 3.2 millions deaths worldwide are attributable to diabetes every year that is 6 deaths every minute. 80% of people with diabetes will die of cardio-vascular disease!
Types of Diabetes
Type 1 Diabetes
People with type 1 diabetes are producing only little or no insulin due to an autoimmune destruction of the insulin-producing cells in the pancreas. They require lifelong insulin for survival.
About 10 to 15% of all people with diabetes have type 1.
Type 2 Diabetes
In this form of diabetes the cells are resistant to the action of insulin combined with a progressive insulin secretory defect. The resistance to insulin is mostly due to obesity, physical inactivity and some genetic factors. Since the prevalence of obesity has worldwide increased dramatically, there has been a corresponding increase in the incidence of type 2 diabetes in adults and children.
Around 85 to 90% of all people with diabetes have type 2.
Patient Management
All treatment goals have to be tailored to the individual. Patients should assume an active role in their care. The goal of therapy is to achieve blood glucose levels as close to normal as is safely possible. Many studies have shown that improved glycemic control is associated with decreased rates of diabetic complications.
Virtually all type 1 patients and some type 2 patients require three or more injections of insulin per day. The insulin dosage may change from day to day according to food intake, exercise regimens and actual blood glucose levels.
For people with type 2 diabetes in most cases the primary approach is a change in lifestyle, which includes a reduction in energy intake and an increase in physical activity.
Self-Monitoring of Blood Glucose (SMBG) is an integral part of the management strategy- especially for type 1 diabetics. SMBG allows patients to evaluate their individual response to therapy and assess whether glycemic targets are being achieved. In addition it is helpful in preventing too low blood sugar levels (hypoglycemia) and adjusting medications and physical activity.