World diabetes day-have you checked your blood glucose?

Diabetes is one of the leading non-communicable diseases causing high rates of morbidity and mortality. Diabetes is a chronic disease that affects the body’s ability to digest and use the food consumed.

When food is ingested it is eventually turned into sugar (glucose) that the body uses as energy. Normally the levels of glucose are strictly controlled, however, in patients with diabetes, this control is lost.

The table below shows the number of people living with diabetes and the numbers that are projected to rise in the coming years

In Tanzania, according to WHO STEPS (2012), the prevalence of diabetes is 9.1%.

World Diabetes Day is held every year on November 14^th to raise awareness on the disease. The theme for 2021 to 2023 is “Access to diabetes care” whereby the importance of intense diabetic education is provided to all health care providers, people with diabetes and the community to allow for prevention by encouraging healthier lifestyles and providing early diagnosis and appropriate management for patients with diabetes.

There are many types of diabetes but the most known are Type 1, Type 2 and Gestational diabetes.

Type 1 diabetes is caused by an autoimmune condition whereby the pancreas fails to produce insulin – an essential hormone that allows the body to take up and use glucose. The prevention of Type 1 diabetes is currently not known.

Type 2 diabetes is mainly caused by unhealthy lifestyle choices from the food consumed, body weight, level of physical activity as well as family history. Therefore Type 2 diabetes can be prevented by early lifestyle modification.

Gestational diabetes can develop in pregnant women previously not known to have diabetes. The baby is also at risk of obesity and diabetes. Mothers may recover after the delivery of the baby, but the chances of developing diabetes later in life are more.

General prevention measures include maintaining a healthy lifestyle revolving around keeping a healthy weight range, being physically active and consuming a healthy diet low in sugars, carbohydrates, and saturated fats. It is recommended to do 30-45mins of exercise three to five times a week. People at higher risk such as those with a family history, high cholesterol or overweight often need an individualised meal plan.

At Shree Hindu Mandal Hospital a professional nutritionist offers this service for free.

Diagnosis and management

Early diagnosis is key, and it is relatively inexpensive. A simple blood glucose measurement can help diagnose diabetes. If you experience any of the typical symptoms of diabetes (shown in the table below) you should see a healthcare specialist. At the facility mentioned above, there is a team of 8 physicians full and part-time who can be accessed consistently and easily.

As part of the evaluation of a person with diabetes,  various complications need be screened and addressed. These include r complications of the kidneys, eyes, heart and blood vessels, infections, nerves, teeth, cholesterol levels as well as chronic foot wounds.

The hospital provides these services for cash-paying as well as insurance-covered clients.

When managing people with diabetes, holistic approach is necessary. . Patients are “empowered” by providing them appropriate counselling & support so that they can manage their blood glucose control better, have appropriate lifestyle modification, adhere to medications (oral and or insulin) and prevent or delay the onset of complications due to inadequate or poor control of blood glucose.

One of the most important advice for people with diabetes is foot care. Each complication is diagnosed and managed by respective specialists in conjunction with endocrinologists and nutritionists.

Shree Hindu Mandal Hospital and diabetes services

Shree Hindu Mandal Hospital, Dar es Salaam is one of the hospitals providing comprehensive diabetes care services.. The hospital has become an important pillar in the provision of screening, counselling, and managing of patients with diabetes & its complications in the country. 

The hospital's physician, Dr. Thuraiya Hashim says Shree Hindu Mandal Hospital receives large numbers of patients with diabetes due to its one stop holistic approach to the management of diabetes and its complications. She says they provide screening and counselling services to patients of all ages seven days a week which has attracted many patients from different parts of the country. 

Dr Thuraiya says that diabetes is caused by lifestyle choices in our communities: "Diabetes is a disease that results from the way we live our life – from the choices of food and drinks, and whether or not we incorporate adequate exercise in our day to day activities. We may not be able to change our family history with chronic diseases, but we certainly do have the ability to improve our lifestyle habits".

To ensure that patients get the services they need, Shree Hindu Mandal Hospital has specialized departments for nutrition, heart, eye, and kidney diseases. Doctors also provide counselling on foot care for patients to prevent the risk of developing chronic foot ulcers. Explaining about diabetic foot, Dr. Thuraiya says this problem results from patients with diabetes getting small injuries to the feet which eventually become infected and can worsen very quickly into gangrene.

"Diabetic foot ulcers are a major complication among diabetic patients, many of which result in amputations. Therefore, prevention by providing proper foot care in these patients is far better" Says Dr. Thuraiya. 

The other common complication which is forgotten is the involvement of the eyes. Regular screening of eyes is important preventive approach with of course good blood glucose control being the basic objective.

In many cases, the Hospital receives patients with diabetes who also have other complications which the patient is not yet aware of such as nerves, eyes, kidneys & heart.     

In addition, the hospital also provides home-based care services to all patients to ensure that they follow their management and care as advised by their doctors. 

Through its state-of-the-art services, Shree Hindu Mandal Hospital has succeeded in helping thousands of patients with diabetes in the country.

Dr. Thuraiya advises that to protect ourselves from developing diabetes we need to undergo regular check-ups and seek expert advice about the disease and how to improve lifestyle habits. If you have already been diagnosed with diabetes it is critical to have regular follow-up clinics with your doctor to ensure you’re on the right track to manage your disease so as to improve the quality of your life.