Diabetes Mellitus: The Increasing Burden in Kenya, Here's What You Should Know

 

Diabetes Mellitus: The Increasing Burden in Kenya, Here's What You Should Know

The World Health Organization (WHO) estimates that the prevalence of diabetes in Kenya is at 3.3% and predicts a rise to 4.5% by 2025.

With non-communicable diseases being the leading cause of death globally, diabetes mellitus is the 4th main contributor. But what exactly is diabetes mellitus?

These are groups of conditions that are characterized by causing high blood glucose levels. 

The excessive build-up of glucose in the blood results from lack of insulin production or inadequate insulin production or body cells insensitivity to the insulin being produced.

Body Glucose Processing

Normally food will be broken down into simple glucose forms by the digestive system. The formed glucose will then be taken into the blood. 

A chemical known as insulin produced by pancreas cells will then stream the formed glucose now in blood into the body cells. 

At the cells the glucose will be utilized for energy production and the remaining will be converted into a chemical form known as glycogen which can later be broken down into glucose for energy needs whenever the blood glucose level is low.

Types of Diabetes

Pre-diabetes

Here the blood glucose level is above normal however it hasn't gone overboard for it to qualify to be classified as diabetes.

Type 1 diabetes(Juvenile diabetes)

The body's pancreas cells don't produce insulin that is required in the uptake of glucose from the blood stream into the cells.

It's commonly diagnosed in children and in young adults though it can also be found in the middle aged people.

Type 2 diabetes

It is characterized by inadequate insulin production by the pancreas cells or insensitivity of the body cells to the insulin being produced. 

It's commonly diagnosed in the middle aged people however it can still be found in children and young adults. It is the most common type of diabetes.

Gestational diabetes

It's a type of diabetes that may develop during the period of ones pregnancy due to the elevation of certain hormones that may make the body cells to be insensitive to the insulin being produced.

It later resolves after delivery. It increases the risk of one developing diabetes type 2 later.

Type 1 and 2 diabetes symptoms

Increased urination frequency, increased episodes of thirst, fatigue, extreme hunger episodes, blurring vision, weight loss(in type 1), increased infections frequency e.g UTI, slow healing wounds.

Type 1 risk factors

Presence of destructive immune cells that destroys pancreatic cells which produces insulin, a positive family history of type 1 diabetes, extreme viral infections that may destroy pancreas cells.

Pre- diabetes/type 2 risk factors

Middle age, excessive weight, inactivity/sedentary lifestyle, positive family history of pre-diabetes/type 1 diabetes, polycystic ovarian syndrome, low levels of HDL(which is a type of good cholesterol)/high triglycerides levels in the body, and race.

Gestational diabetes risk factors

Excessive weight gain before the pregnancy, a positive family history of gestational diabetes, and race(Blacks, Hispanics and Asian-Americans).

Diagnostic tests for diabetes

HbA1c(glycated hemoglobin)

This test measures the average blood glucose levels in the past recent 2 to 3 months as follows; 4 percent to 5.6 percent (considered normal), 5.7 percent to 6.4 percent (classified as pre-diabetes-) and 6.5 percent and above(classified as diabetes melitus).

Random blood sugar(RBS)

This is a blood glucose measuring modality that can be used at any point of the day irregardless of the last time that one fed.

The measuring ranges are as follows; 4.0 to 7.7mmol/l(considered normal), 7.8 to 11.0mmol/l(classified as pre-diabetes) and 11.1mmol/l and above(classified as diabetes melitus).

Fasting blood sugar(FBS)

This test is done after one has starved for 8 to 10 hours. The measuring ranges are as follows; 4.0 to 5.5mmol/l(considered normal), 5.6 to 6.9mmol/l(classified as pre-diabetes) and 7.0mmol/l and above(classified as diabetes).

Oral glucose tolerance test

Here one starves first for 8 to 10 hours then a fasting blood sugar is taken first after which the person is given 75Mg of glucose if he/she is an adult and 1.75Mg/ Kg but not exceeding 75Mg cumulatively if it's for a child.

The glucose is to be taken within 5 minutes at most then blood sugar test is done after  2 hours.The measuring ranges are as follows; 4 to 7.7mmol/l(considered normal), 7.8 to 11.00mmol/l(classified as pre-diabetes) and 11.1mmol/l and above(classified as diabetes melitus).

Treatment

A part from gestational and sometimes pre-diabetes, the other types of diabetes are chronic and therefore they don't resolve.

Medications therefore are meant to prevent further disease progression and improve the quality of life.

There are several types of medications for diabetes and the choice will therefore be determined by the type of diabetes that one has/the general well-being of the patient e.g artificial insulin for type 1 diabetes and oral biguanides/sulfonylureas for diabetes type 2.

Complication of pre-diabetes is the development of diabetes type 2.

Complications of diabetes type 1 and 2

Nerves damage(neuropathy), eyes damage(retinopathy), cardiovascular diseases, Alzheimer's disease, foot damage making it susceptible to chronic wounds.

Complications of gestational diabetes

To the mother - pre-eclampsia(high blood pressure, protein in urine and swollen legs in pregnancy), subsequent gestational diabetes in future pregnancies, diabetes type 2 development.

To the baby - being overly big, low blood sugar after delivery, increased risk of type 2 diabetes development later, dying shortly after being delivered.

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