World Diabetes Day : Increasing number of diabetics

Dr Th Premchand Singh
Globally the number of people with diabetes mellitus is estimated to increase from 382 million individuals in 2013 to 592 million by 2035. A further 316 million people are currently at high risk of developing Type 2 diabetes, with the number expected to increase to almost 500 million within a generation.  The number of diabetes population in India is expected to be over 134 million by 2045 from 77 million in 2019. Approximately 57% of these individuals remain undiagnosed.
World Diabetes Day is observed on the 14th of November every year all over the world, which is primarily a global awareness campaign. It was introduced in 1991 by the International Diabetes Federation and  World Health Organisation in response to the alarming increase in the incidence of diabetes around the world. This day marks the birthday of Fre-derick Banting who along with Charles Best  conceived the idea which led to the discovery of insulin in 1922.
The campaign is to promote the importance of immediate action to protect the health and well-being for people with diabetes andfuture generations who are at risk of developing diabetes. The campaign provides a global platform for people with diabetes, health professionals, diabetes advocates, media, the public and Government organisations to raise diabetes awareness and improve the lives of people with diabetes.
Every year World Diabetes Day has a theme. The theme for World Diabetes Day 2024-2026 is Diabetes and Well-Being. The World Diabetes Day 2024 campaign marks the first of a three-year 2024-2026 focus onDiabetes and Wellbeing. International Diabetes Federation awareness activities highlight issues of paramount importance to the global diabetes community and aim to keep diabetes firmly in the public spotlight. The target audiences are people living with diabetes, family members, the care givers and health care professionals who need to support the wellbeing of people with diabetes and lastly policy makers to prepare the policy.
The focuses for the three years are
2024-Awareness : Ensure the impact of diabetes on wellbeing is understood.
2025-Impact : Mobilise audiences to put wellbeing at the heart of diabetes care.
2026-Change : Build on the above two to ensure lasting legacy in healthcare policy
This year's activities and materials will specifically address the topic of  wellbeing in diabetes both mentally and physically and its importance in  the effective management of diabetes. Awareness of the state of wellbeing should be instilled in the people living with diabetes and how to attain it. People with diabetes are more likely to experience depression and anxiety precipitated by fluctuating blood sugar levels. Psychological well-being constructs optimism, positive affect have been associated with superior medical outcomes, including better glucose control and lower mortality rates. Uncontrolled diabetes affect the physical health. High glucose levels can damage blood vessels in the eyes, heart, kidneys and nerves. These lead to health problems like heart attack, stroke, kidney failure, vision loss and even leg amputations.
People with diabetes should follow these good habits to gain wellbeing:
1. Eat healthy
Diet for diabetes is no different from the normal healthy diet except to avoid sugar and sweets. It should be a balanced diet containing carbohydrate, protein, fats, vitamins and minerals. It should consist of plenty of green vegetables, whole  fruits, non-fat dairy products, beans, fish, poultry,  lean meats and minimal amount of saturated oils. Everyone benefits from healthy diet so the whole family can take part in healthy eating.
2. Exercise regularly
Exercise together with good diabetic diet forms the cornerstone of diabetes therapy. This should entail a minimum of 150 minutes of moderate-to-vigorous aerobic activity spread over at least five days a week, and two to three sessions of resistance exercise a week on non-consecutive days. Regular exercise helps to prevent and minimize the weight gain, reduction in blood pressure, improvement in insulin sensitivity and glucose control, and optimization of blood cholesterol profile, all of which are independent risk factors for the development of complications in diabetes. Meeting physical activity guidelines has been associated with a 40% decrease in heart attack with an even greater impact on all-cause mortality. Walking,  jogging, running, bicycling, swimming are excellent forms of exercises which can be done by anybody.
3. Quit smoking and cut down alcohol
Smoking causes increased insulin resistance of the body resulting in high blood glucose level. Smoking among people with diabetes increase risks of high blood pressure and serious complications like heart attacks, kidney failure, blindness, paralysis and even leg amputations. Drinking alcohol carries the same health risks for people with diabetes as it does in otherwise healthy people.
Alcohol carries other certain risks related to diabetes that are important to know. Alcohol can interfere with the effects of some diabetes medicines increasing the risk for low blood sugar or high blood sugar levels and at the same time worsens the diabetes complications, such as nerve, eye, or kidney damage.
Another problem is symptoms of low blood sugar are very similar to those  of alcohol intoxication and severe hypoglycaemia are often neglected thinking to be because of intoxication even leading to death.
4.   Get regular check-ups including blood tests
Regular check-ups and necessary blood tests should be dome time to time. Blood pressure, body weight, blood  glucose levels, HbA1c, kidney tests and  cholesterol levels should be kept within recommended ranges.
In conclusion, World Diabetes Day 2024 is all about diabetes and wellbeing. International Diabetes Federation intends to convey the message about the importance of wellbeing in diabetes. Diabetes is a metabolic disorder caused by lack of physical activity and consumption of calorie dense foods combined with genetic factors.  Increased prevalence of obesity is closely related to increasing incidence  of diabetes   all over the world.
Most cases of Type 2 diabetes can be prevented and the serious complications of diabetes can be avoided through healthy lifestyles and living environments that encourage and facilitate healthy behaviour. A healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.
The writer is a past President, North Eastern Diabetes Society