Healthy lifestyle protects against diabetes

Avoiding fizzy drinks and fruit juices loaded with sugar is just one of the steps you can take to protect yourself against diabetes, says Dr Deon Minnies, a public health management consultant at UCT.

He was speaking at a diabetes wellness day held at Khayelitsha District Hospital on World Diabetes Day, Thursday November 14, which saw more than 300 people screened for the disease.

It was organised by the provincial health department, UCT and the Orbis International, an international non-profit organisation dedicated to saving sight.

Dr Minnies urged the public to be a lot more aware of what they put into their bodies.

“We want to encourage people to take care of their health. We are here to make them aware that eating right will save them from diabetes. But if they have diabetes, we also want them to know how to behave and how to prevent it. But all and all sugar is the danger, sugar is a problem,” he said.

Diabetes is known as a "silent killer" among health workers because many people don’t realise they have the chronic metabolic disease that can cause blindness, kidney failure, heart attacks, stroke and lower limb amputation.

According to a World Health Organization fact sheet, published on November 14, World Diabetes Day, the number of people living with diabetes rose from 200 million in 1990 to 830 million in 2022.

Prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries.In 2021, diabetes was the direct cause of 1.6 million deaths, and 47% of all deaths due to diabetes occurred before the age of 70.

Another 530 000 kidney disease deaths were caused by diabetes, and high blood glucose causes around 11% of cardiovascular deaths. And since 2000, mortality rates from diabetes have been climbing.

Diabetes, notes the WHO, is characterised by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type-2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin.

Type-1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself.

Early detection and treatment and education play a vital role in tackling diabetes, say health experts, and “Breaking Barriers, Bridging Gaps” the theme for World Diabetes Day this year stressed the importance of improving access to quality health-care, according to Red Cross War Memorial Children’s Hospital, Groote Schuur Hospital and Tygerberg Hospital.

According to the WHO, lifestyle changes, such as maintaining a healthy weight, exercise, a healthy diet that avoids sugar and saturated fats and quitting smoking, are the best ways to prevent or delay the onset of type 2 diabetes.

Speaking at the wellness day, Bulelwa Gantshi, the assistant manager at the Site B clinic,  said clinic staff often battled with diabetic patients who didn't take their medication or follow a healthy diet.

"Our people are just not doing it. We have a project... where we teach them how to eat and exercise. Those are people that have diabetes, but the challenge is diet. People are unemployed so they cannot afford the diet. But we encourage them to have a small garden where they can have vegetables."

Dr Michelle Carrihill, a paediatric endocrinologist at the Red Cross War Memorial Children’s Hospital, says the hospital sees around three to five newly diagnosed patients a month and most children present with type 1 diabetes, often in a critical condition.

“According to our registry, over the last six years, we have averaged around 50 new patients per year. However, this number can vary significantly, with as few as three or as many as 12 new cases in a single month. Our primary concern is that many young patients with diabetes arrive very sick, sometimes requiring ICU admission, which can be traumatic for both the children and their families."

Dr Carrihill says common symptoms in children include sudden bed wetting or frequent urination, increased thirst, weight loss or not picking up weight, difficulty concentrating at school, vision problems, and vomiting.

Early detection is crucial in preventing severe illness, she says.

The hospital also provides care to children with type 2 diabetes.

“Obesity is a concern in children and children can develop type 2 diabetes. We are seeing more type 1 diabetic children presenting earlier because they’re overweight or obese and need more insulin, which their pancreas can’t produce. Some of our patients are as young as 6 or 7 years old,” she says, adding that they also see cases of “double diabetes”, where children had both type 1 and type 2 diabetes.

Prevention begins in utero with healthy pregnant mothers, she says.

Antenatal care should include education on healthy eating, which continues with healthy feeding and breastfeeding after birth which can reduce the risk of diabetes.

“Families need to be educated on nutritious meals and the dangers of processed foods, starting in schools and extending beyond.”

Dr Marli Conradie-Smit, head of endocrinology at Tygerberg Hospital, says the hospital’s adult diabetes clinics treats between 109 type 1 to 190 type 2 patients a month with about six new cases each week.

In adults, she says, the most common type of diabetes is type 2.

Dr James Rice, head of the retina service at Groote Schuur Hospital’s ophthalmology department, says the hospital has done 456 retinal operations between January 2023 and June 2024, of which 256 (57%) involved diabetic eye problems.

Diabetic eye problems, he says, specifically a condition called diabetic retinopathy, can be prevented if caught early enough.

“Eye screening is an important part of managing your condition, regardless of the type of diabetes you have. As diabetic retinopathy does not show any symptoms in the early stages when they are most treatable, it can become quite advanced before you start to notice it."

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