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Asian Tribune is published by World Institute For Asian Studies|Powered by WIAS Vol. 12 No. 731

Diabetes is becoming deadlier in Sri Lanka

By Quintus Perera – Asian Tribune

Progress and development in human life is also not without evil or negative effect as some of the widespread diseases in the contemporary world are due to the conveniences offered through development and modern technology.

Earlier, there was less transport convenience, as many use to walk to reach short destinations and for agriculture and other work there were less equipment and many things have to be operated manually and as such exercises were part and parcel of daily life itself.

Further, free availability of readymade food (commonly known as junk food) plays a major role in making people sick as they are prepared with lot of oil and high calorie ingredients. Consuming lots of food soaked in oil and the use of sugar and convenience living without exerting energy (with no exercises) is the root causes for such deadly diseases like diabetes which entails other deadly diseases like heart attacks and stroke.

Dr (Mrs) Padma Gunaratne, Head, Neurology Unit, Colombo National Hospital and also President, National Stroke Association of Sri Lanka has said that while stoke has become the number two killer in the world and alarmingly it takes the fourth place in Sri Lanka. She has said that but as these patients are prematurely sent home from hospitals and some are being treated with indigenous medicine the number of deaths at home and under the care of indigenous medical practitioners are not know. If proper statistics are compiled stroke deaths would take the number two or three slot.

Advancement of life entailed some negatives that threatened the very lives of the people, prone to some dangerous diseases and among them diabetes is becoming more serious and alarming in the world said Dr Mahen Wijesuriya, who pioneered the Diabetes Association of Sri Lanka (DASL). He said that Sri Lanka too has heavily caught up with this phenomenon.

Earlier DASL was processing people above the age of 40 years considered prone to diabetes and then it was from the age of 20 years, but due to the alarming pattern of getting the disease they have now changed the age limit has been brought down to 10 years.

According to medical records until 1920s patients with diabetes usually died within one year of developing it. In 1922 a team of scientists at the University of Toronto discovered that the hormone insulin could be used to control the effects of diabetes. It is not a cure for the disease, but it regulates levels of blood sugar, allowing people with diabetes to remain in good health.

In appreciation of one of the history’s great medical breakthroughs, in 1923 Canadian physiologist Dr Frederick Banting and British physiologist Prof James Macleod, shared the Nobel Prize in physiology or medicine for the discovery.

Medical Science indicates that Diabetes Mellitus, disease in which the pancreas produces insufficient amounts of insulin or cells of the body fail to respond appropriately to insulin. Insulin hormone helps the cells of the body to absorb sugar to use as energy.

In people with diabetes, glucose levels build up in the blood and urine, causing excessive urination, thirst, hunger, and problems with fat and protein metabolism.

There are two types of diabetes. Diabetes mellitus, if untreated, may cause life-threatening complications. Type 1 diabetes can result in diabetic coma (unconsciousness) caused by extremely high levels of glucose in the blood that would sometimes lead to death.

According to medical information, in both types, complications may include blindness, kidney failure, and heart disease. Diabetes can cause tiny blood vessels to become blocked; when this occurs in blood vessels of the eye, it can result in retinopathy, causing blindness. In the kidneys, diabetes can lead to nephropathy (the inability of the kidney to properly filter toxins from the blood).

Blockades of large blood vessels can lead to many cardiovascular problems, including high blood pressure, heart attack, and stroke. Although these conditions also occur in non-diabetic individuals, people with diabetes are two to four times more likely to develop cardiovascular disorders.

Diabetes Mellitus could also be described as no or little production of insulin in the pancreas and also the condition developing in the poor response to insulin in muscle, fat and liver cells. Insulin is a hormone that helps the body’s tissues absorbs glucose (sugar) as a source of energy.

Dr Wijesuriya said that diabetes prevalence in Sri Lanka is in excess of 16 percent in the urban population and 8 percent in the rural and the total when calculated according to population is 10 percent and it makes the equation of 2 million out of a population of 20 million.

He said that this is a significant increase from the previous figures and it is mainly due to changes in the lifestyle commonly associated with urban living which increase refined fats, fast foods which have an excess of sugars starches and fats together with reduced exercises and increased comfort seeking. He said that where either television watching computer usage, excessive tuition and other studies take away time for exercises.

Dr Wijesuriya said that on top of this there is the element of the mind where stress of educational excellence and achievements together with high expectation of employment and financial gains are incriminated in a state of mental stress. This passion could lead to overweight, obesity, late diabetes and heart diseases. While the process with diabetes are increasing there is another salient feature of increase in the younger generation under 20 years which was not witnessed before.

He said that the combination of early onset and increased number tend to produce high risk of complications in the society which is to be catered by the medical services. With available resources with them, the best method to combat this illness is primarily prevention. Where the population at risk should be first identified by going into the family history of different persons to observe weight increase, reduced physical effort

Dr Wijesuriya said that they are embarking upon this exercise and this group of persons is advised in the correct way of doing and living so that the risk of development of the conditions mentioned above could be eliminated.

He said that in their Association by now have screened 25,000 persons under the age of 40 years and identified approximately 7,800 persons of high risk and are in the process of advising the of lifestyle modifications for a period of three years.

He said that the incidence of this condition could be minimized in the future, and they advice to eat nutritionally adequate meals made up of high bran starch products such as vegetables, fruits, fish and chicken. On a regular basis in moderate quantities distributed during the day as three or four meals. According to the working times or the school times of the individual.

They also advise parents and young persons to accept their maximum potential and work towards achieving their goals within this potential so that they are not disappointed or depressed.

Dr Wijesuriya felt that the most significant variable in the development of this diabetes prone condition is the change from rural to urban life where in the former healthy food products were often available and exercises came through walking, running, cycling or manual work and the aspiration of the people were kept to manageable level. Having left the village people can still make use of the habits in the urban environment but they will have to make a greater effort to achieve these goals, Dr Wijesuriya said.

He said that if however, both parents take it upon themselves that health is their greatest wealth and do not compromise former for the later in seeking long hours of work with high remuneration which would come by wrong kind of lifestyle, they would be luckier to save life.

Diabetes Mellitus could be described as no or little production of insulin in the pancreas and also the condition developing in the poor response to insulin in muscle, fat and liver cells. Insulin is a hormone that helps the body’s tissues absorbs glucose (sugar) as a source of energy.

Sergeant Commodore Dr Lalith Ekanayake, Director, Naval Medical Services, one of the experts on Diabetes also spoke to the Asian Tribune on the issue of Diabetes in regard to World Diabetes Day that fell in mid November.

He also conceded that there is high prevalence of diabetes but there are also wonders taking place in the areas of medical science where the treatment, investigations, detection and application are vastly advanced. Therefore the morbidity and mortality is not that high compared to the increased prevalence.

He said that there is a possibility of getting the disease transferred from parents to children. There are certain conditions, such as obesity can lead to diabetes, taking certain medicine for a long time, surgical conditions involved in the pancreas all these can cause diabetes he said. Diabetes is most common in adults over 45 years of age in people who are overweight or physically inactive; in individuals who have an immediate family member with diabetes.

Dr Ekanayake said that Insulin, made in the pancreas, helps control levels of the sugar glucose, needed to fuel many chemical processes. In a healthy person, when food is digested, glucose levels in the bloodstream rise; the pancreas releases insulin; which helps body cells take up glucose. Insulin helps convert glucose into glycogen, which is stored in the liver and muscles until needed for fuel. Hormones regulate the release of insulin by causing blood sugar levels to drop, which in turn causes the pancreas to secrete less insulin.

When affected with diabetes mellitus, either pancreas produces insufficient levels of insulin or the body is unable to use the insulin it makes. He said the symptoms of diabetes are feeling thirsty, passing lot of urine, loosing weight and increased appetite.

He said that diabetes is directly related to heart attacks and strokes because diabetes affects both small and large blood vessels of the heart and the brain and it increases the serum cholesterol which eventually cause heart attacks and strokes.

If left untreated, diabetes mellitus may cause life-threatening complications resulting in diabetic coma or death. In both Type 1 and Type 2 diabetes could cause blindness, kidney failure, and heart disease.

Diabetes mellitus may also cause loss of feeling, particularly in the lower legs. This numbness may prevent a person from feeling the pain or irritation of a break in the skin or of foot infection until after complications have developed, possibly necessitating amputation of the foot or leg.

Burning pain, sensitivity to touch, and coldness of the foot, conditions collectively known as neuropathy, can also occur. Other complications include high-risk pregnancies in diabetic women and a greater occurrence of dental disease.

Dr Ekanayake said that diabetes is detected by measuring the amount of glucose in the blood after an individual has fasted for about eight hours. In some cases, physicians diagnose diabetes by administering an oral glucose tolerance test, which measures glucose levels before and after a specific amount of sugar has been ingested. Another test being developed for Type 1 diabetes looks for specific antibodies present only in persons with diabetes. This test may detect Type 1 diabetes at an early stage, reducing the risk of complications from the disease.

Once diabetes is diagnosed, treatment consists of controlling the amount of glucose in the blood and preventing complications. Depending on the type of diabetes, this can be accomplished through regular physical exercise, a carefully controlled diet, and medication.

He said that diabetes could be prevented, by reducing weight, increasing physical exercises, controlling the diet and by controlling stress. If the parents have got diabetes, by adhering to strict discipline schedule as given above in all probability it could be prevented. If diabetes is infected due to bad dietary habits and due to continuously taking some medicine, strict diet schedule and change over to other medicine, it could be controlled.

He said that more than drugs treatment as indicated earlier by reducing weight, increase in doing exercises, stop smoking and alcohol and reduce stress and go on a strict diet, which would be very effective.

- Asian Tribune -

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