Healthcare partnerships can control diabetes mellitus

DIABETES MELLITUS or diabetes global prevalence in 2014 was 422 million persons. Diabetes incidence in Jamaica is approximately 17 per cent of the population, and presently about 1,000 new patients are being placed on dialysis yearly. Diabetes results from problems with the metabolism of sugars (glucose), and is characterised by high levels of sugar in the blood. Normally, the body uses its own insulin to allow the cells to use glucose as an energy source for metabolism and other body functions. However, in the diabetic person, this does not happen. Diabetes is classified as either type 1 and type 2.

Type 1 diabetic persons produce no insulin, so have to be given insulin and are diabetic before the age of 20 years. Type 2 diabetes results from a combination of genetic and environmental factors, resulting in insulin resistance or reduced insulin production and is generally seen in persons older than the age 40 years and the obese. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

Persons with diabetes find themselves eating a lot, drinking a lot of water, and urinating often. Your doctor will request confirmatory blood test, of which the HbA1c (Glycated haemoglobin A1c) is best indicator of diabetes. Persons are diagnosed as having diabetes mellitus if their HbA1c > 6.5.

Management of diabetes requires taking your diabetic medicine, eating healthily, and exercising for 30 minutes five times per week. You will also need to see a nutritionist, ophthalmologist and your doctor every three months. Of significance to the treatment and management of diabetes is the need to always monitor blood sugar levels at home and at every visit to the doctor. Of the the four methods of monitoring blood sugars, HbA1c gives best and most accurate estimation of blood sugar levels. Advantage of HbA1c test include:

• Can be done at any time of day, without any specific requirements

• It gives a good measurement of sugar levels over a period of eight to 12 weeks

• Good predictor of diabetic disease and the possible complications of heart disease, kidney disease, diabetic nerve problems affecting the eyes and limbs

• Importantly, it is also covered under the National Health Fund

In conclusion, diabetes mellitus is a serious, chronic non-communicable disease that affects the small and large blood vessels and the nervous system, and can have significant debilitating consequences. Partnerships between patients, their doctors and both private and government health services can reduce the impact of this disease. Patient-focus treatment and management, nutritional and lifestyle adjustments with routine monitoring of blood sugar, with blood test such as the HbA1c, can result in a longer, more productive and fuller life for persons with diabetes.

DR CALVIN SOLOMON

MBBS (UWI), MBA (FIU), BSc. (UWI) General Practitioner

Diabetes Centre

1 Downer Avenue,

Kingston 5