Diabetes is a chronic disease that occurs either when the pancreas
does not produce enough insulin or when the body cannot effectively use the
insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycemia,
or raised blood sugar, is a common effect of uncontrolled diabetes and over
time leads to serious damage to many of the body's systems, especially the
nerves and blood vessels.
Type 1 diabetes
Type 1 diabetes (previously known as insulin-dependent, juvenile or
childhood-onset) is characterized by deficient insulin production and requires
daily administration of insulin. The cause of type 1 diabetes is not known and
it is not preventable with current knowledge. Symptoms include excessive
excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight
loss, vision changes and fatigue. These symptoms may occur suddenly.
Type 2 diabetes
Type 2 diabetes (formerly called non-insulin-dependent or
adult-onset) results from the body’s ineffective use of insulin. Type 2
diabetes comprises 90% of people with diabetes around the world, and is largely
the result of excess body weight and physical inactivity. Symptoms may be
similar to those of Type 1 diabetes, but are often less marked. As a result,
the disease may be diagnosed several years after onset, once complications have
already arisen. Until recently, this type of diabetes was seen only in adults
but it is now also occurring in children.
Gestational diabetes
Gestational diabetes is hyperglycemia with onset or first
recognition during pregnancy.
Symptoms of gestational diabetes are similar to Type 2 diabetes.
Gestational diabetes is most often diagnosed through prenatal screening, rather
than reported symptoms.
Impaired glucose tolerance (IGT) and impaired fasting
glycaemia (IFG) Impaired glucose tolerance
(IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the
transition between normality and diabetes. People with IGT or IFG are at high
risk of progressing to type 2 diabetes, although this is not inevitable.
What are common
consequences of diabetes?
Over time, diabetes can damage the heart, blood vessels, eyes,
kidneys, and nerves.
·
Diabetes increases the
risk of heart disease and stroke. 50% of people with diabetes die of
cardiovascular disease (primarily heart disease and stroke).
·
Combined with reduced
blood flow, neuropathy in the feet increases the chance of foot ulcers and
eventual limb amputation.
·
Diabetic retinopathy
is an important cause of blindness, and occurs as a result of long-term
accumulated damage to the small blood vessels in the retina. After 15 years of
diabetes, approximately 2% of people become blind, and about 10% develop severe
visual impairment.
·
Diabetes is among the
leading causes of kidney failure. 10-20% of people with diabetes die of kidney
failure.
·
Diabetic neuropathy is
damage to the nerves as a result of diabetes, and affects up to 50% of people
with diabetes. Although many different problems can occur as a result of
diabetic neuropathy, common symptoms are tingling, pain, numbness, or weakness
in the feet and hands.
·
The overall risk of
dying among people with diabetes is at least double the risk of their peers
without diabetes.
How can the burden
of diabetes be reduced?
Prevention
Simple lifestyle measures have been shown to be effective in
preventing or delaying the onset of type 2 diabetes. To help prevent type 2
diabetes and its complications, people should:
·
achieve and maintain
healthy body weight;
·
Be physically active –
at least 30 minutes of regular, moderate-intensity activity on most days. More
activity is required for weight control;
·
eat a healthy diet of
between three and five servings of fruit and vegetables a day and reduce sugar
and saturated fats intake;
·
Avoid tobacco use –
smoking increases the risk of cardiovascular diseases.
Diagnosis and
treatment
Early diagnosis can be accomplished through relatively inexpensive
blood testing.
Treatment of diabetes involves lowering blood glucose and the
levels of other known risk factors that damage blood vessels. Tobacco use
cessation is also important to avoid complications.
Interventions that are both cost saving and feasible in developing
countries include:
·
Moderate blood glucose
control. People with type 1 diabetes require insulin; people with type 2
diabetes can be treated with oral medication, but may also require insulin;
·
blood pressure
control;
·
Foot care.Other cost saving interventions include:
·
screening and treatment
for retinopathy (which causes blindness);
·
blood lipid control
(to regulate cholesterol levels);
·
screening for early
signs of diabetes-related kidney disease.
These measures should be supported by a healthy diet, regular
physical activity, maintaining a normal body weight and avoiding tobacco use.
WHO response
WHO aims to stimulate and support the adoption of effective
measures for the surveillance, prevention and control of diabetes and its
complications, particularly in low and middle-income countries. To this end,
WHO:
·
provides scientific
guidelines for diabetes prevention;
·
develops norms and
standards for diabetes diagnosis and care;
·
builds awareness on
the global epidemic of diabetes; including partnership with the International
Diabetes Federation in the celebration of World Diabetes Day (14 November);
·
conducts surveillance
of diabetes and its risk factors.
The WHO Global strategy on diet, physical activity and health complements WHO's diabetes work by focusing on population-wide
approaches to promote healthy diet and regular physical activity, thereby
reducing the growing global problem of overweight and obesity.
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