The diagnosis of diabetes mellitus depends solely on the demonstration of hyperglycemia. According to the 1997 revised diagnostic criteria, one of the following three conditions must be identified, and then confirmed on a subsequent day:
|A random plasma glucose ≥ 200 mg/dL (≥ 11.1 mmol/L) coupled with classic diabetic symptoms such as polyuria, polydipsia, and unexplained weight loss.|
|A fasting plasma glucose ≥ 126 mg/dL ( ≥ 7 mmol/L) after no caloric intake for at least 8 hours.|
A plasma glucose ≥ 200 mg/dL 2 hours after a glucose load (oral glucose tolerance test; 75 g dissolved in water).
Diabetes mellitus is a very serious complex chronic disease with epidemic proportions. Currently, there are 450 million people with diabetes in the world. Projections indicate there will be more than 333 million people with diabetes by 2025. The majority of the new cases will be those with type 2 diabetes. The regions with the greatest potential increase are africa, latin america, asia and middle east where type 2 diabetes could become 2 to 3 times more prevalent than it is today. With a prevalence of around 30 % in bahrain and it could reach 50% in certain age and gender, a rate considered one of the highest in the world
According to the international diabetes federation, five countries among the six highest diabetes prevalence rates in the world are gulf states countries. Type 2 diabetes will constitute a major public health problem in nearly every nation through the corresponding burden of complications and premature mortality. The complications resulting from the disease are a significant and are associated with the damage or failure of various organs such as the eyes, kidneys, and nerves. Individuals with type 2 diabetes are also at a significantly higher risk of death from coronary heart disease, peripheral vascular disease, and stroke. Despite all those shocking statistic and being the leading cause of blindness, renal failure, amputations, stroke and heart attack, awareness about the disease and its complications remains pitifully low.
In december 2006, the united nations general assembly unanimously adopted a a landmark resolution concerning world diabetes day, recognizing diabetes as a chronic debilitating and costly disease. This resolution makes diabetes day stronger than ever as a global event and makes significant increase in the opportunity to participate by government agencies and media. The gulf ministers, gcc, pledged to place diabetes as top priority on their healthcare agenda and to celebrate the diabetes day with measures taken to prevent and control this epidemic
That’s all are great news, but the real goal of this to raise the awareness of diabetes at various levels from those decision makers politicians to health care providers and people in the community. It is the responsibility of all in making diabetes a health priority now and every one can do what’s in his capacity
There is a way out as many complications of diabetes can be prevented and there is a wealth of convincing clinic evidence that diabetes type 2 could be delayed or prevented. Experience from around the world indicated that lifestyle related measures, a low cost investment strategy with substantial returns, could significantly prevent diabetes, reduce heart disease, stroke, kidney failure, obesity, hypertension, hyperlipidemia and improve quality of life. There is absolutely no excuse for not intervening immediately and no need to wait for further evidence as we know what needs to be done about diabetes
Three important messages should be delivered in protecting our people which are clear, simple and focused. First, diabetics and pre-diabetics could have no symptoms and earlier diagnosis with treatment can make an impact on preventing the complications. Second, those at risk could be easily identified before getting in the diabetes or prediabetes range and they could prevent or delay the disease. Third, those with established diagnosis of diabetes could have a long healthy life without any complications.
Diabetes and pre-diabetes usually are not symptomatic in most cases and such diagnosis could be delayed to around 10 years if not appropriately screened. We know that one third to one half of the cases with diabetes are not aware that they have the disease. On a global scale, this translates to around 100 million not aware of the disease and may already have complications at the time of diagnosis. For pre-diabetes, there are approximately 314 million people and is expected to rise to 500 million cases by 2025
Screening for those high risk groups have been shown to be cost effective and beneficial. Those with pre-diabetes could delay the onset of diabetes or revert back to normal by appropriate intervention.
There is substantial evidence in the literature to support that lifestyle changes can prevent or delay the onset of type 2 diabetes among those at high-risk. Those studies included people with pre-diabetes and other characteristics for developing diabetes like obesity, high lipids, hypertension, family history of diabetes, mothers who had gestational diabetes or large babies and people of certain ethnic background. The lifestyle interventions included diet and moderate intensity physical activity (such as walking for 2 ½ hours each week). In the diabetes prevention program, a large prevention study of people at high risk for diabetes, the development of diabetes was reduced by 58% over 3 years
It is important for us to choose a healthy pathway. Our young people look up to us and will follow in our paths. If you are at risk for developing diabetes, you may be able to prevent or delay it. By making healthy food choices and being physically active almost everyday (such as walking), you will create a healthy lifestyle pathway for generations to follow
We need to raise the public and medical community awareness in diabetes and encourage all to be more involved in the prevention and control of this epidemic of diabetes
We in the Gulf area and The Middle East area are not short of medical expertise or lack of knowledge about this epidemic. However, successful management of the disease requires a collaborative approach, effective strategies, advocacy and recruiting stakeholders. It is every body job to act and participate in any way to reduce the burden of this disease.