WOMEN AND THE THREAT OF DIABETES

Tayo Ogunbiyi

Diabetes Mellitus is a life-long disease noticeable by elevated levels of sugar in the blood either because the body does not produce enough insulin or because cells do not respond to the insulin that is produced. Insulin is the principal hormone that regulates uptake of Glucose from the blood into most cells. It is released into the blood stream by beta cells found in the Islet of Langerhans in the pancreas in response to rising levels of blood glucose, typically after eating.

Globally, diabetes has become a huge medical concern. Though the disease is prevalent across the world, experts have predicted that there would be an upsurge in its occurrence in Asia and Africa due to the trend of urbanization and the dynamism of lifestyle change.

Relevant statistical data has shown that as at 2010, an estimated 285 million people had Diabetes Mellitus. Scarily, experts have predicted that this figure would almost double by 2030. In Africa, an estimated 14.7 million adults had the disease in 2011.  With an estimated figure of 1.7 million, Nigeria has the largest number of people living with diabetes in Africa.  Sadly, this number is expected to rise to 4.8 million by 2030.

It is in an attempt to promptly deal with the disease and the threat it poses to mankind that the World Diabetes Day is celebrated annually. Globally, the Day is held on November 14 of every year to draw universal attention to the reality of the threat posed by diabetes to the well being of millions of people across the world. The Day was launched in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO) in reaction to the increase of diabetes around the world.

By the 2016 edition, the Day was being commemorated by over 230 IDF member associations in more than 160 countries as well as by other numerous global stakeholders. Traditionally, activities lined up to mark the Day often include diabetes screening, media campaigns and numerous other social events among others.

Each year, the World Diabetes Day commemoration focuses on different themes and factors that promote the risk of diabetes and its complications. Deliberately, this year’s edition, with the theme: ‘Women and diabetes - our right to a healthy future’, has been particularly chosen to focus on the increasing rate of women with cases of the disease.

The essence is to promote the significance of affordable and reasonable access for all women at risk for or living with diabetes to the necessary diabetes drugs, technologies, self-management education and information they require with a view to attaining best possible diabetes outcomes as well as strengthening their ability to avoid type 2 diabetes. Without a doubt, every woman with diabetes requires reasonable and equitable access to care and education to better manage their diabetes and improve their health outcomes.

The fact that this year’s World Diabetes Day focuses mainly on women is an indication that quite a reasonable number of women are becoming increasingly vulnerable to the disease. Research has shown that two out of every five women with diabetes are of reproductive age, thus accounting for over 60 million women globally. According to available WHO record, there are currently over 199 million women living with diabetes all over the world. This, of course, is a staggering figure. But then, experts opine that the present figure is very much likely to increase to 313 million by 2040.

To further underscore the threat posed by diabetes to the well being of women across the world, it has been discovered that the malady is now the ninth leading killer of women globally, causing 2.1 million deaths per year. Women with type 2 diabetes are almost 10 times more likely to have coronary heart disease than women without the condition. Women with type 1 diabetes have an increased risk of early miscarriage or having a baby with malformations.

As a result of socio-economic conditions, girls and women with diabetes experience barriers in accessing cost-effective diabetes prevention, early detection, diagnosis, treatment and care, particularly in developing countries. Socio-economic inequalities expose women to the main risk factors of diabetes, including poor diet and nutrition, physical inactivity, tobacco consumption and harmful use of alcohol.

Two out of every five women with diabetes are of reproductive age, accounting for over 60 million women worldwide. Women with diabetes have more difficulty conceiving and may have poor pregnancy outcomes. Without pre-conception planning, type 1 and type 2 diabetes can result in a significantly higher risk of maternal and child mortality and morbidity.

Equally, 1 in 7 births is affected by gestational diabetes (GDM), a severe and neglected threat to maternal and child health. Many women with GDM experience pregnancy related complications including high blood pressure, large birth weight babies and obstructed labour. A significant number of women with GDM also go on to develop type 2 diabetes resulting in further healthcare complications and costs. Stigmatization and discrimination faced by people with diabetes are particularly pronounced for girls and women, who carry a double burden of discrimination because of their health status and the inequalities perpetrated in male-dominated societies.

To ensure that the rate of occurrence of the disease among women becomes reasonably low, women living with diabetes should have access to pre-conception planning services to reduce risk during pregnancy.  Also, they should have access to physical activities that are geared towards improving their medical status.  In same vein, pregnant women must have unhindered access to screening, care and enlightenment to attain better health effects for mother and child.

Similarly, Type 2 diabetes prevention strategies must focus on maternal health and nutrition and other health behaviours before and during pregnancy, as well as infant and early childhood nutrition. Antenatal care visits during pregnancy must be optimized for health promotion in young women and early detection of diabetes and GDM.

It is also crucial that screening for diabetes and GDM is integrated into other maternal health interventions and services at primary healthcare level to ensure early detection, better care for women and reduced maternal mortality. Healthcare workers should be trained in the identification, treatment, management and follow up of diabetes during pregnancy. Women, as mothers, have a huge influence over the long-term health status of their children.

Other measures that can be employed in the control of this disease in addition to insulin include maintenance of a healthy body weight, adding beans and other legumes like peas and lentils which are rich in protein, fibre, vitamins and minerals to diet appear to help people with type 2 diabetes improve their blood sugar control through binding of cholesterol, keeping it from being absorbed in the guts [intestines] and lowering risk of heart disease. Regular exercises are also very essential to prevent obesity. Also tobacco and alcohol consumption should be avoided while fruits and vegetables intake as well as losing of excess weight, if obese, should be encouraged.

Ogunbiyi is of the Lagos State Ministry of Information and Strategy, Alausa, Ikeja.