KATHMANDU: World Diabetes Day is being marked today with the theme “The Family and Diabetes”.

The day is marked to raise awareness of the impact that diabetes has on the family and support network of those affected, as well as promoting the role of the family in the management, care, prevention and education of diabetes.

Diabetes is essentially referred to as a group of diseases that result in too much sugar in the blood. Type 1, Type 2 and gestational diabetes are the three kinds of diabetes. In the case of type 1 diabetes, the immune system attacks and destroys cells in your pancreas that make insulin.

Children and young adults usually suffer from type 1 diabetes, but it can occur at any age. People with type 1 diabetes need to take insulin injections every day.

Diabetes is a disease that affects the way the body uses glucose, also called sugar, to fuel the body’s cells. People with diabetes have too much glucose in their blood and a poor mechanism for converting it to energy.

Type 2 diabetes is the more common form of diabetes. Poor lifestyle and being overweight puts you at risk of type 2 diabetes. The body is unable to make insulin well in case of this kind of diabetes. Losing weight and living a healthy lifestyle can reverse type 2 diabetes.

Gestational diabetes: This is the kind of diabetes that develops in pregnant women. Mostly, this kind of diabetes goes after childbirth. However, women with gestational diabetes are at risk of developing type 2 diabetes later in life.

According to the World Health Organization, obesity is found to be a cause of diabetes among 16.6 percent female population and 13.6 percent male. Likewise, dullness is identified to be another cause among 3.3 percent population.

Doctors involved in this field said that the data have shown that Nepal is at high risk of diabetes.

According to the WHO, there is no exact data of patients with diabetes in Nepal. But, the 2016 Diabetes Profile has shown that 9.1 percent of the Nepali population is living with diabetes. It includes 10.5 percent men and 7.9 percent women.

Nepal is one of the 6 countries of the IDF SEA region. 425 million people have diabetes in the world and 82 million people in the SEA Region; by 2045 this will rise to 151 million. There were 657.200 cases of diabetes in Nepal in 2017.

Similarly, according to the International Diabetes Federation (IDF) statistics, presently every seven seconds someone is estimated to die from diabetes or its complications, with 50% of those deaths (4 million in total per year) occurring under the age of 60 years. (1) This is against the background of a global diabetes prevalence of 8.8% (95% confidence interval 7.2-11.3%) of the world population in 2017, standardized for the age group 20-79 years.

The prevalence is expected to further increase to 9.9% (95% CI 7.5-12.7%) by the year 2045. In total numbers, this reflects a population of 424.9 million (95% CI 346.4-545.4 million) people with diabetes worldwide in 2017 with an estimate of a 48% increase to 628.6 million people (95% CI 477.0-808.7 million) for the year 2045. Global umbers of diabetes prevalence have continuously risen from 151 million in 2000, when the IDF Diabetes Atlas first was launched, to 285 million in 2009 and to 382 million in 2013. Disturbingly in this context, some 50% of all individuals with diabetes are undiagnosed, especially in developing countries.(1)

The figures given in the IDF Atlas fit well with the estimates of an international consortium reporting worldwide trends in diabetes since 1980 based on a pooled analysis of 751 population-based studies with 4·4 million participants. (2) According to this group global age-standardised diabetes prevalence increased from 4.3% (95% CI 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women.

Moreover, it was estimated that the number of adults with diabetes in the world had increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and aging, and 31.8% due to interaction of these two factors). Besides the growth and aging of the world population in general, the global obesity epidemic has turned out to be a key factor for the rise of diabetes incidence together with the immense progress of multifactorial cardiovascular risk management and successful revascularization therapy of people with diabetes also contributing to the expansion of the worldwide diabetes population.

In addition to overt diabetes, the IDF Atlas estimates another352.1 million (95% CI 233.5 -577.3 million) people worldwide to have a pre-stage of diabetes, called Impaired Glucose Tolerance (IGT), a figure which is anticipated to rise to 531.6 million (95% CI 353.8-883.9 million) in 2045.

Diabetes Specialist Dr. Jyoti Bhattarai said that the changed lifestyle and consumption of asymmetric food such as food with high carbohydrates, salt, sugar, and oil have caused obesity and consequently the emergence of diabetes as an epidemic.

“Diabetes is emerging as a formidable killer. We are between two highly diabetic prone countries India and China. It has also increased our challenge to overcome the epidemic”, she said.

The disease is highly pervasive among those having obesity and a sedentary lifestyle in Nepal.

Lifestyle tips for blood sugar control in diabetes

1. A well-managed diet with a balance of carbs, protein, fat, and fiber.

2. Foods that are rich in protein and fiber can be helpful. Almonds, fresh fruits, and vegetables, walnuts, seeds, sprouts, whole grains, etc are all examples of foods rich in fiber.

3. Check your blood sugar levels several times in a day to ensure that your numbers are fiber.

4. Diet needs to be modified according to the severity of the disease, a person’s weight, eating habits, etc

5. Avoid refined carbs like maida and refined sugar. High-fat foods also need to be off the table for diabetics.

6. Include more complex carbs in your diet but in controlled proportions.

7. Stay away from aerated drinks and beverages if you have diabetes.

8. Avoid exercising on an empty stomach, unless their blood sugar levels are under control. Have a light snack before a workout if you have diabetes and workout in the morning.

9. Quit smoking and alcohol.

10. Exercise regularly and be physically active. Make sure you include strength training in your fitness routine.