Could diabetes become the next HIV/AIDS?
The World Health Organization (WHO) estimates that more than 346 million people worldwide have diabetes. It is a number they expect will more than likely double by 2030, without intervention. With numbers that staggering, Dr. Patrick Whitfield says the disease will probably become the next HIV/AIDS.
“With HIV/AIDS, we may have a better chance of control- ling somebody’s sexual practices using condoms, but it is very difficult to control people’s desires and appetites,” says the general practitioner. “And it’s important because [diabetes] would probably do as much damage to the population as AIDS. As a matter of fact, it will have the same serious effect that HIV/AIDS has as far as mortality and morbidity.”
Because of today’s lifestyle where people lead relatively sedentary lifestyles, and are on the computer all the time, and most people eat a lot of fast food, Dr. Whitfield says this is a breeding ground for an increase in obesity which is associated with dia- betes.
Diabetes is a disease characterized either by a lack of insulin or insulin- resistance that simply means the tissues do not respond to insulin. The insulin cannot get into the person’s cells and stays in the blood.
There are two types of diabetes — Type 1 and Type 2.
People with type 1 diabetes have an absolute lack of insulin. It is seen more in younger age groups and is a “more serious” disease than type 2 because of the damage it can cause, according to the doctor who practices out of the Oxford Medical Center, and is also the medical chief of staff at the Princess Margaret Hospital. He says luckily only between five and 10 percent of the Bahamian diabetic popula- tion has type 1 diabetes.
Type 2 diabetes is a genetic pre-dis- position, and most people would have a family history of it, as they would have the gene. He describes type 2 as a less insidious disease, which over the long term can cause significant dam- age to the kidneys, eyes and lower limbs. Once insulin stays in the blood it can cause major damage to some vital organs — primarily the kidneys, small blood vessels in the leg, which can lead to ulceration and eventually gangrene and loss of limbs. It also damages the small blood vessels to the eye, and is one of the leading causes of blindness.
Being overweight or obese is the dis- ease’s trigger, along with the gene that would take the sufferer into overt dia- betes.
Primary symptoms of diabetes include frequent urination, weight loss, blurry vision because of its effect on your eyes, and generalized fatigue. Some people describe an itching in the skin as well. A controlled diabetic does not have any of the symptoms.
There is a stage between the normal and overt diabetes that is referred to as pre-diabetes when doctors can detect and delay or prevent diabetes.
“People with pre-diabetes have a higher risk of developing overt dia- betes. If we can catch people at the stage where they are pre-diabetic, then there are some things we can do to certainly, if not delay, prevent diabetes. But you have to be able to pick them up at the pre-diabetic stage, which is typically picked up on during routine screenings, or routine physical exams.” While the doctor does not know the numbers of Bahamians that have been diagnosed with diabetes, he says he does not believe people take the dis- ease as seriously as they should.
“I don’t think people recognize or realize the outcomes of diabetes. It is important from an individual level, because of the potential for loss of limbs, kidney failure, and it is probably one of the most common causes of renal failure we currently see in the country and the leading cause of dialy- sis. And high blood pressure associat- ed with diabetes increases your risk of
kidney damage.” He says most diabetics die from heart disease — whether a stroke or heart attack — because diabetes increases the risk. Diabetic pregnant women are also a huge concern for medical practi- tioners as they are at an increased risk for stillbirth, premature births and birth defects.
Dr. Whitfield says it’s important for pregnant women who are diabetic and those who are attempting to get preg- nant, to have their blood sugars well controlled,because most of the damage that occurs to a fetus in a pregnant diabetic woman will occur within the first three months and end up with major problems like stillbirth, birth defects and premature labor.
With the WHO predicting the num- ber of people with diabetes doubling by 2030, without intervention, Dr. Whitfield says controlling the disease is important at a community level to stem the rising cost of healthcare.
“This is one of the reasons why the United Nations (UN) held that recent chronic disease conference which our prime minister attended, because worldwide, there’s an increasing fear of the effects diabetes can have, not only on the individual, but countries at large in terms of expenditure spent on health.”
The doctor says people with diabetes who are not controlled, and develop the complications, leads to increased utilization of the healthcare services, and an overwhelming amount of peo- ple, attending both the clinics and the hospital. He says it is one of the major drivers of increased healthcare costs in The Bahamas in the private and public sector. Because of the increase in healthcare cost, and the loss of pro- ductivity in the workplace, the disease has an indirect financial cost related to loss of productivity in the workplace, as well as the amount of money that has to be spent on healthcare.
He says billions of dollars are being spent on diabetes from investigations, doctor’s visits, medications and ultimately dialysis.
World Diabetes Day was recognized globally on Monday, November 14. The day raises global awareness of the disease and its escalating rates around the world and how to prevent the ill- ness in most cases. The day is cele- brated to mark the birthday of Frederick Banting, who along with Charles Best, was instrumental in the discovery of insulin in 1922, a life-saving treatment for diabetes patients.