Thursday (14 November) is World Diabetes Day. In an opinion piece for News24, Prof Faadiel Essop from the Centre for Cardio-Metabolic Research in
Africa at Stellenbosch University highlights four steps people can take to protect themselves and their families against diabetes.
- Read the article below or click here for the published version.
There are currently 425 million people living with diabetes globally, with this number projected to further increase to 629 million by 2045. Research shows that in South Africa, the prevalence of diabetes is estimated at around 5,6% but this number is likely much higher due to the substantial number of individuals that are currently undiagnosed. As a country, we are burdened with this debilitating condition which can cause blindness, amputation, heart disease, kidney failure and early death.
Since diabetes doesn't discriminate, it is important that individuals and families arm themselves with the knowledge of how to prevent and manage it. An opportune time to start doing so would be on World Diabetes Day that's being celebrated annually on 14 November since 1991 when it was initiated by International Diabetes Federation (IDF) and the World Health Organisation in response to the growing global threat of diabetes.
The theme for this year's World Diabetes Day is ''Protect your Family'' which, according to the IDF, is to raise awareness of the impact that diabetes has on the family and to promote the role of the family in the management, care, prevention and education of the condition. Protecting your family against diabetes need not be a daunting task. There are four relatively easy steps that people can take to help protect their family against the onset of diabetes and also assist those already burdened with this disease.
A very important first step is to test your status. Statistics produced by the IDF show that there are a substantial number of persons who are actually diabetic but who are not yet diagnosed. For example, a study completed in Bellville in 2012 revealed that around 56% of those diagnosed with diabetes (by the researchers) were not aware of their condition. It is therefore essential to test for diabetes because failing to do so holds serious consequences for the health and well-being of such individuals. In this regard, an easy online self-assessment for diabetes should do the trick. In addition, knowledge regarding the warning signs for diabetes e.g. excessive thirst, frequent urination, and numbness of the hands and feet is useful and informative to then seek assistance from the medical fraternity.
Secondly, a supportive culture should be promoted within families and communities. Research studies show that good support provided by family members or spouses plays an important role in this context. Such support can be useful in both prevention of diabetes onset and also for relatives already diagnosed with diabetes. In this instance, family support can help individuals in terms of their medication compliance, associated mental health complications such as depression, and also with the adoption and longer-term implementation of modified lifestyle choices (e.g. diet, physical activity, etc).
Thirdly, suitable lifestyle changes need to be implemented. The onset of diabetes is a complex process where there is an intersection of genes and lifestyle choices. We know that poor dietary choices and a sedentary lifestyle are strongly linked to the onset of diabetes and heart diseases. However, recent data show that so-called epigenetic changes – stable changes at the gene level without altering the gene sequences – also play a key role in the onset of diabetes. In this case, the impact of environmental factors can now extend beyond the individual and be passed on to your offspring and future generations. For example, this would mean that a pregnant woman's behavioural and lifestyle-related choices such as smoking, substance abuse and malnutrition can result in epigenetic changes in the foetus and hence place the new-born at increased risk for the future onset of diabetes and heart diseases. Thus there is now a much stronger onus than ever before on individuals and families to adopt healthier lifestyle choices.
As research studies show that it is difficult to sustain lifestyle-related changes over a long period of time, it is best to start with smaller, manageable changes. The plan should be to establish lifestyle changes as part of a revised daily routine and thereafter to continue to build from this platform. There are a plethora of online diets and lifestyle interventions available that can often result in poor choices being made as such options were not necessarily subjected to rigorous scientific testing and/or clinical trials. It is, therefore, essential that people consult with their doctor and to only use authoritative online sources when deciding on a particular lifestyle intervention(s). For example, a useful starting point would be the reputable Mayo Clinic that recommends healthy carbohydrates, fiber-rich foods, fish, ''good'' fats and the avoidance of saturated and trans fats, cholesterol and sodium.
People should also be mindful of hidden sugars in processed foods such as sugar-sweetened beverages (sodas, fruit juices). Our research group recently reviewed the impact of sugar-sweetened beverages on health and found that in some cases as little as two sugar-sweetened beverage servings per week is linked to a greater onset of diabetes. It is important to remember that the daily limit for sugar intake is nine teaspoons per day for men and six teaspoons for women as stipulated by the American Heart Association. People need to be aware that drinking an average can of sugar sweetened beverage already exceeds the daily sugar intake limit.
Lastly, but certainly not least, it is essential that we stand up and walk. Many people live sedentary lifestyles which include both the lack of physical activity and sitting for long periods at the office in traffic, or spending too much time in front of the computer or television. This type of sedentary behaviour is associated with an increased risk for diabetes onset. An easy way to start ditching a sedentary lifestyle is to walk wherever you are able to. For example, walk up the stairs instead of taking the elevator, go on lunch time walking breaks, walk to nearby friends and family or to the local store. If you spend most of your day at the office, try to take regular breaks and/or short walks, and also consider sit-stand desks. These could be the first steps towards protecting you and your family against diabetes.
*Professor Faadiel Essop is the Director of the Centre for Cardio-Metabolic Research in Africa at Stellenbosch University.