Keeping diabetes at bay

More than half of diabetes cases remain undiagnosed in Nepal. Families need to be provided with knowledge, resources and environment to understand diabetes and its management

Diabetes is one of the most common chronic diseases affecting people globally. Some 425 million people are currently living with diabetes globally. Low-and middle-income countries are more vulnerable to diabetes and related deaths. Nepal is also seeing an increase in diabetes cases. There is marked countrywide variation in its burden with as few as one percent people affected in rural areas, compared with up to 19 percent in cities. Management of diabetes is a big challenge in the country due to lack of access, low disease awareness, financial and cultural barriers and resource constraints.

In view of the growing concerns about escalating health threats posed by diabetes, the World Diabetes Day is celebrated on 14th of November every year. And it was celebrated this year too. November 14 marks the birthday of Canadian medical scientist Frederick Banting, who co-discovered insulin. The International Diabetes Federation and World Health Organization first introduced the World Diabetes Day campaign in the year 1991. The World Diabetes Day became an official United Nations Day in 2006 with the passing of the United Nations Resolution.

For 2018 and 2019, the theme of World Diabetes Day is ‘The Family and Diabetes’. The two-year campaign is aimed at raising 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 a medical condition marked by high blood glucose, also known as blood sugar. There are different types of diabetes—type 1, type 2, and gestational diabetes. In all three cases, the body cannot produce any or enough of the hormone insulin or use insulin effectively. Most of these cases are of type 2 diabetes, which is largely preventable through regular physical activity, a healthy and balanced diet, and the promotion of healthy living environments.

Gestational diabetes, a common pregnancy complication constitutes a greater impact on diabetes epidemic as it carries a major risk of developing type 2 diabetes to the mother and children in the future. It currently affects 14 percent of all pregnancies, or one in every seven births globally. As the world is talking about diabetes prevention activities, it is equally important to advocate to screen all pregnant women for gestational diabetes during their antenatal care visits.

Diabetes is a concern in every family. Living with diabetes requires daily attention and commitment for the whole family to take decisions in managing the challenges of the disease. People with diabetes need to monitor their blood glucose, take oral medication or inject insulin for treatment, exercise regularly and adjust their eating habits. Without family support and diabetes education, people with diabetes are less prepared to take informed decisions, make behavioral changes, address the psycho-social problems presented by diabetes such as fear and discomfort, and ultimately, may be unfit to deal with their diabetes condition effectively. Further, this will result in their worsened health outcomes and an increased risk of developing a number of serious diabetes-related complications. Since a major part of the management for this disease occurs inside the family, it is often called as a “Family Disease”.

Indeed, family support is of paramount importance in countries like Nepal where treatment and diabetes management is a great challenge, for reasons such as low disease awareness among the population, lack of education and lack of policies and programs to manage diabetes and its complications. More than half of diabetes cases remain undiagnosed in Nepal. It is essential that families be provided with the knowledge, resources and the environment to better understand diabetes and its management and live a healthy lifestyle.

Nepal has an opportunity to reduce the increasing burden of diabetes. Families can play a crucial in raising awareness of the disease, improving diabetes outcomes and quality of life of those affected with diabetes. Designing family focused intervention programs, such as educating family members about diabetes care-needs may positively influence health behaviors among individuals with diabetes. Family, community, and the nation all need to work together to create an environment that facilitates diabetes management, and enhances the quality of lives of people with diabetes.

The author is a postdoctoral researcher at the Section of Global Health, Department of Public Health, University of Copenhagen, Denmark