By Dr Md Anwarul Quadir

World Diabetes Day is observed globally on November 14. The theme chosen for this year _ ‘Eyes on Diabetes’ _ aims to raise awareness about the need of early diagnosis and treatment of type-2 diabetes, while minimising the risk of complications. Most of type-2 diabetic patients remain unaware that they are suffering from a silent killer. By the time they find out that they are victims, the process of complications may be already underway.
Every 1 in 2 adults suffering from diabetes remains undiagnosed. In 2015, 415 million adults worldwide were afflicted with diabetes. The number is expected to increase to 642 million by 2040. This simply means that 1 in every 10 adults will have this disease by 2040. It is alarming that diabetes is on the rise and there is lack of action to face the threat.
Bangladeshis remain susceptible to this disease. With hectic life styles, stress, decreased physical activities, increased consumption of fast food and lack of self-care, we stand as easy targets for diabetes. According to an International Diabetic Federation report, there were 7.1 million people suffering from diabetes in Bangladesh last year.
There is also growing number of diabetic patients in our neighbouring countries. Diabetes affects over 90 million adults in the South Asia region. Nearly 80 percent of deaths due to diabetes occur in low and middle income countries.
Diabetes is a chronic metabolic disease. It onsets when there is lack of insulin hormone secretion from the pancreas, or the body cannot effectively use the insulin it produces. This leads to problems in controlling the blood sugar level. This raised level of sugar, or hyperglycaemia, then leads to damage of vital organs in our body, mainly the nerves, kidneys and retinas.
There are three types of diabetes, which are _ type-1, type-2 and gestational. Type-1(insulin-dependent diabetes) usually occurs in children and starts early in life. The number of patients has increased in recent times. Although we do not know its cause, it is believed that the disease occurs due to environmental and genetic factors. Modern science is still searching for a way to prevent type-1 diabetes.
The commonest form of diabetes _ about 90 percent _ is type-2 diabetes mellitus (non-insulin-dependent, or adult-onset diabetes). It results from lack of insulin production. Symptoms may include excessive thirst or hunger, and increased frequency of urination. Though it occurs mainly in adults, recent studies indicate that children have increased risk of developing it as well. In children, this disease damages vital organs in the cardiovascular, renal and nervous systems, resulting in complications, and even early death. The global rise of childhood obesity and physical inactivity are widely believed to play crucial roles in this case.
Gestational diabetes is when a non-diabetic mother shows signs of diabetes. This makes the pregnancy and delivery complicated, in addition to increased risk of type-2 diabetes for the mother in the future. The baby also risks being bigger than normal size. That is why regular maternal checkups are important for diagnosis of the disease to avoid complications.
Diabetes can be diagnosed simply by taking blood and urine samples. The blood strip test is most commonly used. Treatment depends mostly on the condition of the disease. It can range from just changing lifestyle _ regular exercise and healthy diet, to oral drugs or insulin injection.
The good news is that it is a disease that can be kept under control. Many patients live a significant part of their lives with diabetes. Some patients feel that this disease makes them realise the importance of discipline in life. Although we all know that eating healthy and doing exercises are good for health, sometimes, we somehow fail to follow what we believe.
Diabetes consumes 12 percent of the global expenditure on health. Early diagnosis can help earlier treatment, and reduce complications while minimising cost. It is thought that 70 percent of type-2 diabetes can be delayed or prevented. Diabetes is a disease that actually affects all the organs in the body. If diabetes is present in the family, one should be extra careful, and follow up with regular diabetes tests.
Healthy eating and lifestyle habits are  strong defences against getting the disease. Keeping the body in shape, a morning walk or some sports, as well as avoiding smoking, can always help. A bit of awareness about health and wellbeing can keep diabetes at bay.

The writer is a fellow of Karolinska Institutet, Sweden.
Reference, graphics: idf.org