Diabetes aids, articles, financial matters etc: Diabetes Education in Middle-age Schools

Diabetes aids, articles, financial matters etc: Diabetes Education in Middle-age Schools: "New! Diachieve Brand Diabetic Supplies & Health Products EasyHits4U.com - Your Free Traffic Exchange - 1:1 Exchange Ratio, 5-Tier R..."

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Diabetes Education in Middle-age Schools

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Diabetes Education is a recent phenomenon which is an ingredient for Diabetes prevention strategies. The relevance of Diabetes Education cannot be by any means overemphasized. It is relevant to health care professionals, persons living with diabetes, relations of persons with diabetes and those at risk of developing diabetes.
Majority of the damages posed by diabetes is fueled by ignorance which can be effectively cured with education. Schools are environment for learning both moral and academic. It is the environment where peers are much influenced. This is the breeding ground for poor hygiene and eating habits and lifestyle that are on a long run injurious to the body wellbeing. This is the avenue where most smokers where given birth to!
Introducing diabetes education to school curricula is indeed a necessity to help address some of these ills at infancy. Diabetes Education does not involve diabetes matters alone but useful information on how best to enjoy a healthy life style.
Seasoned expert trainers should be sponsored to carry out trainers training to enable reach out to majority of persons living with diabetes presently and to help fight the damage ignorance is posing to those already with diabetes and those at risk of diabetes.
Diabetes education in middle age schools will automatically assist the school in meal planning; there will be appropriate regulation of beverage and fast foods vendors in around school environment and general consciousness on healthy living techniques.
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DIABETES AND HYPERTENSION THE RELATIONSHIP

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Hypertension is a cardiovascular disease which has been with man for a long time. Most people in the medical palance view hypertension as a twin of diabetes. Hypertension is twice as common in diabetes as in the general population and affects some 10 – 30% of type 1 and 30 – 50% of type 2 diabetic patients. It is also present in about 20 – 40% of people with impaired glucose tolerance.
The World Health organization(WHO) and International Society for Hypertension (ISH) considers lower target range in people with diabetes to be below 130 -140/85mmHg and Lower (<125/80mmHg) in people with nephropathy. There are several ways which insulin resistance or hyperinsulinaemia which is mainly found in type 2 diabetes could lead to hypertension. - Blunting of the vasodilator effect of insulin an action mediated by the release of nitric oxide from endothelium. - Insulin can act in other ways to raise blood pressure and this can be supported by hyperinsulinaemia that accompanies insulin resistance. Insulin stimulates sodium and water absorption at the distal renal tubule, insulin also stimulates the cell membranes Na+ K+ ATPase, which can raise intracellular Na+ and Ca+ in vascular smooth muscles and therefore enhance contractility and peripheral resistance. Several components of the augmented cytokine induced, acute phase inflammatory response associated with type 2 diabetes may cause hypertension including cytokine stimulation of ACTH and glucocorticoid secretion and activation of the sympathetic nervous system. In type 1 diabetes, hypertension is obviously associated with diabetic nephropathy. Blood pressure begins to rise when albumin excretion rate enters the microalbuminuric range (>30mg/24hrs).
Control of hypertension in diabetes is important because hypertension worsens both macrovascular and microvascular complications. The effect of blood pressure on the risk of fatal coronary heart disease is 2 – 5 times greater in diabetic than in non-diabetics.

GASTROPARESIS AND DIABETES

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Gastroparesis is a stomach disorder that results due to a complication of Diabetes called neuropathy. When there is nerve damage, sensation to the stomach muscles reduce and these cause the stomach to empty too slowly.
Gastroparesis could occur in people without diabetes but it is a common occurrence in persons living with diabetes especially type 2 diabetes. People with type 1 diabetes do not develop gastroparesis until they have had diabetes for a long time about 20 years. Women appear to be more likely to get gastroparesis than men.
The most important factor in preventing gastroparesis is good blood glucose control. These are for two major reasons:
- High levels of blood glucose directly slow stomach emptying.
- Good diabetes control slows or prevent the development of complications, including nerve disease called neuropathy.
Symptoms of Gastroparesis
The most common symptoms includes:
- Nausea
- Abdominal pain
- Periods of lows within 1 to 2 hours of eating . others include:
- Feeling full after eating
- Bloating
- Vomiting
- Getting full quickly
- Belching after eating
- Pain in the general area of the stomach
- Upset stomach
- Gastroesophageal reflux.
Diagnosis
In addition to history and physical examination, the doctor can request the following diagnostic tests:
1. Scintigraphy
2. Radioisotope breath test
3. Electrogastrography
4. Manometry
5. Endoscopy
Treatment
The overall treatment goal is aimed at improving blood glucose control, normalizing stomach emptying so that drugs and food absorb properly, and relieving symptoms.
The following multilevel approach is involved:
1. Diabetes Control
Controlling the blood glucose is the foremost treatment measure.
2. Diet
It is important to understand that several small meals are easier for the stomach to process than few large ones. The diet should be low in fat because fat slows stomach emptying. Vegetable consumption in our meals should be encouraged.
3. Exercise
Moderate exercise after eating, studies shows can improve stomach emptying.
4. Review of drugs
The doctor might review a persons drug to remove or change those with side effects of slow stomach emptying also there is the need to cut out alcohol and tobacco.
5. Drug treatment
The doctor may prescribe some range of drugs example
- Prokinetic drugs: to increase stomach activity.
- Antiemetic drugs: to prevent vomiting.
One such drug which has both of these property approved by FDA is metoclopramide.
Other treatment options includes:


1. Surgery
2. Electrical stimulation
3. Electrical pacing.

Diabetes mellitus and Depression

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Diabetes mellitus is a metabolic disorder resulting in characteristic rise in plasma blood glucose. There is also a cascade of hormonal disturbance as the body try to compensate for this disorder.
The first time a person is diagnosed with diabetes, there seems to be a weight of emotions tied to that person. There is confusion as to what to eat, how to leave and loads of many questions like ‘why me’, ‘what will people say’ amongst others.
The initial reaction or response to this early stage goes a long way to tell how someone copes with diabetes later in life. The early stage of diagnosis if not properly managed by the doctor and relations, then depression automatically finds a root.
Depression could result if one no longer take interest or pleasure in things you used to enjoy doing, you have trouble falling asleep, wake often during the night, or want to sleep a lot more than usual, you wake up earlier than usual and cannot get back to sleep, you eat more or less than you used to, you quickly gain or lose weight. Feeling down once in awhile is normal. But feeling really sad and hopeless for 2 weeks or more might be a sign of serious depression.
Research has shown that depression mostly arises in persons diagnosed with diabetes following periods of denial, anger and frustration.
Diabetes clinics cannot do without the services of Diabetes Educators who are crucial in handling the initial stage of diagnosis and the period of living with the condition.
It is important to make the patient realize that diabetes is not a death sentence, people can have a full and normal life even with diabetes. Relations of people with diabetes must be made to know their responsibilities of care and support. Diabetes must be handled as a team, where the person with the condition is the team leader who takes decision in other for the goal to be attained.
Relations must be on the watch for signs of depression and inform the physician or any member of the diabetes care team promptly.
The following are useful tips on detecting depression:
• You have trouble concentrating, other thoughts or feelings distract you, you have no energy, you feel tired all the time, you are so anxious or nervous, you can’t sit still, you cry often, you feel you never do anything right and are a burden to others, you are less interested in sex, you sad or worse in the morning than you do the rest of the day, you feel you want to die or are thinking of ways to hurt yourself etc.
If someone Notice these sign in oneself or a relation or loved one call for urgent attention.
Some researchers are looking at the bidirectional tendency of depression and diabetes. Some school of taught suggest that people with depression if unattended to could develop type 2 diabetes but the mechanism is still hypothetical but one could infer that insulin resistance might be responsible.
Living with diabetes is not easy, considering the daily challenge of what to eat, what the blood glucose level is and the cost of medications.
Diabetes therefore should be seen as a journey not a destination, hence persons with diabetes requires a lot of support, encouragement and goodwill to make the journey without wearing the clothes of depression.

LIVING WITH DIABETES IN RURAL AREA- SUBSAHARAN AFRICA PERSPECTIVE.

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Diabetes mellitus is a metabolic disorder in which the individual lacks the ability to control normal metabolism of carbohydrates, protein and fats, due to absence or partial activity of Insulin.
Over the years, many theories and practices have emanated towards alleviating this condition. Ranging from orthodox medical approach to trado-medical practices. It is even worthy of note that some traditional healers or herbal doctors make bold to say they have gotten cure. I however, have not seen anybody who is totally cured, hence in my practice as a diabetes Educator, I constantly remind my patients that there is no cure yet but it can be managed. With all these chaos of medical practice, the person who suffers most are those living with the condition, especially those in rural area.
The information and practice of medical practitioners in rural area is in most cases at parallel to what is obtainable in cities. For instance in rural area of sub-Saharan Africa, many patients are being told not to eat anything containing carbohydrate but to concentrate on proteins in form of beans. I have met people who thrive on beans three times daily for nearly 5 to 10 years for the period of their encounter with diabetes. This makes life unpalatable, uninteresting and not fun.
Persons living with diabetes should be encouraged to balance their meals around the food classes of carbohydrate, protein, vitamins, fibres and roughages inform of vegetables, unsaturated fats and fruits. These food items are commonly available in our environment, the challenge is patronage. Like the saying by Dr Joslin in 1934 “Diabetics who knows the most, live longer and healthier”.
The importance of diabetes education both to patients living in rural area and cities cannot be overemphasized. Our traditional methods of information dissemination like ‘town criers’, market places, churches, mosques, community meetings should be exploited even drama in local languages needs to be encouraged as a means of improving and empowering those living with diabetes.

World Diabetes Day 2010 Celebration

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Finally, World Diabetes Day celebration for the year 2010 has come.It was a great day for us here in Jos, North Central Nigeria. Many stake holders who were involved in the celebration. There was participation by pharmaceutical companies like Taylek drugs company ltd, Pharmacy Plus ltd, Fixcon Networks Ltd to mention but a few. Highlights of the occasion was the presentation of a drama by lenscope media on the need for diabetes Education and poem recitation by the youngest people living with diabetes on the plateau. The youngest is mr Phinas who is 3 years old. The government of plateau state was appropriately involved and media houses where not left out, FRCN, NTA where adequately represented. Coupled with all these celebration Aung Sang suu kyi was released in far away Burma. It was indeed a happy day for me because diabetes is finally having a voice in Nigeria.

ADDRESSING DIABETES EDUCATION NEEDS USING THE POWER OF MOTION PICTURES.

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With the increasing prevalence and incidence of diabetes globally, it is pertinent that diabetes education be incorporated into school curricula. However, for those who are out of school or not opportune to enjoy formal education, it becomes a challenge towards meeting their educational needs.
Majority of the problems of diabetes is fueled by ignorance. It is eminent across board both in on the part of health professionals and persons living with diabetes.
With the outcome of motion pictures, new revolution evolves on how stories and information are passed across to different class of the population. With the introduction of home videos in Nigeria in the 90’s, Africans all over the world got new ways of listening, seeing and feeling the challenges of Africans as told by Africans. These medium has been used to address challenges of female genital mutilation, the problems and ways of preventing vesico vaginal fistula. These medium is equally being exploited to send home the message of HIV infection prevention. This medium is also useful if properly organized by professionals to address the paucity of information and ignorance surrounding diabetes prevention strategies.
As we celebrate this year’s World diabetes day 2010, with a theme of “Diabetes Education and Prevention”, the motion picture as a tool for diabetes education should be considered using local languages like Hausa, Swahili, French, and English. This will help fight ignorance which is fueling the increase incidence of diabetes and other non communicable diseases.

Congressional Briefing by Global Diabetes Initiative to US Congress - Expectations

Following the discussion held at the UN summit on Millennium Development goals assessment, the world has began to retrace its steps to look inwards on neglected concerns. I recently did a write up on Millennium development goals and Diabetes, it was quite alarming at what the statistics are saying concerning the prevalence and incidence rate of diabetes, cancer amongst others.
On September 27th, 2010, Researchers from Albert Einstein College of Medicine of Yeshiva University held a Congressional briefing in Washington D.C, focusing attention on the alarming Global diabetes epidemic.
It is no longer news that incidence of diabetes is increasing worldwide at a rate that exceeds most other diseases. The WHO estimates that by the year 2030, more than 366million people will be suffering from diabetes, a figure far higher than number of persons living with HIV/Aids. Unfortunately majority of this figure about 298million will live in developing Countries especially sub Saharan Africa.
This Congressional briefing is a welcome development and I strongly subscribe to publication of the outcome of such briefing for the consumption of other Legislatures and parliaments across the World.
Like the Words of Wisdom by Ban Ki Moon “Diabetes and other NCDs are public health emergency in slow motion”

DIABETES AND WEIGHT MANAGEMENT STRATEGIES

Weight loss is one way to lower blood glucose and to reduce risks for heart and blood vessel disease. Being overweight is a risk factor for developing diabetes even if one is healthy and not yet diabetic, being overweight could predispose an individual to insulin resistance.
Persons with insulin resistance lack the ability to utilize insulin properly. It is difficult to lose weight for most people. Losing 10 to 20% of weight can have a big impact on an individual’s blood glucose levels.
Losing weight too quickly often results in rebound, hence it is important that it should be slow and steady process. The body weight is determined by the following factors:
- The type of food we eat.
- Physical activity level
- Body build and heredity
- Body chemistry
- Medicines.
Physical activity helps the body to respond better to insulin. If you are overweight, losing weight and maintaining a healthy weight also helps the body respond better to insulin.
The Body Mass Index (BMI) is a relationship of the body weight to height. The internationally accepted standard adopted by National Institutes of Health, National Heart, Lung and Blood Institutes, Clinical Guidelines on the Identification, evaluation and treatment of Overweight and Obesity in adults, the evidence report states that:
Underweight (BMI <18.5)
Normal (BMI 18.5 – 24.9)
Overweight (BMI 25.0 – 29.9)
Obesity Class 1 (BMI 30 – 34.9)
Obesity Class 2 (BMI 35 – 39.9)
Obesity Class 3 (BMI ≥ 40).
A calorie is a measure of stored energy. Eating fewer calories is one way to lose weight. The minimum recommended calories to obtain needed vitamins and minerals is 1200 for adult females and 1500 for adult males. Fad diets and quick weight loss plans can harm health and interfere with diabetes management weight loss of no more than one ib per week is recommended. Awareness of the calorie content of food can also help one choose foods to gain weight or avoid weight loss.
It is important to note that carbohydrates, protein and fat all contribute calories when digested. Hence the teaching by health care providers especially in Africa that people living with diabetes should only eat proteinous foods should be condemned. Fat provides more calories per gram than carbohydrate or protein and is most easily changed into body fat.
Foods high in water and or fiber have fewer calories per bite. Fresh fruits, vegetables and whole grains heave the lowest calorie per bite. These foods tend to require more chewing, take longer to eat and help you feel full and satisfied without lot of calories.
Exercise helps with weight management by burning calories, relieving stress, and maintaining muscle mass. Exercise helps persons with type 2 diabetes improve blood glucose levels by improving insulin sensitivity and decreasing glucose output from the liver.
In some parts of Africa, weight gain is a sign of affluence and well being hence people spend so much money to gain weight but with education and awareness on the dangers of overweight and obesity keeping moderate weight should be encouraged

The Prevalence of Diabetes mellitus in Nigeria updates and challenges

Diabetes mellitus is a metabolic disorder that affects the way the body handles basic food components like carbohydrates, protein and fats. This is mostly due to lack or abnormaly in action or effect of the hormone insulin.
Diabetes mellitus is old with man. Globally, there are different prevalent levels varying from country to country, race and ethnic groups. The International Diabetes Federation in its recent publication came up with prevalence and incidence values around different regions and countries of the World.
Nigeria with over 250 tribes and different culture and food values, the prevalence values has not been uniform though the International Diabetes Federation recorded 3.9% in its current Diabetes Atlas.
Over the past 30years the prevalence of Diabetes has been increasing steadily. In 1971, a hospital survey by Osuntokun et al in Ibadan estimated a prevalence of 0.4%; In 1989, while screening for Diabetes during a World Diabetes Day(November 14) in Lagos metropolis, Ohwovoriole et al found a prevalence of undiscovered Diabetes of 1.6%; A national survey in 1992 by the Non-communicable Disease Expert Committee of the FMOH recorded a prevalence of 2.2% (National)- Lowest 0.5% in Mangu, Plateau State and highest 7% in Lagos Island; A survey by Puepet 1994, in urban adults in Jos metropolis discovered a prevalence of undiscovered Diabetes to be 3.1%; by 2004, a second survey in Jos recorded a prevalence of 10.3%.
The progressive increase in the prevalence rates of Diabetes is associated with lifestyle changes; overweight and obesity, physical inactivity, alcohol consumption, dietary changes and cigarette smoking- factors that are potentially modifiable.
So much attention is being given even recently to Communicable diseases like HIV, Tuberculosis and Malaria at the detriment of the emerging epidemic of Non-Communicable disease like Diabetes, hypertension and heart disease. Over 30% of our elite population including decision-makers is Diabetic. More painfully so, the majority of the Nigerian Diabetic population cannot afford meaningful treatment; and over 80% of the healthy population are ignorant about Diabetes.
There is a need for more sponsored independent studies on prevalence and incidence rates around the different states of the Federation or geopolitical zones in collaboration with the Federal Ministry of Health, to ensure proper documentation for future references and to provide proper policy framework and guidelines for legislators. This is to help formulate appropriate health policies towards prevention and care for people living with diabetes and also to regularize and standardize the treatment guidelines. This is important and urgent because presently there is no nationally accepted guideline for management of diabetes in Nigeria like we have for malaria or Hiv infection.
These standards will help the patients because presently there are pools of information and misinformation even among health care professionals who have not been in touch with current realities and publications on diabetes management.
In some parts of this great country Nigeria, some health care professionals still advice persons living with diabetes not to eat any carbohydrate but only proteins when current research findings advocates use of complex carbohydrates and other food groups in moderate quantity.
The Federal government of Nigeria through the Federal Ministry of Health needs to quickly act through the Diabetes Association of Nigeria which have chapters in many states of the Federation and other stake holders associations and non governmental organizations to ensure uniformity of standards of care and practice.

CONTINUOUS GLUCOSE MONITORING DEVICES, HOW USEFUL, HOW COMMON?

Continuous Glucose monitoring Devices are recent phenomenon in diabetes management (CGMD). This devices are products of painstaking research effort towards improved glucose control in people living with diabetes.
They come in different shapes, sizes and functions but the entire goal is the same. It enable an individual knows what happens to the glucose in 24 hours of the day and there are graphic displays to further help enumerate the situation and most have alarm installed for hypoglycaemic situation and hyperglycaemic situation as well.
Persons living with diabetes are able to eat freely and yet be in control, since they can estimate their calorie needs in the day.
The challenges associated with use of this devices entails what happens when an individual goes to an environment where the devices are not available or some components like insulin differ in brand or type. The device could malfunction or get soaked in water. This situations may pose a big issue if the occur, hence it is good to always have the contact of your doctor, go with spare device and the manufacturer of such devices should ensure even distribution around the world since the World is already a global village at affordable cost with ease of access.
These devices are being improved upon almost on yearly bases yet there are many countries of this world, where this continuous glucose monitoring are mere imagination and television displays. The manufacturers of this products should do more to get this products to end users because I believe that is when the chain of production is fully complete.

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PUBLIC PRIVATE PARTNERSHIP SCHEME AND DIABETES CARE POSSIBLE APPROACH BY COUNTRIES OF AFRICA.

The management of Diabetes is quite expensive especially in the developing World. It is more expensive if not managed hence there is no limit to the cost until the final knock of death. The hope however is that early actions in terms of management and care always bring about notable change in outcome measures in a diabetic well being. Ideally, resources should be made available to ensure that people diagnosed with diabetes carry out blood glucose self monitoring, receive appropriate meters, strips and education free of charge. Unfortunately at this stage, such a goal is unrealistic in many Countries even though possible due to competing priorities for very limited health budgets particularly in the context of the HIV/AIDs and TB epidemics sweeping across Sub Saharan Africa.
Through public private partnership scheme, the following can be achieved:
- Provision of free glucometers and test strips and drugs for Children and Pregnant women with diabetes this will aid the fight against the upsurge in Child Maternal Mortality rate.
- Arrangement can be made with Manufacturers whereby the meters are provided free to the patient while the test strips are paid for at subsidized rate.
- In areas or institutions where meters are available, information on the importance of blood glucose self monitoring needs to be explained in a culturally appropriate manner using local languages that people can understand.
- The media should foster dialogue and initiate discuss among stake holders, interest groups and policy makers towards engineering change to best practices.

WORLD DIABETES DAY 2010 CELEBRATION A CALL TO ACTION PART 1

World Diabetes Day – a day set aside by the United Nations following resolution 61/225 on Dec 20th 2006 in conjunction with International Diabetes Federation for Diabetes Advocacy, awareness, support and care for persons Living with Diabetes and those at risk of diabetes. The beauty of this years’ celebration is that it coincides with the UN Summit year on Non communicable diseases of which diabetes mellitus is a major stateholder. It is my fervent prayers along with many other concerned persons and institutions am sure for a Global Fund to be set aside for the purpose of diabetes awareness, research, support and care to help check Diabetes edpidemic and other non communicable diseases like cancer and others.
Going through the website of International Diabetes Federation, a number of activities has been lined up to celebrate this occasion. These ranges from Walk shows, concerts, blue lighting festivities amongst others. The theme of this year’s celebration is Diabetes Education and Prevention. It is important that as we carry out our activities in line with this theme, we need not only educate people about healthy living style alone but also Education about the need for everyone to be committed to do something about Diabetes. People in Government need to make definite commitment regarding appropriate Legislation concerning sales of fast foods and beverages around junior and high grade schools ,introduction of healthy living as a subject in school curricula. Above all provision of support to persons living with Diabetes especially orphans and widows in area of procurement of drugs especially insulin and other accessories like glucometers amongst others to relieve the pressure and encourage people living with Diabetes.

ARTIFICIAL PANCREAS

The Pancreas is an organ in the body that is responsible for production of hormones particularly insulin which is important for metabolism of glucose and other food groups. Artificial Pancreas is a term widely referred to in the old as theoretical. Thanks to modern technology, it is a reality. However, I do wonder about the durability of this product. Considering the experimental work of Prof Taylor et al who developed the device from De Montfort University, Leicester, it could put an end to the daily injections people living with diabetes have to endure to regulate their blood glucose levels.
The new artificial pancreas, invented and patented by Prof Taylor, is made of a metal casing containing a supply of insulin kept in place by a gel barrier. When the body’s glucose levels drop, the gel barrier starts to liquefy and lets insulin out. The insulin feeds into the veins around the gut then into the vein to the liver, mimicking the normal process for a person with a healthy pancreas. As the insulin lowers the glucose level in the body, the gel reacts by hardening again and stopping the supply.
When Insulin came up in 1921, There was a lot of mixed feelings as regards the reliability, quality and availability. Such fears were later fixed, thanks to the commercialization of this whole process. When the Artificial pancreas eventually came to be, will it only benefit those living with type 1 diabetes or could it be modified to handle those with insulin resistance which is the case with most persons living with type 2 diabetes.

Diabetes a Burning Issue on the Global Agenda, Not limited to Global health Agenda.

Incidence of diabetes is increasing Worldwide at a rate that eclipses most other diseases. The WHO estimates that by the year 2030, more than 366 million people will be living with diabetes, this is ten times the number affected by Hiv/Aids. It is even more devastating in that of this figure, more than 298 million people will be living in developing Countries, where the World is currently battling poverty and hunger amongst other challenges.
The major point is this, who will take up this diabetes challenge, why do we all seem not concerned about this epidemic yet we all are either directly or indirectly being affected by diabetes? This is a question I want to pose to every human living currently on planet earth.
As we prepare to celebrate this years’ World Diabetes Day come November 14th , with a theme ‘Diabetes Education and Prevention’, let us strife to know more about diabetes. Research has shown that with Education, Glycaemic control is improved and frank diabetes preventable.

Blood Glucose control and Meal Planning

It is quite challenging and interesting to note that many persons living with diabetes mostly consider being in charge of diabetes only when the engage in use of their drugs as recommended by the doctor. However, they are careless about what happens with their meal planning, exercise and education which are cardinal incredients in the business of blood glucose control.
Meal planning is beyond what is on the table. It is a mixture of meal timing, portion size and food composition.
Without the proper integration of this rudimen, the blood glucose will definately go up and down and the eventual stress that comes with poor glucose readings follows and if not quickly checked depression may follow.
As we engage in the business of blood glucose control today and always, let us inculcate the need for adequate and appropriate meal planning.

TOAST TO THE THIRTY THREE TRAPPED MINERS IN CHILE CENTRAL AMERICA

The Will to be alive has kept you all these 65 plus days despite being in the custody of the Earth which is not satisfied with taking life.
When I take a critical look at the mystery of these men being alive and keeping on, it points to the fact that when there is unity and comradeship, sky is the limit to which we can achieve anything we so desire. It so happens that someone among the thirty three persons is living with diabetes.
There are so many lessons to be learnt from these men who are instantly heroes .When they where going down the mine no body among them new this fate is coming their way. Had they been opportune to know, many would have turn down the offer to be a hero.
The spirit of survival both from families and Government and indeed the international community has been fully in operation since these days. As you come into this world, I wish to welcome you and encourage you to continue to build comradeship amongst your colleagues and other workers in your company. I wish to urge you not to fear anything in the near future and I wish you good health and happy stay with your family here on Earth.

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THE MUCH EXPECTED,AWAITED AND BELATED UN SUMMIT ON DIABETES AND OTHER NON COMMUNICABLE DISEASES SCHEDULED FOR 2011, EXPECTATIONS.

That Diabetes is a current global epidemic is no longer news. Ban ki Moon, the UN Secretary General sum it all with his statement “Diabetes and other NCDs are global epidemic of public health concern in slow motion”, I beg to differ from his position, am of the view that it is already in quick motion.
The current WHO,IDF, ADA abridged statistics shows that over 285 million persons are living with diabetes and a quarter of this figure are unknown. Where has the World been, when this figure got to this, and as am writing this piece, many more are being diagnosed.
This premises announce the global expectation of the summit of the UN. Following Resolution 61/225 adopted in December, 2006, diabetes has eventually gotten the World attention.
This summit is a first step in ensuring World leaders make the prevention and treatment of NCDs are urgent priority both globally and nationally.
Recently in South Africa there was a leadership summit organized to fine tune framework and position statement toward this much awaited summit, an alliance of all sectors of society will be needed to turn around this global epidemic. It is of prime importance and crucial that we keep up to date and informed in the lead up to the summit.
The UN Summit on NCDs is our biggest and best opportunity to get the action needed to achieve the IDF vision of a World without Diabetes.
It is hoped that a global fund to assist the numerous challenges posed by Diabetes is set up and I want to appeal to member nations of the UN to contribute generously towards this cause.
Some immediate challenges faced by Diabetes around the globe revolves around the following though more prevalent in sub-Saharan Africa and other developing economies
- There is a poorly developed healthcare infrastructure to support chronic and acute treatment.
- Lack of coordinated healthcare policy that would ensure screening, treatment and prevention are accorded priority.
- A lack or inadequate knowledge by healthcare providers on how to treat or manage the disease.
- Ignorance on the part of the general population about diabetes prevention strategies.
The much expected, awaited and belated UN summit on Diabetes and other non communicable diseases scheduled for 2011, expectations are high, it can be achieved and surpassed if we work as a team and family.
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Millenium Development Goals, Any hope for people living with Diabetes?

The millenium development goals is a novel initiative by world leaders to adddress the problems affecting people world over especially in Africa. It is estimated that by 2015 many countries will meet up with set objectives. Taking a critical look at MDG goal 6, Diabetes and other NCDs are cleanly eliminated, how come this omission, it is that Diabetes and other NCDs are not a problem? It is sad to note that countries especially in Subsaharan Africa don't realize the potential danger that this pose, the concentrate mainly on malaria and Hiv because many foreign donors support these with funds and diabetes and other NCDs have no funding, hence they are not considered as a global challenge. I take solace and consolation in the words of UN sec General Mr Ban Ki Moon that NCDs are a public health emergency in slow motion. As over one hundred and forty leaders meet today to delebrate on the MDG goals, Let one of them have the courage to mention the efforts they are doing towards NCDs especially diabetes.

WORLD DIABETES DAY 2010 A CALL TO ACTION PART 2

Diabetes Education and Prevention is the World Diabetes Day theme for the period 2009 to 2013.
The campaign calls on all those responsible for diabetes care to understand diabetes and take control.
For people with diabetes, this is a message about empowerment through education.
For Governments, it is a call to implement effective strategies and policies for the prevention and management of diabetes in order to safeguard the health of their citizens with and at risk of diabetes.
For healthcare providers, it is a call to improve knowledge so that evidence based recommendations are put into practice.
For the general public, it is a call to understand the serious impact of diabetes and know, where possible, how to avoid or delay diabetes and its complications.
Key messages of the campaign are:
- Know the diabetes risks and know the warning signs.
- Know how to respond to diabetes and who to turn to.
- Know how to manage diabetes and take control.

Insulin Pen Needles and Syringes are “Disposable Items” Our Experience in Subsaharan Africa.

The Insulin Needles for insulin pens is clearly written by manufacturers that it is Disposable. This means after a single use it should be discarded.
If one has a box of 100 pieces and he uses twice daily injection, that will be fifty days. Hygienically it is better, more healthier to comply with this directive but unfortunately economically speaking, this advice is not pocket friendly especially for patients living with diabetes on insulin in Subsaharan Africa.
Some people use the insulin pen needle up to ten times, some fifteen times or others who want to be moderate five times and for the affluent about twice daily. This is a challenge that is being ignored and the gross effect is increased incidence of ulcers especially on the thighs or around areas where insulin is administered.
Recently, I was had the opportunity to attend a seminar on insulin administration and injection devices. I saw electron microscope slides of insulin pen needles following use once, twice, thrice till the tenth times. It was amazing how rough and dangerous the needle looks following each use. The needle undergo gradual wear and tire as the usage times increases. This explains why the muscles are torn and bleeding is often noticed and also the frequent ulcers around the injection area.
Having noticed this anomaly, the weight of the awareness is how can you tell someone to do something he or she knows but doesn’t have the financial muscle to decide? When I came back from the workshop, I started telling people that the ideal number of times to use the disposable needle for the same person is once but if you don’t have the finance try twice. Many people listen to me may be because am a diabetes Educator but I do see some doubt and since of no commitment on some faces because the don’t have the finance to continually buy them. One piece of insulin pen needle on the average is sold at 50cent per one in some places it may be up to 80cents. I want to call on the manufacturers to try any way they can to reduce the cost of this accessories as a way of alleviating the burden of people living with diabetes especially in Subsaharan Africa.

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The Challenges of Self Glucose Monitor Among Persons Living with Diabetes in Sub Saharan Africa.

The revolution of glucose meter introduction into the World of Diabetes brought hope, relief and ease to many persons living with Diabetes. Before now, when one intends to do a blood glucose check, it may take several weeks to months. Subsequently with this innovation, within five seconds one can have a clear picture of blood glucose and more recently, non invasive glucose monitoring machines are being developed.
In many developing Countries of Subsaharan Africa like Nigeria, there is a chaos in the complexity of the challenge. Many persons living with diabetes are able to acquire glucose meters yet are not able to get the test strips to buy. The glucose meter may have gotten to them via relations who are living in America, UK, France among others or donations from Non Governmental organizations on medical outreach missions. Yet there are some companies with established glucometer brands but their cost are exorbitant for an average person to buy. In the mist of these confusion there are new companies coming with new model of meters for people living with diabetes to buy. The question on the mind of many people is this, what happens if these companies stop to supply this meters how can they buy test strips in future? Any company who intend to come into the glucometer business should give assurance of continous supply of test strips and other accessories to ensure confidence in persons living with diabetes who intends to buy their meter.

www.diabetesguidenigeria.blogspot.com

SMOKING AND DIABETES MANAGEMENT

Old habits die hard - so goes the popular saying. The habit of smoking has been in existence for a long time.Pictures and findings from early times reveal that smoking activity either directly or indirectly has been practiced by man for long.
What then are the best technique and strategies towards handling this age old habit?
Recently in my effort to find answers to my many questions, I had an audience with a traditional healer- he opined that smoking is a spiritual spell that can be casted out via incantations and some herbs. I then journeyed to have a session witha priest who smoke. He told me to encourage people not to smoke and that he is going to quit as soon as he attains age 75. In the medical world there are presently electronic cigars, nicotine patch and many other devices available to enable one quit smoking and henc live healthy with diabetes.
The question that am yet to answer in cause of my research is thus:
Is it possible to quit smoking having all these means available witout Discipline?

PUBLIC PRIVATE PARTNERSHIP SCHEME AND DIABETES CARE

The management of Diabetes is quite expensive especially in the developing World. It is more expensive if not managed hence there is no limit to the cost until the final knock of death. The hope however is that early actions in terms of management and care always bring about notable change in outcome measures in a diabetic well being. Ideally, resources should be made available to ensure that people diagnosed with diabetes carry out blood glucose self monitoring, receive appropriate meters, strips and education free of charge. Unfortunately at this stage, such a goal is unrealistic in many Countries even though possible due to competing priorities for very limited health budgets particularly in the context of the HIV/AIDs and TB epidemics sweeping across Sub Saharan Africa.
Through public private partnership scheme, the following can be achieved:
- Provision of free glucometers and test strips and drugs for Children and Pregnant women with diabetes this will aid the fight against the upsurge in Child Maternal Mortality rate.
- Arrangement can be made with Manufacturers whereby the meters are provided free to the patient while the test strips are paid for at subsidized rate.
- In areas or institutions where meters are available, information on the importance of blood glucose self monitoring needs to be explained in a culturally appropriate manner using local languages that people can understand.
- The media should foster dialogue and initiate discuss among stake holders, interest groups and policy makers towards engineering change to best practices.

The United Nations in December, 2006 came up with Resolution 61/225 which resulted in officially and globally recognizing the need for concern towards Diabetes Awareness, improved care and search for possible cure. November, 14th was recognized as World Diabetes Day. The International Diabetes Federation has been a champion of this campaign since 1991.
Some developed Countries have realized the danger posed by non communicable disease like Diabetes among others. However, the challenge is still much considering the attitude and approach many developing Countries especially those in Subsaharan Africa have towards Diabetes mellitus. Many of these Countries do not have a National Clinical Guideline for Management of Diabetes hence the order of the day is no standardization of practice. The gross effect is poor glycemic control, increase prevalence of avoidable or preventable complications, spread of wrong or harmful methodologies of care.
Government in developing countries struggle to deal with many pressing health and social issues. Diabetes Care is expensive, and funding must compete with programme such as those striving to control infectious diseases – which can often save more lives on a cheaper per- capital basis.
Government provision of Insulin and other accessories at lower cost contribute not only to the well being of a portion of her population but also prevent expensive disabling and life threatening complications.
Some of the reasons for disparity in the standard of care in sub-Saharan Africa in contrast to developed Countries includes:
1. Government of majority of the developing Countries do not regard diabetes as a priority and therefore allocate little or nothing at all in terms of resources for diabetes care.
2. In many of these Countries all outpatient costs including medications and monitoring equipments are the responsibility of individual persons living with diabetes or their families.
3. The media is yet to recognize the socio-economic burden of Diabetes and other non communicable disease like cancer. This is a challenge that the media should champion and not political issues alone as Diabetes is presently causing more amputation than landmines. All media organizations need to create awareness about this public health concern from time to time because majority of the people living with type 2 Diabetes could have been prevented if appropriately cure of their ignorance by education on lifestyle modification.
As the situation is, the problem seem to be increasing, no body accepting full responsibility but those who are directly or indirectly affected by Diabetes feels the brunch each second, minute, hour , days and years. Let us arise from our comfort zones and speak out towards Diabetes awareness, Diabetes aid for less privilege ones especially widows and orphans. The Government on its part should wake up to its responsibility, one wonders, a careful observation will show that majority of persons in places of authority that can influence appropriate policy towards these cause seem not to show interest or concern.
Come November 14th 2010, I want to challenge all to speak to someone about Diabetes mellitus, learn more about Diabetes and be physically active.

: IMPACT OF CLIMATE CHANGE ON DIET AND DIABETES MANAGEMENT