Diabetes: A silent killer that hurts the world’s poorest

Events during World Diabetes Day are intended to raise awareness about diabetes identification and prevention. [GovernmentZA/Flickr]

Diabetes is on the rise, both in Europe and worldwide. In Nicaragua, 600,000 people, more than 12% of the population, are affected by the chronic disease. EURACTIV’s partner El País – Planeta Futuro reports.

Dr. Tatiana Leiva, an expert on the disease and a professor at the University of Nicaragua, has conducted studies that show that around 400,000 people have been diagnosed and close to 200,000 are unaware that they are suffering with it. “Given the huge figures, diabetes can be considered the pandemic of the 21st century, with around 347 million cases worldwide. It has grown exponentially in developing countries and is one of the main public-health problems in this country,” said the specialist.

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Diabetes is a chronic, degenerative disease that manifests itself when the body produces no or little insulin. It is considered to be a silent epidemic, killing one person every eight seconds across the globe and causing around five million deaths a year. In Nicaragua, only cardiovascular disease kills more people than diabetes. It is estimated that one person is forced to undergo amputation every day in the Central American country, with 80% being preventable.

According to the World Health Organisation (WHO), diabetes is becoming a bigger and more serious problem, with it due to become the seventh leading cause of death by 2030. The United Nations acknowledged the seriousness of the disease on 20 December 2006, by recognising diabetes as a chronic, debilitating and costly disease associated with major complications that pose severe risks for families, countries and the entire world. To raise awareness, 14 November was declared World Diabetes Day.

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The condition comes in two clinical forms: type 1 results from the pancreas’ failure to produce enough insulin and develops most often in children and adolescents. The cause is unknown. Type 2, which is most commonly diagnosed, generally begins in adulthood and results from insulin resistance.

Additionally, there is gestational diabetes, which occurs when pregnant women develop a high blood sugar level. In this instance, the body is unable to produce enough insulin to cope with the pregnancy. “Not having the right information can be a person’s worst enemy, especially when it comes to early identification and dealing with risk factors,” concluded Dr. Leiva.

The Association of Parents of Diabetic Children and Youth is a Nicaraguan volunteer-organisation that helps children and young people affected by the disease. The majority suffer from type 1 and come from low-income families. The help provide insulin and other medical supplies to children that are admitted to La Mascota hospital in the country’s capital, Managua. It also provides guidance to families on how to recognise and treat the disease.

Aura Cuadra, the organisation’s president, said that the percentage of children and adolescents diagnosed with the disease had increased considerably. “When we started our work, we had 80 children. Today, that number is 800. We’ve seen an annual increase of between 8 and 10%,” she said. Cuadra pointed out that in other countries the average number of children affected by the disease is 3%, making the situation in Nicaragua look even more serious.

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“There is no cure. But, if the instructions of a specialist are followed to the letter and the necessary changes made to the patient’s lifestyle, one can live with this disease,” said Dr. Leiva, adding that nothing will improve if changes to diet are not made. Doctors, therefore, have to build a relationship with their patients, not impose changes on them.

Experts agree that the symptoms of diabetes can be reversed through changes to lifestyle, especially exercise and a healthy diet. Fast food is extremely popular in Nicaragua and although the Ministry of Education has banned the sale of soft drinks in schools, students continue to buy products with a high sugar-content in the cafeterias and from kiosks near the school gates. Their low price and ready availability often convince parents to include them in their children’s diets in place of fruits and vegetables.

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The Association of Adult Diabetes of Nicaragua (ADANIC) raises awareness about diabetes, through events at hospitals, universities and other locations. Their team is made up of specialists, medical students and diabetic patients.

Maria Emilia Zapata is 75 years old and was diagnosed with diabetes nearly a decade ago. For seven years she has collaborated with ADANIC to encourage people to get themselves tested and to catch the disease in its early stages. “Due to its nature, it’s a disease that can begin to attack in total secrecy, with the affected person going a decade without realising they have something wrong with them. In my case, it was 15 years,” said Zapata.

Emely Chavarría is 18 years old and a student at Managua University. She believes that the project is very necessary: “The Nicaraguan population is extremely susceptible to this disease and we have to intervene urgently in order to control it and educate people.”

Nicaragua faces an uphill battle to tackle the disease, mostly due to it being one of the poorest nations in the world. United Nations statistics show that 17% of the population lives in extreme poverty. The sheer scale of the diabetes problem poses a huge burden for the health system and the country may struggle to break the vicious cycle that is associated with poor diet, health and low income. 

The International Diabetes Foundation Europe, in collaboration with Therese Comodini Cachia MEP and Nicola Caputo MEP, marked World Diabetes Day 2015 in the European Parliament in Strasbourg. This year, it focused on raising awareness about the importance of sports and physical activity as a means to better manage all type of diabetes and help in the prevention of type 2 diabetes.

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