Diabetes: Nurses make the difference


By Henrylito D. Tacio


From 108 million in 1989, the number of people with diabetes rose to 422 million in 2014, according to the Geneva-based World Health Organization (WHO). “Between 2000 and 2016, there was a 5% increase in premature mortality from diabetes,” the United Nations health agency reports.

In 2019, 463 million adults – that one in 11 – were living with diabetes, the International Diabetes Foundation (IDF) claims.  The number of people living with diabetes is expected to rise to 578 million by 2030.

“More than 3 in 4 people with diabetes live in low and middle-income countries,” says the IDF, an umbrella organization of over 230 national diabetes associations in 170 countries and territories.  “Two-thirds of people with diabetes live in urban areas and three-quarters are of working age.”

In 2016, an estimated 1.6 million deaths were directly caused by diabetes.  By 2019, the number of deaths rose to 4.2 million.

With the number of diabetes cases and deaths keep increasing, it was not surprising that the IDF teamed up with WHO to create World Diabetes Day (WWD) in 1991.

In 2006, WWD was marked every year on November 14, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922.  The campaign was created in response to growing concerns about the escalating health threat posed by diabetes.

Every year, WWD campaigns focus on a dedicated theme that runs for one or more years.  This year, the theme is The Nurse and Diabetes. “(It) aims to raise awareness around the crucial role that nurses play in supporting people living with diabetes,” the IDF points out.

The UN health agency says nurses account for 59% of health professionals.  The global nursing workforce is 27.9 million, of which 19.3 million are professional nurses.  “The global shortage of nurses in 2018 was 5.9 million, 89% of that shortage is concentrated in low- and middle-income countries,” the WHO states.

“The number of nurses trained and employed needs to grow by 8% a year to overcome alarming shortfalls in the profession by 2030,” the WHO adds.

(Photos courtesy of WHO)

When it comes to diabetes, nurses make the difference.  “As the number of people living with diabetes continues to rise across the world, the role of nurses and other health professional support staff is becoming increasingly important in managing the impact of the condition,” the IDF says.

“Nurses are often the first and sometimes only health professional that a person interacts with and so the quality of their initial assessment, care and treatment is vital,” the IDF notes.

According to IDF, nurses play an important role in: diagnosing diabetes early to ensure prompt treatment, providing self-management training and psychological support for people with diabetes to help prevent complications, and tackling the risk factors for type 2 diabetes to help prevent the condition.

The IDF says one in 2 adults with diabetes remain undiagnosed.  The majority of them have type 2 diabetes.

“There remains a significant need for more education and funding to equip nurses around the world with the skills to support people living with diabetes and those at risk of developing type 2 diabetes,” the IDF says.

The IDF urges healthcare providers and the government to recognize the importance of investing in education and training.  “With the right expertise, nurses can make the difference for people affected by diabetes,” the IDF believes.

In the Philippines, an estimated 7.3 million people have diabetes, with 3.5 million of them diagnosed and the remaining ones undiagnosed.  It is no wonder why the Philippines is now touted as a “diabetes hotspot.”

The prevalence of diabetes in adults is 6.2%.  Every 6 seconds, studies show, one person dies of diabetes complications.  “Diabetes is the sixth leading cause of death among Filipinos,” says the Department of Health (DOH), the country’s leading public health government agency.

If that doesn’t scare you yet, diabetes is a very destructive disease.  “It destroys many of the organs in our body,” Dr. JM Co, chair of the Department of Medicine at the University of the East Ramon Magsaysay Memorial Medical Center, Inc., was quoted as saying by the Philippine Daily Inquirer.

Over time, diabetes if not treated can damage the heart, blood vessels, eyes, kidneys and nerves, according to the WHO.

Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes, WHO says.  Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation.

Diabetic retinopathy is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina, the WHO says.  In fact, diabetes is the cause of 2.6% of global blindness.

(Photos courtesy of WHO)

More importantly, diabetes is among the leading causes of kidney failure.

In a battle, you need to know your enemy first. “Diabetes is a lifelong condition that occurs in individuals who may not have enough insulin produced in the body or who does not respond properly to insulin,” explains Dr. Maria Princess Landicho-Kanapi of the Philippine Center for Diabetes Education Foundation, Inc.

Actually, there are two forms of diabetes.  Type 1 diabetes (also known as insulin-dependent diabetes) is caused by a reduction in the level of insulin.  The body’s immune system destroys the insulin-producing cells in the pancreas, causing insulin deficiency.  As a result, individuals with this type of diabetes need regular insulin injections to maintain glucose control.

In contrast, type 2 diabetes (also called as non-insulin-dependent diabetes) arises in the first instance not because there is a lack of insulin, but because the body fails to respond to circulating insulin effectively.  This condition is known as insulin resistance.  For this reason, newly diagnosed individuals do not require insulin injections.

“If you look at the spread of the scourge around the world, Type 2 diabetes occurs as a country advances technologically, when people come out of the fields to sit behind desks,” notes Dr. Irwin Brodsky, director of the Diabetes Treatment Program at the University of Illinois in Chicago.

Type 2 is the strain most people fear.  This is the real epidemic, accounting for 85-90 percent of diabetes cases in the country.  “Getting diagnosed early is important because most of its serious complications are preventable,” assures Dr. Marie Yvette Rosales-Amante, who had her fellowship in endocrinology, diabetes, and metabolism at the University of Massachusetts. – ###

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