Ensuring education for people with diabetes
Every 10 seconds a person dies from diabetes-related causes and at the same time, two people develop diabetes. Diabetes affects 246 million people worldwide. Each year another 7 million people develop diabetes. These statistics are scary and indicate that diabetes is growing faster than most people imagine. Experts warn that if we fail to stop or slow the trend, diabetes will affect some 380 million by 2025. They recommend — promoting education, changing diet habits, increasing level of physical activity, maintaining a healthy weight can make a significant progress in the fight against the silent epidemic diabetes. World Diabetes Day is being observed today with various programmes. In 2009 and for next four years, the theme of the day is "Diabetes education and prevention". The campaign slogan for 2009 is "Understand Diabetes and Take Control". It promotes the importance of structured diabetes education programmes as key to prevention and control of diabetes and advocates for increased opportunities for diabetes education within healthcare systems and communities. The world is experiencing an epidemic of diabetes that threatens to overwhelm healthcare systems. It imposes life-long demands on people with diabetes, requiring them to make multiple decisions related to managing their diabetes. People with diabetes need to monitor their blood glucose, take medication, exercise regularly and adjust their eating habits. Furthermore, they may have to face issues related to living with the complications of diabetes and may be required to make considerable psychological adjustments. As outcomes are largely based on the decisions they take, it is of paramount importance that people with diabetes receive high-quality diabetes education that is tailored to their needs and delivered by skilled health professionals. Without diabetes education, people with diabetes are less prepared to take informed decisions, make behavioural changes, address the psycho-social issues presented by diabetes and ultimately, may be ill-equipped to manage their diabetes effectively. Poor management will result in reduced health outcomes and an increased likelihood of developing complications. Education is therefore of the utmost importance in the prevention of diabetes complications and central to the World Diabetes Day campaign. Ironically, diabetes education is lacking in Bangladesh. Many people with diabetes cannot access diabetes education in Bangladesh due to various factors like cost, distance, the lack of appropriate services etc. Many more may be unaware of the services that do exist. Perhaps they are not convinced of the benefits that diabetes education could bring. They may feel, for example, that interactions with their physicians provide all the education they need. Diabetes not only imposes health effects, but also it has been an economic burden for Bangladesh. For example, the health expenditure for diabetes was USD 73,321 in 2007 and is expected to increase at USD 122,269 in 2025, according to International Diabetes Federation. The mean health expenditure per person with diabetes is about USD 19. Maximum of this expenditure is spent only for lowering blood sugar. But prevention of diabetes and its complications, diabetes education are grossly neglected. Promotion of this could be a significant step in reducing the disease burden as well as economic burden. The costly and fatal effects of diabetes arise largely from its complications, especially heart diseases, stroke, amputation, kidney failure and so on. These can be prevented or long-delayed by education, inexpensive pills to control blood sugar, blood pressure, and bad cholesterol — by low-dose aspirin to reduce heart disease risk by 20-25 percent; by stopping smoking and by adopting a healthy diet and exercise. The most effective way to prevent diabetes is by losing weight and getting regular exercise. In 2006, the World Bank systematically assessed the cost-effectiveness and feasibility of diabetes interventions in developing countries. They identified four life saving and inexpensive treatments that would actually save money for everyone. They are simple, minimal control of high blood sugar and high blood pressure, foot care in people at high risk of ulcers, and preconception care for women with diabetes. These diabetes treatments are not only inexpensive and cost-saving, they are straightforward to distribute and easy for patients to take. There is an important role for the diabetes educator to help people understand the risks and set realistic goals to improve health in control, prevention of diabetes and its complication. IDF recommends a goal of at least 30 minutes of daily exercise, such as brisk walking, swimming, cycling or dancing. Taking low carbohydrate diet and regular walking for at least 30 minutes per day, for example, has been shown to reduce the risk of type 2 diabetes by 35-40 percent. E-mail: rajibssmc@gmail.com
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