Each year, diabetes causes an approximate 5 million deaths worldwide. More than 415 million people are thought to be suffering from the disease, of which only 50 per cent have been formally diagnosed, meaning that millions of individuals are at risk of developing complications due to delayed diagnosis.
Alarmingly, more than 2 million Thais are unaware that they have diabetes, and have no access to treatment, while 7.7 million are at risk of developing this chronic disease.
Being overweight and obesity are major factors contributing to the increasing prevalence of diabetes, especially in the urban areas. The incidence of obesity among the Thai population continues to show a significant increase, especially among females. Moreover, obesity prevalence among Thai females is ranked second in Asia, after Malaysia, due to unhealthy eating habits and lack of exercise.
Besides kidney failure and high blood pressure, diabetes can lead to the development of complications like cardiovascular disease, which is the second leading cause of death among Thais. The two most common forms of diabetes are types 1 and type 2. Type 1 diabetes develops because the body’s immune system destroys cells that produce insulin and requires those with this form of the disease to take insulin as part of their treatment. Type 1 diabetes can occur in people of any age, but is most common in children and young adults. Type 2 diabetes is 90 per cent caused by insulin resistance, where the body compensates by making more insulin but not enough to keep blood glucose at normal levels. Type 2 diabetes is commonly found in adults aged 30 years of age and over and is related to excess weight or obesity, one of the causes of insulin resistance.
“Patients who have diabetes and fail to strictly follow their doctors’ instructions will develop serious and fatal complications, such as cardiovascular disease, which is the most common among patients with type 2 diabetes, or non-insulin dependent diabetes. The leading causes of death among patients with insulin-dependent diabetes are kidney failure and cardiovascular disease. People with diabetes are more likely to develop depression or suffer from a stroke, heart failure, and peripheral arterial disease. Furthermore, diabetes is the leading cause of kidney failure in Thailand,” says Prof Emeritus Wannee Nitiyanant, President of the Diabetes Association of Thailand.
The key to success in diabetes prevention starts with promoting behaviour changes, for example, losing weight, having an active lifestyle, incorporating more fibre into the daily diet, avoiding consuming food high in saturated fats and stopping drinking and smoking. The more changes people make to their lifestyle, the less likely they are to develop diabetes. Moreover, it is essential that individuals who are at risk of developing diabetes get regular blood glucose tests to allow for early diagnosis. Screening for diabetes can assess the risk of developing this chronic disease in the future, which will not only prevent diabetes, but also stop prediabetes from progressing.
Patients with type 1 diabetes have a condition in which the pancreas produces no insulin, making treatment complicated. The treatment includes a healthy diet plan, exercise, self-monitoring of blood glucose, and several insulin injections each day or a Multiple Daily Injection (MDI). Type 2 diabetes can be managed with dietary changes, exercise, medication and/or insulin injection.
“The closed-loop insulin pump system is now successfully developed in research with a view of use for the treatment of type 1 diabetes. It involves a blood glucose monitoring and insulin delivery devices inserted under the skin. The monitoring device will continuously monitor blood glucose level and send a signal to the delivery device, which will automatically provide insulin as needed. The system has recently been used in research, but will take years to develop into a viable treatment option for type 1 diabetes. With regard to treatment of type 2 diabetes, medicines have been developed to lessen side effects of hypoglycemia and weight gain. Injectable diabetes medications include non-insulin medication, which helps improve the stability of blood glucose levels and assists with weight loss, and insulin medication. Now a new generation of long-acting insulin is available and not only does it significantly lower risk of hypoglycemia, it can also be taken at any time of the day without affecting its treatment efficacy,” says Prof Chaicharn Deerochanawong, Scientific Chairman of the Diabetes Association of Thailand.
However, successful diabetes treatment requires more than an insulin shot. It also demands the patient’s cooperation in the control of sugar consumption, adopting healthier lifestyles such as weight loss, having a balanced diet, exercise, quitting drinking and smoking, and seeing a doctor regularly.