Society sitting pretty as obesity and diabetes strike

Adult-onset type 2 diabetes is slowly starting to manifest itself in a small number of teenagers as a result of obesity, according to Joseph Azzopardi, head of the University of Malta's Department of Medicine.

Though this type of diabetes still tends to strike people in their fifth or sixth decade, doctors across the world, including Malta, are very worried because more children are getting it.

"Unless children are educated to eat healthier and do exercise, then we could experience a marked increase of type 2 diabetes in the younger generation," Prof. Azzopardi said in an interview.

This type of diabetes is already being reported in children in several European countries, including the UK, Sweden and Poland.

Prof. Azzopardi, who also runs the Diabetic Clinic, said that about 10 per cent of Maltese people aged over 18 already had diabetes, which was well above the European average of about two to three per cent.

The future is not looking so bright as people become increasingly obese. Recent figures released by the National Office of Statistics show Malta is among the leaders in the lumpy league of EU countries.

Sixty per cent of the population are either overweight or obese, with an average male weighing 78.5kg, compared to the EU average of 78.8; while an average female weighs 65.8kg, surpassing the EU average of 65.4kg.

Children are also battling weight problems. A study carried out in 2000 by Christine Baluci among schoolchildren in Church and state schools, aged between six and 10, showed Malta was following in the "heavy" footsteps of other countries.

The study revealed that 27.4 per cent of six-year-old schoolboys had weight problems, compared to 30.3 per cent of girls the same age, which does not augur well for the diabetes crisis.

Not only are children who get diabetes likely to face a life of problems, including higher risk of blindness, heart disease and stroke, they are also a warning sign that something in our way of life has gone drastically wrong.

Prof. Azzopardi said that among the culprits of overweight children were television and computer games as opposed to outdoor exercise.

"Apart from that, some parents are also so obsessed with their child's exams that they do not see the use of having PE classes at school when more time could be dedicated to studying. Society overall is leading a more sedentary lifestyle," he said.

"Education on healthy eating and exercise should start when children are still young because the habits they establish then usually continue throughout their adult life," he continued.

Soft drinks, some of which contain up to six teaspoons of sugar, should not be a staple of a child's diet and unless a person is active refined carbohydrates should be kept to a minimum. If the body does not burn food it simply stores it up as fat.

The pancreas acts as a police to monitor the sugar levels in the blood, releasing insulin whenever blood sugar tends to rise, as for example after a meal. The insulin serves to keep blood sugar levels normal. In people with type 2 diabetes the pancreas does not produce enough insulin - they would be insulin-resistant.

If a person is fat, the pancreas has to work overtime to keep the levels of sugar in the blood normal and is therefore more likely to get "exhausted" and not produce enough insulin, leading to diabetes.

Patients are not so helpless against the ravages of this disease and a change in lifestyle and diet can, in the majority of the cases, make a big difference.

If one does not become overweight and exercises regularly, then the chances of diabetes developing are less.

"My advice is to eat less and walk more. If you can use the stairs instead of the lift do so, if you take the bus get down two stops before your destination. The message is prevention through healthy eating and exercise," Prof. Azzopardi said.

What is diabetes?

Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either does not make enough insulin or cannot use its own insulin as well as it should. This causes sugars to build up in your blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure and lower-extremity amputations.

The number of people suffering from diabetes in Malta at present is calculated to be 30,000, but according to the Maltese Diabetes Association this figure is expected to increase by 20 per cent by 2025.

At least 50 per cent of all people with diabetes are unaware of their condition.

What are the symptoms of diabetes?

People who think they might have diabetes must visit a physician for diagnosis. They might have some or none of the following symptoms:

¤ Frequent urination
¤ Excessive thirst
¤ Unexplained weight loss
¤ Hunger
¤ Vision changes
¤ Tingling or numbness in hands or feet
¤ Feeling very tired much of the time
¤ Very dry skin
¤ Sores that are slow to heal
¤ More infections than usual

It is to be emphasised that a person with diabetes may feel none of the above symptoms.

Types and risk factors of diabetes

Type 1 diabetes was previously called insulin-dependant diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for about five to 10 per cent of all diagnosed cases of diabetes. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes but autoimmune, genetic and environmental factors are involved in the development of this type of diabetes.

Type 2 diabetes was previously called non-insulin-dependant diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes accounts for the majority of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity and race/ethnicity.

Gestational diabetes develops in about two per cent of all pregnancies but usually disappears when the child is born. Obesity is also associated with higher risk. Women who have had gestational diabetes are at an increased risk for later developing type 2 diabetes.

Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections and other illnesses.

Can diabetes be prevented?

A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. It also appears to be associated with obesity. Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop type 1 diabetes but prevention, as well as a cure, remains elusive.

The Maltese Diabetes Association

This association is a voluntary, non-governmental organisation aimed at educating its members and the general public on diabetes and how to prevent complications arising from it. Its mission is to improve the lives of people with diabetes and to work towards a future with fewer complications and more awareness on this condition.

Its headquarters are within the British Legion premises at 111, Melita Street, Valletta.

For more information call on 2122 1518 or check its website www.diabetesmalta.org.