Can one simply accept diabetes and that’s that? A recent study in Gozo showed that the Maltese seem to be doing so rather than seeking to prevent or treat it. This may be because the disease is so common. Indeed, it is one of the commonest chronic conditions worldwide and affects 246 million people.
Diabetes disturbs the way in which the body uses food to produce energy. Food is usually converted, among other things, to glucose. The pancreas, a gland in the abdomen, produces insulin in order to shift glucose from the blood into the body’s cells where it is utilised. In diabetes, this fine control breaks down, resulting in high blood glucose that is harmful to blood vessels and to nerves.
Many things need to be done lest this condition drains the country financially, not only due to costs of treatment but also because of complications, such as eventual blindness, kidney failure, finger, toe and limb amputations, nerve problems and many others.
The study conducted in community pharmacies showed that 30 per cent of fasting blood glucose tests and 14 per cent of random blood glucose tests (non-fasting) yielded high levels! This is alarming and, at nearly one in 10 of the population, the island has one of the highest diabetes rates in Europe. This is expected to increase to over 11 per cent, or 36,000 individuals, by 2030.
The World Health Organisation reports that diabetes care costs up to 15 per cent of a country’s total direct health care expenditure. And, yet, only 11.2 per cent of the country’s health Budget is utilised on combating the disease, ranking ninth in the EU when it comes to expenditure.
In addition, Malta still has no action plan to combat the disease, according to an audit report compiled by four international diabetes organisations.
What can be done? One encouraging outcome of the Gozo study was that pharmacists noted an increase in the number of queries with regard to diabetes and blood glucose monitoring since the study was held. This suggests that awareness was at least temporarily raised. Awareness is crucial to treat and prevent.
More diabetes specialists are also necessary and the government must encourage and invest in training such individuals.
Apart from raising awareness of the condition, multi-disciplinary teams are essential to guide people on how to live with diabetes along with a positive outlook to their condition, which will enhance compliance with treatment and reduce the rates of complications.
The health authorities are evaluating the cost effectiveness of providing diabetics with free insulin pumps for suitable individuals that would offer an alternative to daily injections. These provide insulin treatment more accurately than injections and also improve the quality of life for diabetics.
But prevention is always better than cure. Regular screening can reveal a prediabetic state, a warning that diabetes is developing in the individual. In such cases, the development of diabetes may be prevented by losing weight, making changes in one’s diet and exercising at the recommended level of five 30-minute sessions of moderate exercise a week.
The prevention of obesity, a condition that also heavily predisposes to diabetes, is also crucial as, in this too, Malta excels. A European health survey showed that 58 per cent of Maltese adults are obese or overweight.
Prevention is therefore best and is vastly cheaper both to the individual and to the state. Exercise, a healthy diet and avoiding excessive weight gain are a must. This is particularly timely advice in this festive season. Moderation please.