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KARACHI: Health experts on Sunday said that in Pakistan a staggering 33 million people currently live with diabetes, and projections indicate that this number could surge to 62 million by the year 2045.

The Diabetic Association of Pakistan Karachi organised a scientific session at a local hotel. The speakers stressed upon the need to combat the growing diabetes challenge and taking effective measures for mitigating the risk of Type 2 diabetes in the country.

Prof. Abdul Basit Secretary General, Diabetic Association of Pakistan (DAP) introduced the theme of the World Diabetes Day “Access to Diabetes Care” and this year’s campaign slogan “Know your risk of diabetes and your response”.

He said Diabetes is a persistent and debilitating health condition, imposing significant financial burdens on both individuals and healthcare systems. In Pakistan, 33 million people currently live with diabetes. He said the projections indicate that this number could surge to 62 million by the year 2045.

Central to this initiative is the promotion of a nationwide screening program that utilises the RAPID score, a scientifically validated tool designed to assess individual diabetes risk by considering parameters such as age, waist circumference, and a positive family history of diabetes. With a score equal to or greater than 4 indicates an individual’s risk of developing diabetes.

It is crucial for all stakeholders to unite and take decisive action now. Through this collective effort, we can significantly advance our endeavours to address the diabetes challenge and enhance public health for everyone.

Prof Muhammad Yakoob Ahmedani, Prof of Medicine, Baqai Medical University (BMU), Karachi talked on the topic of “Diabetes and Ramadan”. He said fasting throughout the month of Ramadan is one of Islam’s five pillars for all healthy Muslim adults and adolescents.

People with diabetes must be careful while fasting for long hours. Managing diabetes during Ramadan involve a multidisciplinary approach. For safe fasting they must seek advice from healthcare provider regarding diet, exercise, insulin dosage and medication adjustments.

The fasting diabetics must monitor their blood sugar levels regularly as they are at risk of hypoglycemia and hyperglycemia. Dehydration is a common and serious risk so maintain proper body fluids. Lemon water, fresh water and Lassi are the best. A spoonful of yogurt after Sehri meal is best for health.

He asked to avoid caffeinated drinks like coffee, tea. Avoid high sugar, calories dense foods. Avoid 3S, salty, spicy and sugary foods.

Moderate exercise is allowed. Insulin can be continued during fasting if properly titrated to the patient’s needs. If certain symptoms such as low sugar (below 70 mg/dL), high sugar (above 300 mg/dL), dehydration or acute illness occur the fast should be broken. It is crucial that medical staff educate patients about safe fasting to minimise the difficulties during fasting.

Dr Munira Abbasi, Faculty Adjunct Riphah Institute of Lifestyle Medicine, Islamabad talked on the topic of “Life Style Modification (LSM)”. She said diabetes is chronic, debilitating and costly disease. Currently over 537 million (1 in 10) are living with diabetes.

This number is expected rise to 643 million by 2030. About 541 million adults are at increased risk of developing Type 2 diabetes. Type-1 diabetes can not be prevented but 80% of type-2 diabetes is preventable by adopting healthy life style.

People at high risk of developing type-2 diabetes should be identified. Risk factors are age, waist circumference, family history, pre-diabetic, cardiovascular, gestational and hormonal history. Early detection and timely intervention is the key to prevent the diabetes and complications of diabetes.

There is substantial evidence that life style modification i.e. a healthy diet, losing weight if overweight and regular physical activity – 30 minutes brisk walk daily will reduce the risk of developing type 2 diabetes by 35-40%. “You can’t change your gene but you can change your way of life.”

Dr Somia Iqtadar, Associate Professor Medicine King Edward Medical University Lahore talked on “Navigating the Journey of Hyperglycemia in Pregnancy with Technology”.

She said GDM is one of the most common medical condition in pregnancy. 1 in 6 live births (21 million) are affected by high blood glucose in pregnancy. If resistance of maternal insulin action becomes too pronounced, maternal hyperglycemic occurs and GDM may be diagnosed so GDM is defined as high blood sugar that develops during pregnancy and usually disappear after giving birth. It can happen at any stage of pregnancy but more common in 2nd and 3rd trimester.

GDM is associated with an increased risk of baby growing larger than usual (birth more than 4kg) polyhydramnios, premature birth, preeclampsia, jaundice, still birth. GDM is also associated with type 2 diabetes and Cardiovascular Disease in later life in mother and obesity and associated cardio metabolic risk in offspring. Risk factors for GDM are age over 40 years, obesity, previously had a baby over 4.5 kg at birth, had GDM in previous pregnancy, one of your parents or sibling had diabetes, have a hormone disorder called Polycystic Ovary Syndrome (PCOS). If you have one or more risk factors for GDM screening should be at first appointment (8-12 weeks) then at 24-28 weeks if first test is normal.

To check for diabetes blood sugar first be done 6-13 weeks after giving birth, if result is normal then annually. To reduce the risk of future T2D, women who have had GDM are offered lifestyle advice (weight control, diet and exercise).

Prof Zainab Samad, Ibn-e-Sina Endowed Professor of Medicine, Professor Section of Cardiology and Chairperson, Department of Medicine, Aga Khan University on the topic of “NCD Burden and Role of Multiple Stakeholders”.

She said Non communicable diseases (NCDs) also known as chronic diseases are the result of a combination of genetic, physiological, environmental and behavioural factors.

The main types of NCDs are cardiovascular disease, cancer, diabetes and chronic respiratory diseases. NCDs kill 41 million people each year, of all NCDs death 77% are in low and middle income countries.

Copyright Business Recorder, 2023

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