PRES: November 14th is World Diabetes Day, a date chosen to mark the birthday of Sir Frederick Banting, who discovered insulin. This year the focus is on education and prevention, as the International Diabetes Federation launches a campaign for people to "Understand diabetes and take control". Coinciding with the day, the Federation, in collaboration with the World Health Organization's Africa branch, is holding a 3-day conference in Port Louis, Mauritius. Bissera Kostova spoke to the President of the International Diabetes Federation, Jean Claude Mbanya, who is at the conference, and explains why Mauritius has the second highest per capita rate of diabetes, after the Pacific island of Nauru.
Mbanya: They have adopted Western lifestyle, culture, there is less physical activities, the diet has changed tremendously, the lifestyle has changed and therefore, they have developed all the risk factors for diabetes. Seventy percent of the population are obese, are overweight.
Kostova: And I understand that in the Gulf region, they have five of the top ten affected countries. What are the reasons there?
Mbanya: Again, economic development - you know, with the oil boom, changes in lifestyle and the eating habits - everything has changed in the Gulf region, sot that is actually the diabetes capital of the world, in terms of prevalence. Whereas India tops the world with 50 million, followed by China with 43 million, so those are the hot areas of the world.
Kostova: And what is the situation in Africa, as a whole?
Mbanya: Oh, that is also pathetic, because Africa has about 12 million people with diabetes, sub-Saharan Africa, and if nothing is done to curb this prevalence, in 20 years time there will be 23.9, almost 24 million people with diabetes in Africa, an increase of 98%. Therefore, it is the region with the highest increase in terms of percentage that would occur in the next 20 years. And again, it's changing lifestyle, people are embracing economic development, people are moving from rural to urban areas, problems with urbanization and obesity are rising. 80 to 90% of the 285 million people with diabetes are in the developing world. And this is the same area of the world, where you have an unfinished agenda of chronic diseases, maternal and child health problems and HIV/AIDS and TB and malaria.
Kostova: So what does that mean for treating the disease?
Mbanya: It means that these countries have triple or quadruple burden of disease. It means that their meager health resources will not be possible for them to take care of diabetes, things like diabetes and high blood pressure, where you actually have lots of complications like kidney failure, strokes and heart disease, so what we have to concentrate on, as you know, the theme for World Diabetes Day is diabetes and prevention, so we want to prevent people from developing diabetes, especially those who are at risk. So that the meager funds that are available for health care can go to those who have the disease, so that they live a better quality of life and not develop complications.
Kostova: As you said, the theme of World Diabetes Day, which is tomorrow, is awareness and education. What do people need to know about diabetes?
Mbanya: They have to know - those who have the disease, they have to know how to take care of their disease and how to prevent them from developing complications. Those, who do not know the disease, have to know what the risk factors are, how they can prevent themselves from developing diabetes. More especially, you need to educate the healthcare providers, because if healthcare providers don't know how to advise people, and also do a total body care, instead of disease oriented care - that they have to look at the person, in general. Somebody can come to you with malaria, but if he's obese and has a family history of diabetes, you don't only concentrate on the malaria, you have to concentrate on all the risk factors for disease.
Kostova: Can you just tell our listeners briefly what to watch out for, what are the symptoms?
Mbanya: The first thing you watch out for, if you are obese, if you have a positive family history, if your mother or father especially, or your brother or sister - a first degree relative with diabetes, if you are above the age of 40, especially for type 2 diabetes, and at the same time if you have the symptoms: you over-urinate, you have a good appetite, you put on weight, or you have lost weight tremendously, and if you are physically inactive, you may have type 2 diabetes, and therefore you see a doctor. In fact, I would advise that everyone who is above the age of 40 should do a finger prick test every year to find out during their medical whether they have diabetes.
Kostova: And what are the benefits of early diagnosis?
Mbanya: Oh, tremendous! I think the problem with diabetes - that is not the blood sugar itself, because at all times in your body you need blood sugar for energy, you need blood sugar to walk, to exercise. What the danger of diabetes is the adverse effects of high blood sugar, which is that you can have kidney shut down, you can have heart failure, you can have heart attacks, their legs might be amputated, if you have an infection that is not well treated and then you can become blind, so there are complications of diabetes that are very serious. Therefore, early diagnosis means good treatment and then you will not develop complications and live a miserable life.
Kostova: And when you say prevention - how can you prevent the disease?
Mbanya: If you are overweight, then you exercise. We actually advise people during this World Diabetes Day that they should exercise at least 30 minutes a day, for at least 4 to 5 days a week. You would be able to keep yourself fit, physically active, you reduce the risk factors by exercising, changing the type of your diet, walking more often, you know, and eating the right things, which means rich in vegetable or fruits, and not only filled with carbohydrates, and fried things.
Kostova: Finally, Professor Mbanya, can you tell me what the goals of your conference are, what you hope to achieve?
Mbanya: Yeah, I think one of the things - why did we come to Mauritius? Mauritius has experienced the greatest burden of diabetes and moving from low prevalence to higher prevalence and lots of cardiovascular complications, related to diabetes. They have also started and put in place health promotion activities about treatment regimens, about education in schools, so we thought that the other African countries can benefit from the experience, so that they share ideas and network, and I think tomorrow we will come out with a call for action for the African region. So it is just a networking group now and trying to learn and share experiences how to tackle the epidemic in that region.
PRES: Dr. Jean-Claude Mbanya teaches and practices endocrinology in Yaounde, Cameroon, and is currently the President of the International Diabetes Federation.
Producer: Bissera Kostova
Duration: 5'56"