The world diabetes day is observed each year on the 14th of November since 1996. The primary objective of observing the world diabetes day is to increase awareness among the masses about diabetes, its management, prevention of diabetes and its complications.
The world diabetes day was observed today at Pakistan Institute of Medical Sciences, Islamabad.
The world diabetes day was observed in PIMS diabetic foot clinic by the Department of General Medicine Team 2. Dr. Shajee Ahmed Siddique, Dr. Shafaat Khatoon, Dr.Ahmed Ali Wassan along with the whole team of doctors and pharmaceutical companies actively participated and made the program a success.
List of Guests speakers who talked about Diabetes Mellitus:
Speakers from a variety of medical fields were invited as guests and participated in small group discussions and delivered lectures focusing on various aspects of diabetes, especially on a healthy lifestyle.
- Professor Dr. Jamal Zafar (professor of medicine)
- Professor Dr.Rizwan Aziz Qazi (professor of medicine)
- Professor Dr.Aslam Shah (Professor of surgery)
- Professor Dr. Lubna (Professor of Pathology)
- Professor Dr. Khwaja Ahmed (consultant diabetologist)
- Dr. Junaida Sarfaraz (Public Health Specialist)
Key points shared by professor Dr. Jamal Zafar about Diabetes Mellitus:
After the recitation of verses from the Holy Quran by Dr. Safiullah, Dr. Jamal started his talk with the name of Allah and the following verse
Tabsara e zulme shab se to behtar hota
Apny hissay ka charagh jalaye jaty
He stressed on contributing in any form to the development of the country.
We always blame our country but what role have we played in its development? We owe this country.
About the world diabetes day, Dr. Jamal Zafar said in his speech that 14th November is being observed as the world diabetes day since 1996 when the United Nations declared diabetes as a major disease affecting the health and economy of the world.
The Blue color in the Diabetes logo displayed on this day was developed by a Turkish type 1 diabetic patient. The blue colour represents the sky and the round circle represents the world.
About the demographics, Dr.Jamal stressed labeling diabetes as an epidemic, especially in Asian countries. He said that 500 million people worldwide are suffering from diabetes mellitus. In addition, he said that these 500 million people are like the tip of an iceberg, i.e., most of the people with diabetes remain undiagnosed.
Every 6 seconds a patient dies of Diabetes Mellitus, and 2 patients are diagnosed with Diabetes Mellitus. Similarly every 19 seconds an amputation is being performed.
Diabetes is a leading cause of blindness, renal failure, and stroke.
People blame coronary artery diseases and strokes as the causes of death, but these people are actually dying because of diabetes – which led to strokes and IHDs.
30 – 40 million Pakistanis above 20 years of age are diabetics!
In Pakistan, a survey was conducted by Dr. Jamal and his team according to the International standards. With the help of google mapping, individuals were screened with the standard 2 hours glucose tolerance test for diabetes. According to the survey, 26% of Pakistanis are living with diabetes mellitus above the age of 20 years. This means that around 30 to 40 million people in Pakistan or one in every four persons above the age of 20 years has diabetes.
During his lecture, Dr. Jamal Zafar interacted with the junior doctors as well as patients with diabetes. He stressed on the acute and chronic complications of diabetes mellitus and when to perform screening for each of the complications.
The microvascular complications include diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. Macrovascular complications include cerebrovascular diseases, ischemic heart diseases, and peripheral vascular diseases. Cerebrovascular apart from stroke also include dementia and Parkinson’s disease.
About IHD, he stated that Diabetes Mellitus is equivalent to one Myocardial infarction, rather the risk is 1.6 times high in diabetic patients.
Similarly, gangrene leading to amputation because of peripheral vascular disease is a common macrovascular complication of diabetes mellitus.
Imagine for how long can you stand on one foot. So, prevent your patients from amputations. An artificial limb is nothing compared to the one given to you by Allah.
Further on, interacting with Junior doctors, Dr.Jamal reinforced the results of the two landmark studies – the DCCT trial and the UKPDS study. He stated that the DCCT trial in type 1 diabetes showed the importance of intensive control of diabetes mellitus on long-term complications. This is termed as the legacy effect.
In the UKPDS study, newly diagnosed Diabetic patients were enrolled in the study and followed for 16 years. Patients were divided into two groups – the conventional therapy group and the intensive control group. It was found that with each percent reduction in glycated hemoglobin, the rates of diabetic complications reduce by 33 – 37% – mostly the microvascular but also macrovascular complications.
For control of diabetes knowledge about anti-diabetic medications and recently updated guidelines should be known to the doctors. Previously only metformin, sulfonylurea, and insulin were available but now a variety of medicines are available with different mechanisms, benefits, and adverse effects.
When to screen for complications of Diabetes Mellitus
Regarding the timings and intervals of screening for various complications, Dr.Jamal pointed to a map developed by the Barrett Hodgson pharmaceutical indicating the timings and intervals for screening tests.
Microalbumin should be checked yearly as a screening test for diabetic nephropathy.
Glycated hemoglobin and Fasting a lipid profiles should be checked at 3 to 6 months intervals depending on the level of Diabetic Control
Fundoscopy and Electrocardiography should be done yearly
Insulinization should not be discouraged if required, neither should antidiabetic medicines be unnecessarily changed if the blood sugars are well controlled and within the target ranges.
Staged diabetes management is important and especially the role of a dietitian is very important. Small dietary interventions matter. Furthermore, the basics of Nutrition in diabetes should be known to the doctors.
The Family and Diabetes – Slogan for this year’s World Diabetes Day.
This year the theme for the world diabetes day is “The Family and Diabetes”. This is probably for countries like ours because here one family member affects the whole family. A diabetic mother or father can not care for his family.
I see young boys and girls, instead of their parents taking them to schools, they are bringing their parents to the hospital and missing their schools.
Regarding a healthy lifestyle, Dr. Jamal said that the fizzy drinks are synonymous to weapons of mass destruction. Previously, Diabetes was a disease of individuals above 45 years of age but nowadays teenagers and young adults are frequently diagnosed with Diabetes.
Studies have shown that exercise and a healthy diet is effective in preventing diabetes by 70%. We should counsel our patients and their attendants who have not yet developed diabetes. We should facilitate diabetic patients, arrange for them glucometers, investigations, and medications.
A patient during the group discussion asked why he developed diabetes as he has not been using white sugar for the last 20 to 30 years and is doing regular exercise.
Diet, exercise, stress, and genetics all play their roles. You would have probably got it 20 years back if you were not following the dietary plan. Secondly, despite having diabetes for a long time, you have not developed any complications. Dr. Jamal Replied.
In the end, Dr. Jamal praised the head of the department Dr. Shajee Ahmed Siddiqui for maintaining the diabetic foot clinic. He especially praised him for the new developments i.e. the autoclave machine, multimedia etc.
The Three Pillars of Diabetes Control – Dr. Khwaja Ahmed
Dr. Khwaja Ahmed consultant diabetologist in the polyclinic stressed on exercise, diet, and medications and labeled these three interventions as the pillars of diabetes control. He also said that management of diabetes is not just about the numbers, we should regularly screen for complications of diabetes mellitus and manage them timely. He also said that the pharmaceutical companies should arrange similar programs in the peripheries as well.
Cold Drinks are Toilet Cleaners – Avoid Them. Professor Dr. Aslam Shah
Prof. Aslam Shah reiterated what the previous speakers said and added that willpower is the main factor in the control of diabetes. He said that he has not been using sugar for the last so many years. He quit using sugar when one of his seniors (Dr.Zarina) while having a sugar free tea said “I have developed the taste for it”
In the last 12 years, I have probably taken less than 12 cold drinks
Avoid juices, these contain preservatives, take natural foods instead.
Diabetes is not a disease it is a complexity of diseases.
These cold drinks are toilet cleaners so you can better understand what you are taking
Genes make a difference but your minds make a difference too – Professor Lubna
Diabetes is an epidemic here
“Blood Sugars and glycated hemoglobin” is not a problem, it’s the complications
Avoid juices – You may take sweets but do not drink any
The media needs to play a positive role in spreading the message.
We should focus on prevention more than treatment.
Lifestyle modification is like following the principles of Islam – Everything should be taken in moderation.
Genes make a difference but your minds make a difference too
Knowing is not sufficient to change a behavior – Dr. Junaida Sarfarz
We Asians get the disease 10 years prior to the West
Knowing is not sufficient to change a behavior.
A change in behavior is an important aspect of the management of diabetes mellitus
If knowing was more important, then doctors would have avoided all the risks, on the contrary Doctors are more at risk of developing Diabetes and Ischemic Heart diseases.
Diabetes is the mother of all diseases – Dr. Rizwan Aziz Qazi
In the end, Dr.Rizwan praised all the participants and thanked the pharmaceuticals for making the program a success. He labeled Diabetes as the Mother of all diseases.
Diabetes is the mother of all diseases – Dr. Rizwan Aziz Qazi
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