IGCSE Case Study Courtesy: Amina Tiwana

Has public awareness and educational schemes been able to aid early diagnoses and treatment of diabetes?

Introduction

The chronic condition Diabetes is when a person suffers from really high or low levels of glucose. This disease is categorized into two groups, Type 1 (insulin dependent) and Type 2 (non-insulin dependent). Symptoms of diabetes include frequent urination, intense thirst, hunger and fatigue. Due to high risks of cardiovascular diseases for a diabetic, it is crucial that blood pressure and cholesterol levels are monitored regularly.

At the very start of this research, I carried out a survey to find out the level of awareness regarding diabetes amongst students and professionals, followed by a sugar test for the ones with pre-diabetes. Most of them had no clue about this disease, 70% said the disease targets aged people only while many others were found to be going through most of the symptoms of diabetes and not admitting to be diabetic at the same time. Even the ones who agreed on having a diabetic blood relation weren't able to identify the dark side of this condition.

Only around 10 percent of individuals recognize their diabetic symptoms but no preventive measures can be taken due to it being diagnosed at a later stage. Even in a well developed country like the United States of America it is the seventh largest cause of death (www.diabetes.org). Little or no knowledge regarding diabetes, results in a large number of individuals bringing bad luck to their health through an unhealthy lifestyle. Research shows that those with pre-diabetes who were aware much earlier than others, were less likely to develop this condition while also engaging in a healthy and effective lifestyle.

Global Perspective

According to the 'International Diabetes Federation' it is estimated that around 8.3% of adults have diabetes, which makes 382 million people globally and it is said to increase more than 592 million by the year 2035. Russia is the third country with the highest number of diabetics all around the world. (www.diabetes.co.uk). Annually $12.5 billion are spent on these patients but it still lacks basic supplies for the care of these diabetics such as sugar checking strips and daily medications.The most effective way of addressing this disease here is by conducting programs in smaller cities where people are taught about their health and possible preventions.

First world countries like the United States of America and the United Kingdom have a high level of uncontrolled diabetes because of their relaxed lifestyle consisting of no physical exercise and obesity. Both of them are trying their best to tackle this problem by introducing new ways of awareness campaigns that would catch public eye easily. Recently on the 18th of Oct 2015, hundreds of people came out of their homes to spread awareness of Type 1 diabetes in Agawam, America through a brisk walk while contributing towards the importance of diabetic awareness.

Regional Perspective

The number of diabetics in China is the highest worldwide with more than 100 million cases (www.mediscape.com); however a fixed rate is hard to state since many of these throughout their lives remain undiagnosed and poorly treated. Obesity and lack of knowledge among the population is the main reason for such a high rate of uncontrolled diabetic cases.

While India has a diabetic rate of 62 million, Bangladesh held the rate of 5.6 million in 2014. Due to poor hygiene and bad healthcare/educational facilities these two under developed countries have had a very bad diabetic record.The lower class tends to go through greater difficulties since they are unable to pay for good healthcare while the facilities provided by the government are completely helpless.

National Perspective

The awareness situation regarding diabetes among the population of Pakistan is poor mainly due to the high rate of illiteracy and lack of counseling sessions amongst the educational sectors. An underdeveloped country like Pakistan counts as one of the top ten countries with a high rate of uncontrolled diabetic cases. Diabetic individuals are said to go from 7.1 million to 11.4 million by the year 2025 (www.dailytimes.com.pk). However diabetics themselves as well as some organizations have started to play a part in establishing diabetic related programs that aim to help identify symptoms and provide financial as well as emotional support for others. Cricket legend and diabetic; WasimAkram, whose considered as the greatest fast bowler up to date, has continued to support and encourage many local diabetics as well as others all across the world further helping them deal with their situation in a much better way. His motto "Control diabetes rather it controls you" pressurizes patients to not let this disease come in between their life goals rather take it as an opportunity to develop a healthier lifestyle.

Most of the local residents believe that their own judgments as well as homemade remedies can help tackle any disease without the need to go to a doctor for a checkup. They stand firm by their insight and refuse to put their minds through any research. Many pharmaceutical companies like Roche and Accu-chek have launched diabetic campaigns in major cities of Pakistan where they carry out sugar tests and point out early symptoms which has helped in indentifying early diagnosis to a great extent.

Possible courses of action/ Future Scenarios

In order to reduce the spread of this growing disease, one must start from an individual level by making himself aware first and then carrying out the message around towards his community so that the cycle of knowledge continues to pass on from one to another. Through the help of social-media and television messages regarding diabetic precautions and consequences should reach families who aren't educated and are restricted to their household. In this way a large part of the population will realize the importance of following a healthy lifestyle from an early stage which would reduce the risk of developing diabetes. Unprofessional methods of the treatment of patients also contribute to a high rate of diabetics. It is essential that a strict check is kept on the way hospitals and doctors have been treating the patients with proper medications present at all times.

With self determination and effort, a diabetic can stay healthy and reduce the chance of other dangerous diseases like cancer. Through the help of increased exercise and dietary changes, one can reduce 5-7 percent of his/her body weight, which has been proved by the 'Diabetes Prevention Program'to be a good step ahead. A low fat and a low calorie diet with a 30 minutes' walk daily should be considered very important for someone who wishes to remain healthy.

Special attention needs to be put on whatever goes inside a diabetic's mouth. They would have to avoid certain food items such as Potato's, fried food, processed meals, frozen food, desserts, smoothies/juices and even soft drinks. With all these possible preventive ways of establishing a better bond with one's own health, it may also include some harder restrictions on some kind of people who generally won't agree to change their way of life. Habits like smoking and drugs etc need to be shut down immediately as these drugs have an adverse effect on the diabetic's health, making their situation even worse.

Parents should pay special attention towards their children's health and should look out for early symptoms. Usually guardians tend to misunderstand the way some individuals try to explain what they're going through, which of course can only be recognized if they are aware themselves.

If an individual starts to bring in some of these changes then they would definitely be moving towards a healthier lifestyle, this would further improve the country's economic and medical situation on a global level. Also others might get inspired and aware by their efforts so an increase in educational awareness and a better society.

Personal Perspective

Belonging from a diabetic family where my grandparents, aunts as well as a few cousins have been diagnosed with this disease for almost a few decades now, I should've been able to identify my condition way before it was too late. Unfortunately to my bad luck or to be more precise the misunderstanding of my symptoms contributed towards the situation I am in today. Despite consulting three very well known doctors of the country for 9 months, they failed to point out hypoglycemia (low blood sugar levels) as my major clash with diabetes while making me follow a routine suitable for people with very high sugar levels resulting in sudden unconsciousness and several faint attacks. Lately while in a discussion with a diabetic although younger than me, she pointed hypoglycemia in my condition as she had herself experienced it and warned me to consult a different doctor and reduce exercise which was highly encouraged by my previous doctors. To my surprise she had been right and my sugar readings started to balance out after sometime.

Many people who had developed a healthy lifestyle with this disease often told me a single statement "the cure to diabetes is self discipline only". Unlike other diseases the only way out is to live with this condition without losing hope while having control over yourself. Depression and anxiety was another factor contributing towards my low sugar levels which was again indentified by fellow patients when I started taking part in the "Diabetics Association of Pakistan's" weekly counseling sessions where discussions amongst all age groups takes place so that one can help inspire one another and also to get a better understanding of our own condition. Here the doctors are only confined to this very disease which makes them give more time to patients like us who are still in the process of healing physically as well as emotionally.

Organizations like these are very rare in a country like Pakistan but the few present have helped a lot of people in many different ways specially by pointing out a direct link between depression and diabetes. Many people have admitted to have attempted suicide at least once after not being able to handle their health properly while also being bullied for it or due to other problems in life. While some invest their thoughts in self harm and try to take their own lives by an intentional overdose of insulin, others lose all hope and stop their medication routine due to self discouragement.

I clearly remember joking with my cousins a few months back on a diabetic related awareness program that went well with my condition, not knowing it was addressing me for the near future. I personally believe apart from the much negativity a condition like diabetes brings with itself it although has a positive impact on one's personal lifestyle as well. The positivity that comes helps you shape your life in a better way, like time management through daily alarmed checkups, ending up healthier and stronger than before due to physical exercise and an increase in your knowledge that makes you want to inspire others so that they learn from your mistakes.

Awareness has although helped many diabetics towards a better future however in terms of early diagnosis it has succeeded very little, only after a person falls into the diabetic trap does he catch interest in these kinds of issues. All this time after being diagnosed with Type 1 diabetes; which is the rarer side of this disease (since 90% of diabetic cases are mostly Type 2) I have been inspired by many people both old and young to live with the social stigma attached with this disease and to not let it be a disturbance in my life. Not only was I discouraged by the society and made guilty for such a thing to happen to me but my very own family had been discriminatory towards me to some extent and had asked me to keep all this to myself as it was considered to be a very shameful thing to happen specifically to a women. Today things are very different as compared to the time when I was introduced to it all but now while looking back what made the difference was educating one another through the little awareness present.

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