A population at risk

Henriette Lamprecht – Although Namibia has a relatively low prevalence of diabetes, the potentially large burden of prediabetes in the country predicts a large future epidemic of the disease.Namibia relatively low prevalence of diabetes stands at 4,5%, this according to the World Bank collection of development indicators, compiled from officially recognized sources. The 4,5% of the population ages 20 to 79 was reported in 2019.Diabetes is a chronic (long-lasting) health condition that impairs the body’s ability to process blood glucose, otherwise known as blood sugar.Without ongoing, careful management, diabetes can lead to a buildup of sugars in the blood, which can increase the risk of dangerous complications, including stroke and heart disease.In 2018 a study done by US National Library of Medicine’s National Institute of Health, titled Epidemiology of prediabetes and diabetes in Namibia, Africa: A multilevel analysis, established the prevalence rate at 5%. The study however found a discrepancy in prediabetes prevalence depending on the definition used (7% by WHO criteria and 20% by criteria of the American Diabetes Association.) According to the study, the prevalence of diabetes and prediabetes was highest among overweight and obese individuals, with individuals from the highest family wealth index having the highest prevalence of diabetes.The study further state its finding of the potentially large burden of prediabetes in Namibia predicts a potentially large future epidemic of diabetes, underscoring the need for Namibian health authorities to prepare to manage commonly concurrent burdens of vascular disease and kidney disease among their citizens. Namibia and other countries in sub-Saharan Africa are according to the study also undergoing a demographic transition that may hasten the population's progression to diabetes.“As death from infection declines, these populations age and develop other risk factors, including obesity, that can hasten the onset of diabetes and its complications,” the study states. Findings of significant clustering of diabetes and prediabetes at community level supports preventative efforts that address communities in addition to individuals, and future studies are needed to determine additional community-level factors that contribute to dysglycemia risk.The authors of the study conclude the associations found between diabetes and age and Body Mass Index (BMI) are similar to those observed around the world. Positive associations found between these two factors and diabetes have also been previously observed in South Africa, Nigeria and Zambia. “Our findings of an increased odds of diabetes among individuals with the highest family wealth aligns with the epidemiological transition theory, which suggests the burden of new diseases related to lifestyle would be first concentrated among the wealthy, before shifting to those of a lower income.” A common explanation is that higher socioeconomic status increases access to high-calorie foods and decreases the need for physical activity. The study emphasizes the growing evidence base that several countries in sub-Saharan African and Namibia included, are experiencing a rapidly evolving epidemiological transition marked by an increase in chronic diseases.“Our results underscore the importance of future public health policies in these countries that shift focus from the management of acute to chronic conditions. Further, our finding of the potentially large burden of prediabetes in Namibia points to the need to develop preventive care and education efforts, ideally targeting both at-risk individuals and communities.”Different kinds of diabetes can occur, and managing the condition depends on the type. Not all forms of diabetes stem from a person being overweight or leading an inactive lifestyle, with some present from childhood. Three major diabetes types can develop, namely Type 1, type 2, and gestational diabetes.Type I: Also known as juvenile diabetes, it occurs when the body fails to produce insulin. People with type I diabetes are insulin-dependent, which means they must take artificial insulin daily to stay alive.Type 2: Type 2 diabetes affects the way the body uses insulin. While the body still makes insulin, unlike in type I, the cells in the body do not respond to it as effectively as they once did. This is the most common type of diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases, and it has strong links with obesity.Gestational diabetes: This type occurs in women during pregnancy when the body can become less sensitive to insulin. Gestational diabetes does not occur in all women and usually resolves after giving birth.Less common types of diabetes include monogenic diabetes and cystic fibrosis-related diabetes.PrediabetesDoctors refer to some people as having prediabetes or borderline diabetes when blood sugar is usually in the range of 100 to 125 milligrams per deciliter (mg/dL).Normal blood sugar levels sit between 70 and 99 mg/dL, whereas a person with diabetes will have a fasting blood sugar higher than 126 mg/dL.The prediabetes level means that blood glucose is higher than usual but not so high as to constitute diabetes.People with prediabetes are, however, at risk of developing type 2 diabetes, although they do not usually experience the symptoms of full diabetes.Risk factors for prediabetes and type 2 diabetes are similar. They include:*being overweight*a family history of diabetes*having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dL or 50 mg/dL*a history of high blood pressure*having gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds*a history of polycystic ovary syndrome (PCOS)*being more than 45 years of age*having a sedentary lifestyleExercise and diet tipsIf a doctor diagnoses a person with type 2 diabetes, they will often recommend making lifestyle changes to support weight loss and overall health. A doctor may refer a person with diabetes or prediabetes to a nutritionist. A specialist can help a person with diabetes lead an active, balanced lifestyle and manage the condition. A healthy diet can help prevent, reverse, or manage diabetes.Steps a person can take to embrace a lifestyle with diabetes include:*Eating a diet high in fresh, nutritious foods.*Avoiding high-sugar foods. *Refraining from excessive amounts of alcohol.*Engaging in at least 30 minutes exercise a day.*Recognizing signs of low blood sugar when exercising.Sources: Sciencedaily; Medicalnewstoday; US National Library of Medicine; WHO

A population at risk

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A population at risk

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