Diabetes is a group of metabolic diseases, clinically known as 'Diabetes Mellitus', in which a person has high blood sugar either because the body does not produce enough insulin or because cells do not respond to the insulin that is produced. Glucose is vital for human health since it's the main source of energy for the cells that make muscles and tissues and that is why it is the main source of fuel of the body.
However, high blood sugar produces classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). If anyone has diabetes, no matter what its type is, it means s/he has too much glucose in her/his blood, although the reasons may differ and too much glucose may even lead to serious health problems.
There are different types of diabetes: Type one results from the body's failure to produce insulin, and presently requires the person to inject insulin. (It is also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.) Type two diabetes results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. Acute complications out of this disease include hypoglycemia, diabetic ketoacidosis, and nonketotic hyperosmolar coma. Serious long-term complications include cardiovascular disease, chronic renal failure, and retinal damage.
Adequate treatment of diabetes is thus important. One should keep blood pressure and body weight under control and maintain a healthy lifestyle and stop smoking.
The term diabetes was coined by Aretaeus of Cappadocia, was derived from Greek verb diabaínein. In 1675, Thomas Willis added the word mellitus, from the Latin meaning "honey", a reference to the sweet taste of the urine. This sweet taste had been noticed in urine by the ancient Greeks, Chinese, Egyptians, Indians, and Persians. Indian philosopher Sushruta identified diabetes and classified it as Medhumeha. The ancient Indians tested for diabetes by observing whether ants were attracted to a person's urine, and called the ailment "sweet urine disease" (Madhumeha). In his 14 volume medical encyclopedia The Canon of Medicine, (1025) Avicenna (980-1037) provided, for the first time, a detailed account of diabetes mellitus, "describing the abnormal appetite and the collapse of sexual functions," and he documented the sweet taste of diabetic urine.
The endocrine role of the pancreas in metabolism, and indeed the existence of insulin, was not further clarified until 1921, when Sir Frederick Grant Banting (1891-1941) and Charles Herbert Best (1899-1978) led to availability of an effective treatment - insulin injections. For this, Banting and laboratory director MacLeod received the Nobel Prize in Physiology or Medicine in 1923.
BANGLADESH SCENARIO: The International Diabetes Federation (IDF) estimated that 7.2 million or 4.8 per cent of people living in Bangladesh had diabetes in 2007 and by 2025, that number is expected to grow to 9.2 million or 6.1 per cent of the population. This explosion in diabetes prevalence will place Bangladesh among the top 10 countries in terms of the number of people living with diabetes in 2025.
The Bangladesh Diabetic Samity (BADAS), established on February 28, 1956 with the initiative of late National Professor Dr Muhammad Ibrahim (1911-1989), has a declared its motto - Look after all people with diabetes irrespective of their ability to pay, status or other factors. BADAS has developed several institutions/projects and inspired a large number of affiliated associations all over the country to fulfill the mission. It is self-reliant and not donor-dependent. BADAS is the pioneer, model and first success story of Public Private Partnership (PPP) development in Bangladesh as it has developed infrastructure through partnerships with the government. It provides services to the affluent and to people who don't have diabetes and through a policy of cross-financing, and then help those living with diabetes with surplus capital that it generates.
BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) is the central institute of BADAS, which provides comprehensive diabetic healthcare to people. It's a unique creation of the BADAS and has been acclaimed as a model institution in Asia and the Pacific. The institute has: (a) 650 in-patient beds and (b) a large out-patient programme. BIRDEM has about 0.5 million registered diabetic patients; more than 4,000 people visit every day here and out of these patients 75-100 are new patients. In review of this influx of patients (provided with medicare services), BIRDEM has been adjudged as a unique and successful healthcare service provider across the globe.
BADAS adopted a decentralised model and has spread care throughout the country. There are 61 affiliated associations in Bangladesh - almost one in every district. They are all affiliated to the BADAS. They have to follow certain standards - they must be democratic and transparent and run by social workers, as well as non-for-profit entities. BADAS has been able to create comparatively excellent diabetes awareness. Bangladesh is a developing country, but in terms of awareness of diabetes it is far ahead of some developed countries. People in general are aware of the need to act to soften possible impacts of diabetes.
Research is another area where BADAS puts great emphasis and it is unlike many other associations particularly in developing countries. Research is a tool for generating context-based knowledge and also skilled manpower. Recognising contribution of BADAS, in 1982 the World Health Organisation declared BIRDEM as a 'Collaborating Centre for Research on Prevention and Control of Diabetes'.
Awareness could go a long way towards fighting and preventing diabetes. More people should still know that Type 2 diabetes is, to a large extent, preventable. Future need not be gloomy -- a full and healthy life is possible even with diabetes. That's a very important message for all affected by diabetes. The developing countries typically focus on communicable diseases. Non-communicable diseases or lifestyle diseases such as diabetes have been neglected. More attention is required urgently before these countries are overwhelmed by the diabetes epidemic.
Dr. Muhammad Abdul Mazid, a former Secretary and Chairman of NBR, is Chief Coordinator of Bangladesh Diabetic Samity.
mazid. [email protected]
