World Diabetes Day falls on Wednesday 14th November. The purpose of this day is to raise awareness of a condition that millions of people all around the world live with every day.

It is marked every year on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922.

World Diabetes Day is the world’s largest diabetes awareness campaign reaching a global audience of over 1 billion people in more than 160 countries. The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public and political spotlight.

Diabetes Facts and figures

- Approximately 19 million adults (20-79 years) are living with diabetes as of 2019; by 2045 this will rise to 47 billion in Africa.

- The proportion of people with type 2 diabetes is increasing in most countries, where 4.7% of adults with diabetes are living in low- and middle-income countries. 60% of people with diabetes were undiagnosed.

- 45 million adults (20-79 years) in the IDF Africa Region have Impaired Glucose Tolerance (IGT) which places them at high risk of developing type 2 diabetes. This figure is estimated to reach 110 million by 2045 people are at increased risk of developing type 2 diabetes.

- Diabetes caused 366,200 deaths and at least USD 9.5 billion was spent on healthcare for people with diabetes in 2019 in Africa —less than 1% of the total global expenditure on diabetes.

- More than 25,800 children and adolescents are living with type 1 diabetes.

- More than 10,300 live births (1 in 9 live births) are affected by diabetes during pregnancy.

Diabetes and it's complications

Diabetic eye disease is essentially the body’s ability (or lack of it) to produce the required amount of a hormone called insulin to control glucose levels in the blood which in turn causes diabetes, then later leading to major organ problems such as the eyes.

There are broadly two types of diabetes: Type 1 requires daily administration of artificial insulin by means of injection or insulin pump. Type 2 is more generally managed by a combination of dietary control and medication in the form of tablets.

Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation. In 2016, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.

Complications

The eye is the earliest and most common complication of diabetic disease compared to other complications.

Hence those living with the disease are at high risk of losing their sight if proper care is not taken. Diabetic eye disease among others includes; Cataract which is a clouding of the eye’s lens.

Adults with diabetes are 2-5 times more likely to develop cataract and also tends to happen at an earlier age in people with diabetes; Glaucoma is a disease that damages the eye’s optic nerve—the bundle of nerve fibers that connects the eye to the brain. Some types of glaucoma are associated with elevated pressure inside the eye. In adults, diabetes nearly doubles the risk of glaucoma.

Diabetic Retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. As a result, the blood supply to the retina from these damaged blood vessels is reduced or cut off.

In response to the lack of blood supply, the eye may create growth factors that lead to diabetic macular edema, which can lead to decreased vision, or proliferative diabetic retinopathy, which can lead to retinal detachment and vision loss.

Diabetic retinopathy is one of the most common causes of vision loss among people with diabetes and the leading cause of vision impairment and blindness among the working-age population.

Maintaining blood glucose levels, blood pressure, and cholesterol at or close to normal can help delay or prevent diabetes complications. Therefore, people with diabetes need regular monitoring. All forms of diabetic eye disease have the potential to cause severe Vision Loss and Blindness.

Symptoms

It is possible to have diabetic retinopathy for a long time without noticing symptoms until substantial damage has occurred. Symptoms may include, blurry vision, difficulty reading, the appearance of spots—known as “floaters” in your vision. A person with diabetic retinopathy may also notice a shadow across the field of vision, eye pain or pressure, or difficulty with colour perception.

Some patients may experience a partial or total loss of vision. It is important to note that Diabetic Retinopathy usually affects both eyes.

Risk Factors

People with diabetes have an increased risk of developing a number of serious health problems. Consistently high blood glucose levels can lead to serious diseases affecting the heart and blood vessels, kidneys, nerves, and even teeth.

In addition, people with diabetes also have a higher risk of developing infections. Diabetes is a leading cause of cardiovascular disease, kidney failure, and lower limb amputation.
And also:

• Disease duration: the longer someone has diabetes, the greater the risk of developing diabetic retinopathy.

• Poor control of blood sugar levels over time

• High blood pressure

• High cholesterol levels

• Pregnancy in someone with diabetes can also result in changes in the retina

Investigation and Treatment/Drugs

It has shown that some lasers to the retina or minuscule injections of medications into the middle cavity of the eye. These procedures can be done in an office or hospital setting to prevent, treat, or reverse damage from diabetes in the retina.

Research has shown that eye injections often—but not always in combination with laser treatment—result in better vision than laser treatment alone for patients with diabetic macular edema.

If you have been diagnosed with diabetic retinopathy or diabetes and have vision loss, a retina specialist can help you find a support group and suggest access to rehabilitation with a variety of tools to make everyday living with this disease a little bit easier.

Prevention

The following are ways to prevent Diabetic Retinopathy and Vision Loss caused by it:

Control those blood sugar levels through diet such as vegetables, fruits, nuts, white meat, and seafood e.g. Salmon, Codfish, etc., exercise, and take your medications. The better control of these levels, the less likely one will develop diabetic retinopathy or have worsening of any pre-existing retinopathy.

One of the best ways to monitor your sugar levels is by having the health care provider who manages your diabetes evaluate your haemoglobin A1C. This is measured through a blood test obtained in the laboratory. This evaluation will help you keep your blood sugar levels in a target range.

Furthermore, it’s very important that people with diabetes maintain good control of their condition to help reduce and avoid long term complications.

It is imperative for diabetic patients to maintain the eye examination schedule put in place by the retina specialist. Through early detection, the retina specialist can begin a treatment regimen to help prevent vision loss and slow the disease’s progression.

There have been huge advances in this area over recent years. However, it is vitally important that development work continues, to ensure people with the condition can live as normal a life as possible.

The International Diabetes Federation (IDF) will be involved in coordinating activities on the day, so keep an eye out for an event near you! Any help or support you can give this cause will be greatly appreciated by everyone concerned. Make a note – 14th November is World Diabetes Day!