DIABETES COMPLICATIONS AND THE APPLICATION OF SOCIAL AND BEHAVIORAL CHANGE (SBC) APPROACH IN PREVENTION

George, Kingsley SBC Specialist.

The World Diabetes Day is celebrated on November 14 to mark the birthday of Sir Frederick Banting who discovered the Insulin Hormone along with Charles Herbert in 1922. The first shot was administered to a diabetic boy in coma in Toronto in 1922. 

This day aims at spreading awareness about one of the leading causes of death worldwide and the theme of World Diabetes Day 2021 is “Access to Diabetes Care – If Not Now, When?”

Diabetes Mellitus is a non communicable disease and also one of the co-morbidities that is  challenging the global health system in the Covid-19 period.

According to the World Health Organization (WHO), an estimated 422 million people worldwide suffer from diabetes, with Type-2 Diabetes that needs to be treated with Insulin Sensitisers making up about 90% of cases. 

In Nigeria, data from Diabetes Lions Club has it that 4.3 percent of Nigerian population have diabetes. Half of those with diabetes in Nigeria do not have access to cure and majority do not realize they have diabetes. 

This chronic condition is characterized by an abnormal level of blood glucose in the body which is a consequence of the body’s unhealthy insulin function.

In simple sense, Diabetes is a metabolic disorder where the body cannot generate enough insulin to utilize blood glucose. And as a result of excess glucose, major body organs from the eyes to the limbs etc, are damaged. 

Diabetes accounts for the major cause of lower limb amputation, after accident injuries. 

According to a Lancet article shared on the WHO community of practice, Health Information for All (HIFA) forum, an estimated 76% of children with type 1 diabetes globally are unable to stay within the recommended glycaemic ranges, putting them at risk of life-threatening short-term and long-term complications. The article also hazarded that more than 50% of patients with type 2 diabetes are unable to receive the insulin they need because of cost which pose as a major barrier. Other barriers patients have are: access to basic blood glucose monitoring, and limited access to patient education, says the study.

On insulin availability and access after 100 years of it’s discovery, similar studies published on HIFA forum have also identified that there is a clear opportunity to improve access to insulin and related essential technologies for improved management of type 1 diabetes in low and middle income countries, especially as a part of universal health coverage. These improvements will require concerted action and investments in human resources, community engagement, and education for the timely diagnosis and management of type 1 diabetes, as well as adequate health-care financing.

Government should invest in human resources, train paediatric endocrinologists and diabetologists, develop a country strategy to train existing physicians in the management of diabetes, develop task sharing plan by training and deploying community health workers (CHWs) to increase awareness of diabetes, for referrals, and for assisting in the management of diabetes in marginalized communities and special populations at risk.

Non-Governmental Organizations and other development partners should apply Social and Behavioral Change (SBC) Communication methodologies in designing programmes and strategies required to create awareness and demand for early detection and cure.

 Rationale for SBC application in Diabetes Programming 

Social and Behavioral Change (SBC) is a practical methodology designed through a scientific and ITERATIVE process to arrive at any sector-specific methods.

SBC has been proven to influence individual and group perception, change existing knowledge, and engage community structures to change norms and adopt good practices.

The messages for

Sensitization and public awareness requires Development Communication, which is the basis of SBC and SBC has sector-wide application.

SBC takes into consideration spectrums of audience, captures respective constraints,  challenges and conflict sensitivity indices.  Local recommendations are further tested and validated for  hyperlocalization and application.

Evidence suggests that increased awareness campaigns and education interventions are effective in reducing  diabetic among children and adolescents with diabetes. As such emphasis should be made on early detection (pre-diabetes) and prevention, driven through a scientific and evidence-based strategies like SBC, as highlighted in the previous paragraphs.

 Identifying Early Risk Signs and Pre-diabetes – A pivotal point

When talking about diabetes, it is essential to draw people’s attention to pre-diabetes, a condition that is characterized by elevated blood sugar levels in the body, but not elevated enough to fall into the criteria of diabetes. It is a crucial stage because precautionary measures undertaken at this stage is critical in determining the body’s accession to type 2 diabetes. The risk factors of pre-diabetes may include genetics, age, weight, physical inactivity and gestational diabetes. It is a reversible condition and can be managed with timely diagnosis and appropriate alterations in diet and lifestyle.

Pre-diabetes symptoms 

Pre-diabetes can be a tricky condition and despite being reversible, the lack of symptoms can often make it go overlooked. Therefore, people end up discovering it until it’s too late. This makes it essential to be aware of the risk factors and possible signs to avoid the risk of type 2 diabetes.

Here are some signs and symptoms of pre-diabetes to look out for:

You’re often thirsty: Experiencing dry mouth and increased thirstiness can be a sign of pre-diabetes. It can often go unnoticed so it’s important to be mindful of the water intake. 

Increase in the urge to urinate: Have you been feeling the need to urinate frequently lately? It could be a sign of an underlying condition such as Urinary Tract Infection and pre-diabetes etc.

You have issues with your vision: The eyes can indicate signs of internal turmoil. If you experience a change in vision such as an increase in blurriness, it might be time to get your blood sugar levels tested.  

You’re always tired: An altered blood sugar level in the body is accompanied by fatigue. If you’ve been suffering from persistent lethargy and weakness, it can be a sign of an internal anomaly such as pre-diabetes.  

Changes in skin: People suffering from pre-diabetes may often develop darkened skin near the elbows, neck, knees, or armpits. However, it might often go unnoticed under the pretence of natural hyper-pigmentation.

Are you testing your blood glucose the right way? Avoid vendors that move from street to street claiming to test blood sugar for a token. Those rapid test are often scams. Visit the hospital and get screened. 

Lower your blood sugar with dietary recommendations and observe strict adherence to professional instructions.

Regular exercises like Yoga exercises that can help manage blood sugar levels.

 Disclaimer: Tips and suggestions on pre-diabetes  in the article are for general information and not to be construed as medical advice.

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