Wasswa Diabetic Care Initiative - U Ltd

18/06/2024

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27/04/2024

Signs and symptoms of type 1 diabetes
A child may be at an increased risk of type 1 diabetes if they are ages 4 to 6 or 10 to 14. Symptoms of type 1 diabetes can appear quite suddenly and may include:
• Frequent urination — babies may need frequent diaper changes and children may wet their pants
• Diaper rash in infants caused by a yeast infection
• Unusually high level of thirst
• Dehydration
• Extreme hunger combined with unexplained weight loss
• Loss of appetite
• Fatigue
• Blurry vision
• Fruity smelling breath
• Fast breathing
• Nausea and vomiting
• Stomach pain
• Yeast infections in girls
• High levels of sugar in the blood and the urine
Diabetic ketoacidosis (DKA) may mistakenly be diagnosed as pneumonia or asthma, especially in infants and toddlers. DKA is a serious, life-threatening condition that occurs when cells don’t get the glucose that they need for energy. The body resorts to using fat for energy, and this creates ketones. When ketone levels in the blood build up, it can lead to DKA. DKA symptoms in children include the above symptoms, along with flu-like symptoms. Always seek medical attention promptly if your child or teenager has any of these symptoms.

27/04/2024

Type 2 diabetes
Type 2 diabetes used to be called “adult-onset diabetes.” However, more and more children (some as young as 10 years old) and teens are getting type 2 diabetes, as about one-third of American youth are overweight. People (adults and children) who are overweight are likely to have insulin resistance, which can develop into type 2 diabetes.
Due to certain risk factors, such as family history or being of certain racial or ethnic groups (African American, Hispanic, Native American, Asian American, or Pacific Islander) or lifestyle factors, cells in the body stop responding normally to insulin. This causes the pancreas to make more insulin to help the cells take in glucose. Over time, the pancreas can’t keep up with the demand for insulin, and blood sugar levels start to rise, setting the stage for type 2 diabetes.
Insulin resistance in children may not produce any symptoms, although some kids will develop patches of thickened, dark, velvety skin in body creases and folds such as the back of the neck or armpits, says the (CDC) Centers for Disease Control and Prevention. Children may also have other conditions related to insulin resistance, including high blood pressure, high cholesterol, and polycystic o***y syndrome (PCOS).
Type 2 diabetes is managed primarily by lifestyle factors, including healthier eating and regular physical activity. Weight loss is generally not the goal, as children and teens are still growing, but it’s important to help stop or slow down weight gain if the child is overweight. If blood sugars aren’t managed well with these steps, diabetes medication may be needed. Metformin and noninsulin injectables may be prescribed; sometimes insulin is needed if blood sugars levels are very high. Teens who are significantly obese (meaning, a BMI above 35) may benefit from weight-loss surgery. Early treatment is important to lessen the chances of diabetes complications, such as heart and kidney disease, eye problems, and nerve damage.

26/04/2024

Participants from Uganda were enrolled from two geographic regions: a peri-urban community in the Wakiso District, and a rural community in the Bushenyi District. Wakiso District is a peri-urban community, about 15 km from the capital Kampala. It is the most populated district in Uganda with a total population of two million and 59.2% of the population is within 5 km radius of a health unit (Citation10, Citation11). Bushenyi, a predominantly rural district, is located in South Western Uganda and has a population of 250,000 of which 70% is within a walkable distance to a health facility (Citation10, Citation12).

In Wakiso District, two parishes consisting of 13 villages were randomly selected for inclusion into the study. Participants were recruited in-person through house visits. Written consent was taken or read aloud if the participant was illiterate. In Bushenyi District, households were randomly selected from an enumerated list of all the households in each village. Trained research assistants recruited participants in-person through house visits. At both sites, interviews were done face-to-face and physical measurements and blood samples were taken on-site. In total, 297 people agreed to participate in peri-urban Uganda and 200 agreed to participate in rural Uganda.

Data collection
The administered questionnaire was standardized across all sites and translated into kiSwahili in Tanzania and Luganda and Runyakitara in Uganda. The questionnaire relied on self-report of current medical conditions, family history of disease, and any treatment received. Main questions on diabetes included the following: Do you have a close family member(s) with diabetes or high blood sugar? Have you ever been told by a doctor or other health worker that you have high blood sugar or diabetes? Close family members included parents and first-degree relatives.

Blood glucose was measured in a fasting state (at least 8 h) at all three sites by finger prick using blood glucose meters that were calibrated for plasma glucose values. Diabetes mellitus was defined according to the WHO and IDF guidelines. Participants were categorized as having diabetes if their FBG levels were ≥7.0 mmol/l (126 mg/dl) or they self-reported having diabetes, and pre-diabetes if they had impaired fasting glucose defined as FBG of 6.1–6.9 mmol/l (110–125 mg/dl) with no self-reported history of diabetes (Citation13, Citation14).

Standardized approaches for physical measurements including height, weight, abdominal circumference, and blood pressure were used at all three sites. These were recorded by health providers at Temeke District Hospital in Tanzania, and by trained study staff in Uganda. Physical measurements were used to determine body mass index (BMI). A BMI of 25–29.9 kg/m2 was classified as being overweight, a BMI of ≥30 kg/m2 as being obese and a BMI of 102 cm in males and >88 cm in females. Three blood pressure measurements were taken in sitting position at least 5 min apart using a digital blood pressure device. The average of the last two readings was used for analysis. Hypertension was defined as having a systolic blood pressure ≥140 mmHg or a diastolic blood pressure ≥90 mmHg or self-reporting hypertension.

26/04/2024

Diabetic care

26/04/2024

Introduction
The International Diabetes Federation (IDF) estimates that 19.8 million people have diabetes in Africa where approximately 75% are still undiagnosed (Citation1). Type 2 diabetes (T2D) contributes up to 90% of all cases of diabetes (Citation2). The increase in diabetes prevalence in sub-Saharan Africa (SSA) has grown in parallel with the increase in obesity and other cardiovascular risk factors (Citation3). Countries with the highest estimated numbers of persons with diabetes include Nigeria (3.9 million), South Africa (2.6 million), Ethiopia (1.9 million), and Tanzania (1.7 million) (Citation1). Diabetes exerts a huge societal burden by reducing quality of life and life expectancy, as well as causing economic loss to individuals and nations (Citation4).

Rapid urbanization, increasingly sedentary lifestyles, and unhealthy eating habits have contributed largely to the increased prevalence of diabetes, estimated to be 5.7% and expected to rise to 6% by 2035 (Citation1). The prevalence of pre-diabetes, a transition stage with blood glucose levels higher than normal but not high enough to be diagnosed as diabetes, is currently at 8.3% and expected to rise to 9.3% by 2035. Therefore, interventions to control the epidemic of diabetes and hyperglycemia-related vascular complications should start at this early stage of its development (Citation5).

The prevalence of diabetes in Tanzania and Uganda, two SSA countries with comparable socioeconomic status, is estimated at 7.8% (Tanzania) and 4.1% (Uganda), while impaired glucose tolerance is estimated at 9.1% in Tanzania and 6.6% in Uganda (Citation1). The estimated number of undiagnosed patients is 469.3 per 1,000 and 1281.7 per 1,000 in Uganda and Tanzania, respectively (Citation1). The health delivery service structure for Tanzania and Uganda is pyramidal with primary health care services at its base. Despite policy stating that primary care facilities should provide services for diabetes, studies have demonstrated that most dispensaries and health centers do not provide such services. Lack of guidelines, basic supplies, diagnostic tools, and training are the frequently cited reasons for the underutilization of primary health care in providing diabetes care (Citation6, Citation7).

Although communicable diseases remain the most common causes of morbidity and mortality in low-income countries, the rapid increase in the prevalence of non-communicable diseases (NCDs) including diabetes creates a challenge for prevention and treatment. Data for diabetes in SSA are sparse and often from single-country studies. Lack of comprehensive studies on diabetes etiology and risk factors creates a knowledge gap (Citation8). There is an urgent need to obtain local data in order to implement locally applicable preventive strategies.

We report on data from the Africa/HSPH Partnership for Cohort Research and Training (PaCT), an initiative that aims to conduct a large prospective study in South Africa, Tanzania, Uganda, and Nigeria to gain knowledge on risk factors for NCDs including diabetes. The aim of this analysis from pilot studies was to determine the prevalence of diabetes and pre-diabetes and its associated risk factors in Tanzania and Uganda.

17/04/2024

Type 2 diabetes
Eating the right types of foods can both control your blood sugar and help you lose any excess weight.
Carb counting is an important part of eating for type 2 diabetes. A dietitian can help you figure out how many grams of carbohydrates to eat at each meal.
In order to keep your blood sugar levels steady, try to eat small meals throughout the day. Emphasize healthy foods such as:
• fruits
• vegetables
• whole grains
• lean protein such as poultry and fish
• healthy fats such as olive oil and nuts
Certain other foods can undermine efforts to keep your blood sugar in control.Discover the foods you should avoid if you have diabetes

17/04/2024

17/04/2024

Gestational diabetes
Eating a well-balanced diet is important for both you and your baby during these nine months. Making the right food choices can also help you avoid diabetes medications.
Watch your portion sizes, and limit sugary or salty foods. Although you need some sugar to feed your growing baby, you should avoid eating too much.
Consider making an eating plan with the help of a dietitian or nutritionist. They’ll ensure that your diet has the right mix of macronutrients. Go here for other do’s and don’ts for healthy eating with gestational diabetes.