Diabetes is a disease which can occur at any age. We do ot know why the disease happens. Basically, diabetes means that there is too much sugar in the blood, which is then passed into the urine. Sugar comes into our body from various foods, as well as ordinary sugar. We use sugar to give us energy to live and work, and with diabetes our bodies become unable to use sugars. This is why they accumulate in the body, and spill out in the urine. These changes in the body make diabetic people pass a lot of urine, and become thirsty to make up for the water they are passing. Because they cannot burn up sugar to make energy, people with diabetes may become very tired and often lose weight.

WHICH FOODS CONTAIN SUGAR?

A number of types of food contain sugar which the body needs to make energy. They include:

· Bread

· Mealie Meal

· Sugar

· Cassava

· Beans

· Rice

· Biscuits

HOW CAN WE TELL IF SOMEONE HAS DIABETES?

There are three main features which mean that diabetes may have developed. They are:

· A person often passes large amounts of urine,

· They often feel very thirsty,

They often feel very tired.

Of course, any of the three features may happen to a healthy person who does not have diabetes. If a person is tired, it does not mean they definitely have diabetes.

But if they suffer from any of the features regularly, they may have diabetes. Several other features are often, but not always, present. They are:

· Losing weight, despite eating normally,

· Blurred vision,

Muscle pains.

We now have six features which suggest that a person might have diabetes. If somebody often suffers from many of these, then they probably have diabetes.

WHAT TO DO IF YOU THINK YOU MIGHT HAVE DIABETES

Anybody who thinks they have some or all of the six symptoms, should go to a hospital or clinic.

Any doctor or nurse can test the person’s urine to find out if it contains sugar. The person should take a little urine in a bottle with them.

If there is sugar in the urine, then the person probably has diabetes. The doctor can check this by a simple blood test. This is done quickly and without pain.

DIABETES WITHOUT SYMPTOMS

Diabetes might be discovered by any blood test. This may be done when people go to hospital for any reason. Diabetes may also be found in pregnant women during checks before the baby is born.

Diabetes found like this is just the same as diabetes with symptoms, and must be treated in the same way.

HOW IS DIABETES TREATED?

There are three ways of treating diabetes.

· DIET. All people with diabetes must be careful about what food they eat. Sugar in tea, for example, must be avoided. Overweight people should eat less food, to try to become thinner. The doctor or nurse will tell you more about what people with diabetes should and should not eat.

· TABLETS. Sometimes tablets are needed to make people with diabetes feel better. The clinic or hospital will tell you what tablets to take and how often to take them. They must be taken regularly and continuously.

· INSULIN. If tablets do not work, then injections of something called insulin may be needed. This may sound frightening, but is easy to do and does not hurt. One or two injections are usually needed each day. The doctor or nurse will tell the person what to do.

LIVING WITH DIABETES

People with diabetes, and their friends and family, should remember a number of things about diabetes:

· We do not know what causes diabetes, but we know it is not infectious. Nobody needs to be afraid of catching the disease.

· Diabetes can be treated, but not cured. Treatment must be continuous, with regular check-ups at the clinic or hospital.

· With a little care, people with idabettes can live a normal life. Diabetes should not be seen as a disability.

Caring for diabetic patients.

The main aims of diabetes care are as follows:

a) Keeping the patient feeling well (see the Feeding Young People and Vitamin A materials)

b) Educating the patient in self care (see below)

c) Keeping blood glucose control as good as possible.

d) Preventing serious complications (much of this is again health and diet controlled)

e) Treating complications if they occur (once again sufferers should be encouraged to seek whatever medical help is available)

Diabetes and foot care

People with diabetes are prone to foot problems, in particular infections and ulcers. This is usually due to poor blood supply to the foot. Nerve damage causes numbness, and the diabetic person may injure their feet without noticing. Infection occurs, and a serious ulcer may be the result. If not treated quickly, problems like this can lead to amputation. Any sores or ulcers must be reported to a nurse or doctor promptly. Other factors which help are general attention to diabetic control, and avoiding smoking. (See the Leprosy materials for sandal designs.) Any sores or ulcers must be reported to a nurse or doctor promptly.

Diabetes and eye care

As mentioned before, diabetes may affect the eye, and seriously interfere with vision, sometimes even causing blindness. The commonest cause is cataract, which is a clouding of the lens at the front of the eye. This is quite easily cured by an operation to remove the lens, and for this reason diabetic patients are always best advised to report deteriorating vision.

A further type of trouble however, is “retinopathy”, which involves the retina at the back of the eye. Here, diabetes may cause damage to the blood vessels, interfering with vision. This is not so easy to treat; the only really effective way is to destroy the diseased vessels with laser burns, but this treatment is expensive and difficult, and rarely available in developing countries. Once again, good general diabetic control, and avoidance of smoking, do help greatly.

The importance of education

From all that we have read, it should be clear that the key to diabetes care is self-care. The following is a simple list of suggestions for teaching basic information about the illness:

a) What is diabetes?

b) Why diabetes control is important.

c) Diet and diabetes.

d) Tablets and insulin.

e) Dealing with illness.

The education programme can be adapted to different groups of diabetics.

WORDSEARCH – A game to play.

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1. Diabetes

2. Insulin

3. Diet

4. Disease

5. Blood

6. Energy

7. Sugar

8. Urine

9. Cassava

10. Injection

11. Test

12. Vision

13. Thirst

14. Food

Questions to ask children:

Do you know anyone with diabetes?

How do you know if they do have diabetes?

How can you help someone with diabetes?

We hope these materials help your health education programme.

We also advise the use of:

· Posters

· Poems

· Plays

· Songs

· Competitions

Correspondance address:

6 Foster Road, Woodville, Near Swadlincote, Derbyshire DE11 7DZ, UK.

1. Diabetes

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Diabetes and foot care

Diabetes and eye care

The importance of education