{{Diet! Exercise! Obesity! Diabetes! What come to your mind when you hear those words? Do you get a sentiment of a complete detachment like you are not concerned at all? }}

“Diabetes, that’s absurd! How on earth could I possibly have it?” you are probably uttering.

Well, I have to confess that’s how I personally think. But what if this alleged idea of being almost immune to this threat was just nothing else but a pure utopia? The truth is; we should reconsider our positions.

In the last decade, Diabetes was so rare in Rwanda that a physician had to think twice before confirming it. Although no national prevalence study has been conducted so far, now it appears to be on rise.

Speaking from their several years of experience, physicians often declare that the number of admitted patients due to diabetes or its complications is increasing.
“There are 760 youth who are diabetic in Rwanda and these are the ones we know of from 21 hospitals.

This implies that the number is actually much bigger than this.” cautioned Francois Gishoma, Chairman of The Rwandan Diabetes Association in his address on the 2012 World Diabetes Day.

Prediabetics make up 40% of U.S population (Marc, 7-13). As our health system is getting better and better, communicable diseases such as malaria, tuberculosis, pneumonia… will be fading away to let the way to non communicable and chronic ones including diabetes.

In other words; our population will be more and more resembling that of a developed world and this turn is unfortunately an unpreventable curse. The need of raising its awareness among our people is quite palpable.

To start off, let have a good appreciation of some basic terms and concepts. Diabetes is a disorder of carbohydrate metabolism in which sugars in the body are not oxidized to produce energy and therefore accumulate in the blood.

Evidenced by the detection of glucose higher or equal to 126 mg/dl on 2 occasions after fasting for 6 hours, it can be attested as well by a random glucose higher or equal to 200 mg/dl on 2 occasions without fasting and also HbA1c(a glycated haemoglobin form) level higher or equal to 6.5% (7-13).

Insulin is a protein hormone, produced in the pancreas by the beta cells of the islets of Langerhans, that is important for regulating the amount of blood sugar.

A prediabetic is someone on the verge of becoming diabetic; his blood sugar is higher than normal but has not yet frank diabetes.

Studies show that in this population; only diet and exercise can halt the progression in 58% of them, while the rest will be compelled to take medications like metformin or thiazolidinediones (7-13).

Diabetes can be easily assorted into 4 categories; type 1, type 2, Mature-Onset Diabetes of the Young (MODY) and Diabetes due to secondary causes. The type 1 has usually its onset in childhood but can occur throughout adulthood.

It causes a destruction of islet cells leading to an absolute insulin deficiency. In contrast to type 1, type 2 diabetes has a relative insulin deficiency and occurs generally later in life. Obese, sedentary and people with positive family history are prone to develop this type.

The MODY form is due to defects in insulin secretion genes. From pregnancy, endocrinopathies, to medications like protease inhibitors or atypical antipsychotics; the list of secondary causes of diabetes is pretty long.

Though sometimes asymptomatic, diabetes presents with polyphagia (gluttonous excessive eating), polydipsia (abnormally intense thirst), polyuria (the production of large volumes of urine) and unexplained weight loss.

It can be complicated into blindness, renal failure and peripheral sensory loss resulting into an amputation.

To cut a long story short, because many cases are of type 2, it is about the time we make sure we eat healthy; avoiding too much sugar and exercise on daily basis.

Owing to its disastrous complications, the patient should have a good adherence to medications, stick to the assigned diet plan and respect various checkups with his physician.

If on insulin, patients should be aware of the fact that the amount they take has not necessary to be the same rather is individualized according to everyone’s sugar tolerance.