Radio Miraya
2850: Miraya Breakfast Show - World Diabetes Day
Well, today is World Diabet's Day, and this chronic disease affects millions worldwide in South Sudan as well. And this day highlights the growing concern of diabetes amidst other pressing health challenges. We are happy to be joined by Dr. Wat G-10, who, to just paint a picture of the extent of the disease, and what we should do to safeguard ourselves. Good morning, Dr., welcome to the program. - Thank you, and thank you and for hosting me. - Thank you to all the listeners, but at least to the new today in the World Diabet's Day. - Right, thank you so much, too. So what is Diabet's and what is its burden? - Thank you, thank you, Irene. As you rightly said, today is the World Diabet's Day, and the theme for this year is diabetes and the well-being of the patients. You can see from the theme, diabetes, basically, is the high sugar level. You know that we have a certain level of sugar that is needed and required by our bodies, for the normal function of the body. So sometime when this sugar level exceeds the normal range, it's why I can present symptoms that relate to diabetes. And how to diagnose that one usually? You take a blood sample that needs to be sent to the lab, and you have several ways of taking that sample. You can take a random sample when your patient presents to the clinic, when you check their sugar level, or you can ask the patient to come fasting, and then you take a fasting of sugar level, or you do what you call the hemoglobin A1C, which is basically looking into the percentage of the red blood cells that contain sugar. So this is also another way that you can diagnose the diabetes. - Right, right. - And then the burden globally, actually, the diabetes cases are on their eyes. The same as in South Sudan and all the developing countries. Globally, it is related that almost 10% of other population actually have diabetes. And this percentage actually translated to almost about 500,000,000 one-wide diabetes, and you can see these numbers are very big. And actually there is an explanation that these numbers may arise about 10% to 10% in the next 10 years. So it's really a global problem. - Right, and you spoke about the sugar levels in our bodies. Is that contributed by the intake that we take? Is that from the sugar that we consume, probably from sugar and tea, or eating a lot of sweets? Is that how somebody gets the disease? - The disease is very complex disease. There are many factors. It is not only the sugar that we eat. We know that we take sugar in different forms, whether they're refined sugar, or sometimes through the carbohydrates, like bread, pizza, and all this. All of them, they contain sugar, but there are other contributing factors. One of these factors is like, you know, when we are not physically active, that we need to someone to have to be obese, and then increase in the weight. And the more that is increasing the weight, actually, that also cause resistance to insulin, because insulin is very important, because this is what causing that rise in the blood sugar. Whether that there is no insulin completely in the body, or there is resistance to insulin by the cells. Now, your body will produce little insulin, but the cells are not able to, to take that insulin, because insulin is required that take blood from the plasma to the cell. So if the insulin is not in the body, so definitely that will lead to that rise in the blood sugar that as I said earlier. And then also there are some familiar factors, like, you know, there is no parents, and they're eating the risk of you getting that because also there will be higher. And then also there are other drugs that are used also that can lead to diabetes. - Right, and what drugs could those be that would lead to diabetes? - And there are lots of drugs that are called steroids. - Oh, the steroids? - Yes, steroids, you know, I use actually the half therapeutic indications, especially that people need to overcome the connective tissue diseases, those with allergies, sometimes we use them, but usually they need to be used on the supervision of trained doctors. Nowadays, they are used rapidly, you know, because they have a very powerful difference, especially pain, allergy. So some patients with asthma, sometimes we just go take them over the counter. And then also in this claim that I use mobility also, and then they will come and change the speed of it. - Right, right, right, thank you so much. And for the benefit of the audience that speaks in Arabic, would you just bring them to speed on what diabetes is and how it's gotten plus also, what you just explained to us? - Okay, okay. (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) - Now, so you're saying that the people who are at risk are those from 35 and above. - Basically, anyone can get diabetes, but we're talking about the population where the diabetes is more common. 'Cause we get two types of diabetes. They're what we call the type one, which we see mainly in the younger population, especially the pediatric, the children. And then we get the type two diabetes, which really happens at the old age. Usually the type two diabetes is more common, almost around 95% of the cases. That's why we usually for the screening, we look for it in those who are about 35 years of age. - Right. So what are some of these signs and symptoms? - Okay, diabetes, as I just said, we've got those two types of diabetes. The type one we see mainly in the children or in the young population, those who are like that. - Yes. Usually for type one, most of the time, they will come with more dramatic symptoms. 'Cause for them, they have a complete absent of incident. There is no incident in the body completely. So usually they will have this high sugar level and with the high sugar level, it comes with these other symptoms because already you are not taking sugar in into your body. So the sugar is floating in the plasma. So that will lead to frequent urination. So you'll see them that going to the toilet, you remain almost every 10, 15 minutes. - Wow. - That will lead to them getting dehydrated and when they are dehydrated, you'll never take more, more water. So you'll see them by urinating a lot and taking, try to compensate for that dehydration by taking more, more water. And the other thing also, because there is no sugar in the cells that also will lead to, take the muscle mass. So they will get the dramatic weight loss. Like maybe they will lose 10 to 30% in a very short response. Well, then they will present only to the hospital because of these dramatic symptoms. But at two, that's why we need to do the screening. One of the time they have some residual of eyelid cells which produce incident. So they are incident, but it's not that sufficient. So most of the time they will not have a dramatic symptoms. That's why you need to screen them periodically. And sometimes some of them are just present with already the developed complication line. The kidneys, there's, or the present with the heart related problems or nerves related issues. And as they'll get some numbness in their feet, blaring in their vision because of the effect on the eyes on them they have like a low urine or a small urine because already the kidneys is affected. So that's why it is paramount that you need to screen them because they have less symptoms compared to type one. - Right. And is there a cure for this disease? - This is a very, very good question. And usually for the diabetes, the therapeutic function and drugs that we use, we cannot say the cure for diabetes but we manage diabetes. Because what we need to achieve is to reduce the sugar level to the normal because everyone needs sugar. And when it's in excess, it's where it brings a problem. We have a certain sense of communication but before we go to medicine, usually we advise them on other non-American treatment like the lifestyle. You remember, we mentioned that physically and activity actually contributes diabetes. That's why you advise them that they need to exercise regularly and that all these are that overweight or others also produce weight. By doing so, actually it helps even bring down the sugar level because when you exercise, you reduce weight, you increase the sensitivity of insulin. As you remember, we said that that is resistant to insulin. So you see the sensitivity of cells too, insulin. So you get more insulin into the cells but that in itself also reduces the sugar level. Then the other thing is the diet. The type of food that they eat also matters. So you mentioned, leave alone the refined sugar but now other sources of sugar. - Yeah, and you mentioned the other sources of sugar. I said, "Kissera is one of those and bread." And I figure these are like our staples. We eat this all the time. So, I mean, what does that mean? Does that mean we need to reduce from the intake or how do we even handle it? - Yeah, yeah, this is a very important, but for the every patient, let me tell first, for the every patient, actually we advise them that there's no sugar completely. So you cut down our sugar, carbohydrates, carbohydrates like this, this wheat flour, wheat flour, you will have high carbohydrates now. And I said this one, you'll make pizza there and this other thing. - Yes. - Usually you need to reduce the wheat flour and the carbohydrates. And then you need to advise them that to take more of vegetables. Vegetables is very good because if you take vegetables, actually you feel full and your stomach will be full. - So you mean they should just eat vegetables minus probably the acid, kissera, just sauce? - Yeah, definitely not being done, cut down completely, don't take, but in a smaller portion. - Right. - You take the carbohydrates and proteins and fruits also is very important. So usually we have what you call the Mediterranean diet. Usually when they come to the community and advise them that, you know, if you have a plate, try to divide that plate into three. - Portions. - Into three portions, yeah. So the video portion you put vegetables and then you put the bit of protein, maybe like a piece of meat, a piece of whether red or white meat. And then also you need to put a bit of carbohydrate and fruits. And the other, the other third, so at least that you have more vegetables. When you take vegetables, the portion will feel full. So that will reduce in the carbohydrates that they take. - Right. - That's your important. This is the non-medical treatment. And then also you need to ask them to monitor that blood sugar. Because also you don't want to be drugs that brings down the sugar level to a serious level. Because you really know sugar actually can kill. And the sugar is very, very low. Not so high when you are treating them, you have that vitamin that needs to monitor the blood sugar level. For the drugs, drugs are tied. There are some tablets and also the injection. For the tablets, there are many types of tablets that are available, so usually according to the sugar level, your doctor will decide what to give you, whether it gives you tablets or it will give you the injection. And usually they are the same with just the sugar level which will become and which drugs that you will take. There are some patients that you will see when you tell them, we need to give you injection and feel like now and we are badly open. They think that when you are given insulin, injection doesn't mean you are already terminally safe. You know, it's not like that. Sometimes you can be given injection just to try to bring down your sugar level. When you discover like this, it can be transition to the tablets. - Right. - Yeah. - Okay. Well, thank you so much. Earlier I asked people to send in questions, but it seems that while you are explaining, you answered most of the questions. And someone here, do you believe is asking about the types which you have already mentioned, but he's wondering which one is more fatal, like how dangerous this disease is? - I mentioned earlier for Taiwan that it is, this is one million there in the children. - Yeah. - And how it comes is that sometimes you get what you call an autoimmune that affects actually the pancreas because how would it call the eye itself that produces insulin. So that one affects the pancreas. As we said, it comes mostly with dramatic symptoms and I'm more likely to present to the hospital very, very early. For type two, you usually need more attention because if you don't screen them, they'll come at the latest stages where already they develop complications. You know, usually we say that we need to be very careful we start to do that, because it doesn't come with dramatic symptoms with a regular screen move. I'll tell you about complications. Complication actually, I have many, but I will just mention two acute complications that can lead the patient to come to the hospital in a very serious condition. So what do you call the diabetes coma? - The diabetes coma, usually we see them in these type one diabetes. Those are the symptoms and do not present to the hospital very early. So this is a very serious stage. So you and they come, you get them presented, you carry them. So you address many challenges. And we said they're leaving a lot of water in their body. As they lose, water also can do some other minerals also in their in their body. So they will come already in their loss. They have very high sugar, they are hydrated, they have a low sodium, potassium levels. So when they come, you need to supplement all those. And then after that, you will be insulin to reduce down their blood sugar. But I wonder if the treatment is really insulin, I think, because they are completely not insulin. But as per the diabetes vision, you will need them on our medication. Unless now they are not responding, you have to, could be their insulin. - Right. - Then low sugar, or what do you call it? The hypoglyphin, they're very serious, especially for those who are taking medication, especially insulin, or taking other drug scores of the non-ureus, because they can bring down sugar dramatically. If the person is not aware about those symptoms, sometimes it can be better. - Right. - And that what we do usually when they present to us in the hospital, usually you have to train them how to pick down symptoms of low blood sugar. - Like they'll be very weak, they'll tell you, they're getting squirting, sometimes tremors, and then also they'll have some dizziness. This is where we train them to know, yeah. - Right. And Doctor, thank you so much for making our time to speak to us. What is your general advice to the public? - Thank you. I just mentioned about the theme of this year, while the diabetes day, which is diabetes and the well-being. So when we talk about the diabetes and the well-being, usually what we look for, not only the sugar network, but also we are looking for other aspects. Usually when you come to the hospital, you really learn your advice. One, you need to shed your blood sugar regularly. Two, you need to sleep well. And then three, you need to exercise. This is for every patient that comes to the hospital. The diabetic patient is very, very important that they need to take their medication regularly. For those who are without diabetes, they need to do regular exercise. They need to reduce their weight, their overweight. And then they need to check on their blood sugar, especially when they're about 35, at least every six months or annually. This is very, very, very important, yeah. - Yes, Doctor Rott. And just a conclusion in Arabic before, I bid you farewell. - Yeah. (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) (speaking in foreign language) - No. (speaking in foreign language) - Okay. (speaking in foreign language) Doctor Rott, thank you so much for your time. (speaking in foreign language) - All right. (speaking in foreign language) - Yes, yes, and that's a very important information there and very relevant from Doctor Rott.