New Delhi, Jul 23 (IANS): Diabetes, if not addressed properly, will worsen and cause complications in the form of damage to the heart, blood vessels, eyes, kidneys and nerves, health experts have warned, adding that the blood sugar disease is worsening chronic illnesses.
About 400 million people worldwide have diabetes with more than 100 million in India alone.
According to healthcare providers, individuals with diabetes mellitus (DM), an inadequate control of blood levels of glucose, are at three times the risk of developing TB and there are now more individuals with TB-DM co-morbidity than TB-HIV co-infection.
Pulmonary TB accounts for 70-80 per cent of the cases, and it is generally accepted that immune compromise facilitates hematogenous dissemination of Mtb, predisposing to extrapulmonary TB.
Mtb induces a strong cell-mediated immunity leading to the formation of pulmonary granulomas (tubercles) that are thought to be a double-edged sword for the host treatment failure.
“TB-DM versus TB-no DM patients are more likely to remain sputum smear-positive after completion of the intensive phase of treatment, and this outcome is an early predictor of treatment failure (sputum smear or culture positivity at five months or later during treatment), which is also more likely in TB-DM versus TB-no DM,” explained Dr Kuldeep Kumar Grover, Head-Critical Care and Pulmonology, CK Birla Hospital.
In the last 30 years, the prevalence of Type 2 diabetes has risen to a pandemic level, involving all countries and all income levels.
For people living with diabetes, access to affordable treatment, including insulin, is critical for their survival. It is now a global target to halt the rise in diabetes and obesity by 2025.
Dr Archana Juneja, Consultant, Endocrinologist at Kokilaben Dhirubhai Ambani Hospital in Mumbai said that diabetes significantly exacerbates chronic illnesses by directly affecting multiple systems in the body.
“Uncontrolled diabetes induces cellular-level changes that can adversely impact vital organs such as the kidneys, heart, eyes, nerves, and circulation. The presence of additional factors like high blood pressure, high cholesterol, and smoking further compounds the detrimental effects of long-standing and uncontrolled diabetes, worsening the overall burden of chronic diseases,” Juneja told IANS.
Elevated blood sugar levels can be toxic to cellular functions, affecting cells throughout the body.
Diabetes is commonly associated with chronic illnesses like cardiovascular diseases, kidney diseases, and eye diseases.
“In terms of communicable diseases, diabetes affects the body’s immune system. This is a result of chronic, long-standing diabetes rather than an immediate effect. Long standing uncontrolled diabetes suppresses the immune system and impairs the body’s defense mechanisms, making individuals with diabetes more susceptible to infections such as tuberculosis, as well as fungal, viral, and bacterial infections,” said Juneja.
According to Dr Rakesh Kumar Prasad, Consultant, Endocrinology, Fortis Hospital in Noida, heart disease is more common among people with diabetes.
“Individuals with diabetes have a higher risk of developing heart disease compared to those without diabetes. This increased risk is attributed to various factors, including obesity, age, high blood pressure, high cholesterol levels, and insulin resistance,” he told IANS.
Heart disease in the context of diabetes often manifests as atherosclerosis, a condition characterized by the accumulation of plaque inside the arteries, leading to their narrowing and decreased blood flow to the heart.
This can result in symptoms such as chest pain (angina), heart attacks, or even sudden cardiac death.
To prevent heart disease, individuals with diabetes can adopt several lifestyle changes like quitting smoking, losing weight, eating a healthy and balanced diet, regular exercise and maintaining ideal blood pressure/cholesterol levels, along with managing healthy blood sugar levels which is vital for individuals with diabetes to reduce the risk of complications.
To minimise the impact of diabetes on chronic illnesses, the key solution lies in maintaining optimal glucose levels. This involves adhering to specific targets, such as fasting blood sugar levels between 90-120 (depending on the patient’s age) and post-meal levels between 140-180.
“Additionally, the glycosylated hemoglobin (HbA1c), a marker of long-term diabetes control over three months, should ideally be kept below 7 per cent,” Dr Juneja informed.
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
