One in four Nepalis is diabetic yet public awareness and understanding of diabetes is still very low
One in four Nepalis is diabetic. Thousands have died and hundreds more suffer from visual impairment, blindness, or kidney failure due to complications of having high blood sugar levels for years.
Yet public awareness and understanding of diabetes is still very low. Children are taught about major killers like malaria, TB, HIV/AIDS in school, but diabetes unfortunately does not fall in this list.
The good news is that the government now provides free hemodialysis in select hospitals like Patan Hospital. For hundreds of diabetics whose kidneys can no longer filter impurities in the blood, this free service (which otherwise costs upwards of Rs 25,000 per month) is allowing them to live longer.
Diabetic nephropathy, a progressive kidney disease, is the major reason why so many Nepalis have to undergo hemodialysis. Nephropathy may be functionally silent that means patients may not show any symptoms for 10 to 15 years after the onset of diabetes. The commonly-used dipstick test (a strip of paper put into a urine sample) will pick up albumin (protein) only when nephropathy is in its advanced stage.
Therefore, it is imperative for diabetics to keep their blood sugar level under control during these ‘silent years’ to avoid (or postpone) renal failure. Because once the albumin becomes significant enough to be detected by dipstick, there is a steady decline in renal function with the rate of blood and plasma filtering in the kidney decreasing on an average of 1ml/min per month.
Since the normal function of the kidney is to filter about 125ml/min, this steady decline will lead to kidney failure in about 12 years after diagnosis of diabetes. However, if blood sugar is kept in check and spilling of albumin in the urine is prevented, this complication can at least be postponed or avoided.
Our emphasis has to be prevention though. Healthy and balanced diet, regular exercise, and maintaining age/height appropriate weight will help keep blood sugar to a normal of 70-100 mg/dL. Alongside taking their medicines or insulin shots, those with diabetes too should follow these three steps to lead longer, healthier lives.