Health News Sat, 10 Nov 2012

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Hunger In The Midst Of Plenty

Developing countries keep lamenting over brain-drain but we hardly talk about the large numbers of unskilled labour (is that brawn?) that leave our shores daily in search of the ever-eluding Golden Fleece or greener pastures. Certainly the grass always looks greener next door. Is it not strange that others throng the very land we flee from and become instant millionaires? We are hungry in the midst of plenty and we probably adopt the wrong attitude to life or simply conclude that it is not worth toiling for our dear country. It beats my imagination when after a short plane ride people totally change their attitude to work. The same Ghanaian will now work for several hours without complaining even if it means going to bed on an empty stomach. In a little over a week this ‘economic refugee” suddenly becomes an authority on issues that face his or her country. November 14th is World Diabetes day (WDD) and the disease behaves just like we do and it is referred to as “hunger in the midst of plenty” - because despite the increase in blood sugar (glucose), the cells of the body are unable to access (“eat”) the glucose to produce energy that they need to function optimally from day to day.

I will focus on Type II diabetes (type 2 diabetes), which is one of the many types of diabetes that exist and it may interest you to know that diabetes is a chronic illness so one may often feel perfectly well but the disease will slowly be destroying its victim.

The risk factors for this type of diabetes remain the same as other lifestyle diseases:

• Overweight

• Sedentary life

• > 60 years (start doing routine checks from 40 years even if you are low risk)

• Family history – some relatives with the condition

Our current life-styles have made this disease occur at much younger age groups and people in their teens may have Type II Diabetes.

In Ghana 2.2 million people are known to be suffering from diabetes and by projection a similar number may be suffering from the illness but are either not aware or are not seeking the appropriate medical care. This is the reason the theme for WDD over the past four years has been “Diabetes Education and Promotion” At the current rate that diabetes is spreading, there will be 360 million people in the world with diabetes by 2025.

Preventing or managing diabetes lies in our own hands – exercise often, maintain a healthy weight and eat a healthy balanced meal.

Diabetes management is no longer as harsh as it used to be but MODERATION is key. Even a good thing once it is overdone becomes a negative.

1. Diabetics may eat anything they want but one needs to be reasonable and do everything in moderation. You may have a piece of cake but remember you will need to skip or reduce the carbohydrate content of your next meal or an earlier meal. Your doctor may soon allow you to have some biscuits or even to put sugar in your beverage. Good idea but you will need to play smart. Sugar is “empty calories” so if you want to remain healthy it may be a good idea to opt for other foods that contain nutrients rather than loading your body with sugar. The excess sugar will be converted to fat eventually and this will make control of your diabetes more difficult.

a. Be careful when it comes to fruits; do not overindulge because they contain carbohydrates and the key remains – MODERATION!

b. WATCH products that are labeled as “diabetic”, these can be very deceptive since we tend to think we can consume a lot without consequences. They contain calories or energy and the excess will be stored leaving us with extra weight.

2. Dear friend if you are waiting to urinate several times at night or feel weak or dizzy or get frequent boils before you consider that your blood sugar is high then you may react too late. Diabetes affects virtually every organ in your body and may cause strokes, nerve damage, erectile dysfunction, heart disease, kidney failure and may also lead to amputations. Diabetes can certainly be silent and I have learned over the years that not all silence is golden – hypertension, diabetes, high cholesterol, osteoporosis are a few of the “silent” killers.

3. The new guidelines for diabetes management do not discard the old; a balanced diet is your best bet for good health and blood sugar control. You need all the food groups including fat. Stick to the healthy fats such as salmon and a handful of nuts.

4. It appears the principles of life remain constant – “To those who have, more shall be added” (paraphrased from Mark 4:25). As if having diabetes is not enough to deal with, once you have this disease you are also at an increased risk for hypertension (high blood pressure) and the list will go on and on.

5. I am told a few years ago diabetics were virtually”banned” from getting pregnant. Thank God for his mercies, this is no longer relevant but do discuss with your doctor well ahead of time. You may need to modify your medication.

6. Poor blood flow to the feet of diabetics coupled with nerve damage may mean foot ulcers (sores) do not heal quickly and can easily be infected. To keep it safe, always invest in comfortable shoes and take extreme care when cutting your nails.

7. Checking your fasting blood sugar or random blood sugar is great but do ensure that at least twice a year you request for HbA1c (Haemoglobin A1c), which tells you how well you have controlled your sugar in the long term

a. Have your eyes checked yearly even if you think you can see perfectly well

b. Insist on assessing your kidneys and also your cholesterol

8. My favourite advice is that on exercise; you will need at least 150 minutes of aerobic exercise each week. This includes walking, swimming, cycling and joining a group dance aerobic class. Remember to inspect your feet before and after exercising.

a. Strength training or weight training is extremely important in blood sugar control. Do not avoid this. In addition to increasing strength and agility, strength training improves the effectiveness of insulin and regulates blood sugar.

9. Weight control is extremely important in the prevention and also in the management of diabetes. Exercise and healthy eating habits will help you to manage your weight. If you are overweight, losing weight will reduce your blood sugar. Being underweight is not healthy and you should seek help to reach an appropriate weight.

10. We live in a stressful world? Well, stress increases blood sugar and that is not good news for diabetics. In addition to stress having a direct effect on blood sugar, this evil may lead to poor sleep, poor eating pattern and little or no exercise – setting the stage for poor diabetes control.

Diabetes control and prevention is within everyone’s reach. Fortunately you can now have a reasonable amount of the delicacies you have been craving for and still maintain good blood sugar control. Remember that moderation is key!



Dr. Kojo Cobba Essel

Moms’ Health Club


*Dr Essel is a medical doctor and is ISSA certified in exercise therapy and fitness nutrition.

Thought for the week –Slogan for 2012 Diabetes campaign is”Diabetes: Protect our Future.” We need access to essential education for all. The way we live is putting our life at risk. Do spread the message.


1. International Diabetes Federation Website

2. Webmd.com

3. The Holy Bible; Mark 4:25. Mathew 25:29

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