 Diabetes is one of the chronic diseases that has seen a number of those affected rapidly rising over the years is what we are curious to learn about today as I walk down the hospital corridors am at peace knowing that at least I've tested negative for this disease. The doctor here walks us down the reality of diabetes. I'm Dr. Soko Bonfas. I'm a medical officer in charge of the Equity Affair and Aeroboest branch. Today, currently I'm practicing as a general practitioner, which means I'm not specialized into being a specialist, but then I've done a certificate from the Lobalinda University, which is a management of lifestyle diseases, why we are here today. Diabetes in the simplest format is uncontrolled blood sugar levels in your body, which can be caused by so many factors. So in a nutshell is when the body is not able to control your sugar levels. So that's what we call diabetes. First of all, generally when we talk about diabetes there are two types of diabetes, that is type 1 diabetes and type 2 diabetes. We call them other forms of diabetes, but then the conversation normally narrows in type 1 and type 2 diabetes, which will come to focus on. So there is type 3, which we call gestational diabetes. We have what you call maturity onset or modi diabetes, but I'm not going into those details. So our attention is type 1 and type 2 diabetes, where type 1 diabetes is where you have little or you don't have insulin, and we'll have a conversation what maybe that means. Where type 2 diabetes is then a situation in which you have insulin, but it's not working for you. So we call it insulin resistance diabetes. So type 1 normally comes early on an age, while type 2 comes late in age when we advance in age for so many reasons, because you have no more insulin, you are born with insulin, but then your body becomes resistant. If you have believed that diabetes is an old people or a rich people disease, you are far from the truth. It has no favourites, anyone can be affected if care is not taken. Ya, so there is that misinoma that you have diabetes that is of the old people or the rich people, but that is not the reality. Actually as we speak, we have youth, when I talk about youth I mean 20 to 30, depends on how we look at it. We have seen those cases of young people who have developed diabetes, specifically the younger generation and I know as we are talking here today, most youth will be listening to us, we will say diabetes is a topic of the old people. We are saying 1 in 10 people globally are suffering from diabetes, they are the people, that is the statistics. But then the same statistic as the international federation of diabetes mentioned that we are seeing the youth generation rising to 2 in 10. So yes we are saying this is of the old people, but then the younger generation is catching up quite fast. So then the other conversation is in regards to Kenya, Kenya has been ranked actually the other time I saw 31st in Africa, then the same statistics ranked Kenya mentioning that the rate is increasing as we increase what you call metabolic syndrome, which we will not discuss today, which is related to obesity, weight and other concerns, which I have really increased this incidence of diabetes. So yes age has been the major factors traditionally, but we are seeing other factors like diet among other factors that also affect the youth coming into play, leading to diabetes becoming a pandemic across the age group. That's the reality whereby we are saying children can be born with diabetes and the majority of the cases up to actually more than 90% it's type 1 diabetes. So we call it type 1 diabetes because a child is born and they start using insulin. So basically it means you have your baby in their even first day of life, second day of life, third day of life, they start receiving medication to control their sugars so they get injections. There is currently no auto medications for insulin so they get injections for life and they can live a long life so that is the type 1 diabetes. And like the type 2 which comes in advanced age where your insulin that you had no more starts to get what you call resistance. And that's why I am here to focus how can the youth avoid that because we will be seeing shortly how you are born normally at 30 years you are okay. Then at 36 years when now you have started earning your salary then you develop diabetes. Why is that happening? Yet you are born without diabetes. We look at the major risk factors for diabetes. Of course the first one in the list is age and it's good even the youth should be able to know that we are also advancing in age. The other risk is genetics so genetic exposure can lead to either form of diabetes. The burden of the disease is not to be taken lightly. Think of the numbers around Africa and in Kenya are increasing especially among the youths. One in ten people worldwide especially the adult population are suffering from diabetes. And the latest research shows that 90% of those are suffering from type 2 diabetes. And type 2 diabetes means they were not born with direct diabetes but they accumulated diabetes in their teenage, in their youth, in their adult. So that is why we need to converse on this particular topic. So even in Kenya if you narrow down the statistics to Kenya is that 4.6% of Kenyans are suffering from diabetes. That means you have 100 people, 5 are suffering from diabetes. And Kenya is really being ranked on top when it comes to diabetic prevalence or the number of cases of diabetes in the world. What is very important is to prevent yourself from getting diabetes through adapting right lifestyle. A key step everyone should take is going to test for diabetes. The test takes less than 5 minutes and is painless. Early detection saves life when we talk about cancer. A similar story applies when we talk about diabetes and even any other lifestyle disease. Because when we talk about early detection basically it means we are able to pick it before complications. As I started by mentioning what triggers or what are the risks for diabetes we realize most of those risks are modifiable. That you can modify them in your family. As a youth when you are married you can modify with your family. As an adult wherever you stay you can modify those risks. So why we are conversing about this is that largely the risks for diabetes majority of them apart from age and genetics are modifiable. So in management we apply the same principle. So in management of diabetes we cannot take your diabetes as I mentioned but then we can reverse the risks. We can manage the risks to an extent that the levels of your sugars can go back to pre-diabetic range. So that means if you are diabetes you are taking your drugs if we can work on your risks then we can be able to modify all of them. Let me give you an example. So when I manage diabetes patient today the first thing is we do risk assessment. We look at what predispose to you to develop diabetes. If it's a family history, genetics then we say you cannot do much to that factor. If it's another factor is when we talk about age you cannot change your age Stephanie. But now we look at the other top risks apart from those two. And if it's alcohol intake maybe it's youth who was taking alcohol and they are now 40 and they have diabetes we start to modify that risk. If it's cigarette smoking we modify that risk. If it's lack of exercise we advise them to exercise routinely on a daily basis for 30 minutes daily or 250 minutes in a week. If the issue is stress then we request them or we advise them to manage their stress levels so that they can be able to prevent diabetes. They don't sleep because sleep is also a factor. So we advise them to sleep for more hours so that the body can undergo metabolism so that the sugars are controlled. If the issue is let's say a simple factor is water intake. Stephanie the people don't drink water in Nairobi and you cannot manage your sugars when you are dehydrating. So we advise them to take water routinely 8 glasses a day. And I will tell you as a doctor there are people who have put in those modalities of lifestyle modifications to an extent they stop taking diabetic drugs. If we detect it in early stages we can modify majority of the risks that they can live even drug free. But the most important thing is that early detection so that we can modify those risks before they get into a zone where you cannot modify any of those risks. But above being all that drug compliance is very important. That on a routine basis you have to go to a doctor, they evaluate the drugs you are using to see whether they are working so that if the drugs are under those we add more drugs. And by chance there are people who are taking drugs and their sugars have already been controlled by risk modifications. Then we can eliminate the drugs and advise them to observe strict compliance of the protocol that is on lifestyle protocol. The challenge with that number one is false hope. Most of these you realize Stephanie and control there is no science that you can be able to describe and say this particular supplement has been approved that it can bring back your sugar levels down. Because diabetes is a complex scientific disease. So most of these supplements that are being sold in the dark market is that you are given, you put all your hopes in that supplement and some of them are not bad. They are good nutritional supplements but the challenge is that too much emphasis that you can take this moringa and you will be okay, your diabetes will disappear, your cancer will disappear. That is the challenge with those supplements. So my advice is that when you get those prescriptions, go to the nearest health care worker, they give you the advice so that is how you can actually blend alternative treatment and the conventional treatment. With WHO predicting that the prevalence of diabetes in Kenya will rise to 4.5% by 2025 from the current 3.3%. With therefore odd to exercise caution, prevention is better than cure. Stephanie Ayata for Health Machinani.