Dr. Muhammad Mahtab Hossain Mazed

Thursday is World Diabetes Day 2024. World Diabetes Day is celebrated every year on November 14 in our country like other countries of the world. The theme of this year's World Diabetes Day is 'Diabetes: Good health is our commitment' which means to raise awareness about diabetes and various aspects of health like physical, mental and social well-beingIn 1991, the World Diabetes Federation and the World Health Organization declared this day as Diabetes Day. There is no denying that diabetes is affecting the lives of millions of people worldwide. Obesity, blindness, heart disease and kidney disease have almost doubled over the last decade. Diabetes has many complications.

> Reasons for celebrating World Diabetes Day on November 14:-Frederick Banting was born on this day, who along with his colleague Charles Belt discovered insulin, the master drug to control diabetes in the laboratory of Prof. McKidd. The aim and objective of observing this day is to increase public awareness about the symptoms, treatment and control of diabetes. Around 500 million people in the world are affected by diabetes. Of these, 79 percent live in low- and middle-income countries. 1.5 million people die of this disease every year. Most people do not know that he has diabetes. About 100,000 people die of this disease every year. 70 percent of deaths in the country are due to non-communicable diseases like diabetes, high blood pressure, heart disease, chronic respiratory diseases or cancer. Only 10 percent of people die of diabetes. The epidemic of the disease is going onOn the other hand, according to the information of the International Diabetes Federation (IDF), about 1 crore 31 lakh people are suffering from diabetes in the country. 14.2 percent of people aged 20 to 80 are suffering from this disease. Bangladesh ranks eighth in the world in terms of the number of people suffering from diabetes. If the current trend continues, the number of people suffering from diabetes in the country will be 2 crore 23 lakh in 2045. Then the position in the world will be seventh. The number of diabetes patients is increasing at a high rate in Bangladesh, India and China.

> Aims and objectives are: - To increase public awareness about the symptoms, treatment and control of diabetes. According to a statistic of the World Health Organization, the number of diabetes patients in the world was about 30 million in 1985, and now it stands at 37 million. Diabetes patients are increasing all over the world. 1 in 10 women have diabetes. From this year's theme, it is clear that women's diabetes has been specially emphasizedAccording to experienced doctors, as diabetes is increasing due to urbanization and changing lifestyle, the number of gestational diabetes is also increasing day by day. Studies show that more than half of women with gestational diabetes later develop type-2 diabetes. Even an unplanned pregnancy causes the child to become malnourished, and if the child becomes overweight as an adult, the risk of developing diabetes is manifold.

Why is it happening, what is the risk: I think two things have created a big risk in diabetes in Bangladesh, one is that most of the young people are getting diabetes. This is not the case in most countries of the world. Type-2 diabetes usually occurs in older people. But we have 7, 10 and 12 year olds here, that is younger.

> How diabetes was born:- No one can say exactly how diabetes was born. However, the history of diabetes is ancient. The first concept of diabetes was found in 1862 in a pyramid in the ancient city of Thebes in Egypt, a disease report was discovered on the bark of the Parippus tree dated 1550 BC. On July 27, 1921, insulin was discovered. In this disease report, the first mention of diabetes can be foundThe concept of diabetes was discovered by Hippocrates of ancient Greece, the father of medical science. At that time, it was called zia beted, which means the release of sugar. Millions of billions of cells are working every moment in our body. This task requires energy to be completed properly. Carbohydrates are the largest source of energy. These include rice, pulses, potatoes, vegetables, wheat, maize etc. After complex reactions, they become simple molecules suitable for our body's cells. This simple molecule is glucose. Glucose molecules are taken up by body cells to produce energy through chemical reactions. This energy keeps the body moving.
But a hormone is needed for glucose to enter cells. Its name is insulin. Our body cells have a channel through which glucose enters the body. Normally the channel is closed. We can compare the whole matter as follows. Suppose a room in a house is a body cell. And the door of the house is the channel of insulin entry. Normally, just like we close and lock the door of the house for security, the glucose channel is also locked i.e. closed. Just like a key is needed to open a lock, so is a key to open glucose channels. The name of this key is insulin. Without insulin, glucose cannot enter cells. As a result, the cells will not produce energy. And cells can't do their job properly if they don't get energy. But there is an endless supply of glucose in the blood. But the cells have to be starved. When the blood glucose level increases, the frequency and concentration of urination increasesThis overall condition is known as diabetes mellitus or diabetes for short. Another name for this disease is polyuria for frequent urination. There is another similar disease called diabetes insipidus, where the patient also urinates frequently. But the disease we know around us as diabetes is diabetes mellitus.) Normal healthy human blood contains 5.6 to 6.1 millimoles of glucose per liter in fasting state. It increases two hours after taking food.

> Types:
We return to the previous example. Suppose your house is locked. Now think, under what circumstances you can't enter the house? First, if you don't have the key. And secondly, if the lock doesn't work despite having the key. Also diabetes can be due to some other reasons. Maternal diabetes is particularly important among them. It is called in English. Pregnant women require more insulin than normal. Because insulin is engaged in several other functions in the human body. Now if the mother's body is unable to produce enough insulin, then the glucose will naturally increase in the body. Some hormones are also from the placenta of pregnant women is secreted which is responsible for maternal diabetes. These women do not have diabetes after childbirth. In addition, genetic reasons can cause diabetes. People with autism or Klinefelter syndrome are more likely to suffer from diabetes. Diabetes can also be caused by problems with the pancreas; For example, if there is cancer or infection in the pancreas, it can lead to diabetes. Hormonal problems can also cause diabetes. Cushing's syndrome or acromegaly, which is caused by hormones secreted by the thyroid gland, has implications for diabetes. Some medications can also cause diabetes. For example, medications such as glucocorticoids, thiazides or phenytoin may play a role in causing diabetes. Infections with cytomegalovirus, congenital rubella virus, or coxsackieviruses can cause diabetes.

> Symptoms of diabetes:
Frequent urination is the most common problem faced by diabetic patients. As a result, the fluid in the body decreases and thirst for more water. On the other hand, a condition of 'cellular starvation' is created in the body of people suffering from diabetes. As a result, the body sends a message to the brain that it is hungry. This is why diabetic patients are always hungry. They lose weight despite eating a lot. Tiredness surrounds you all the time. If a wound forms anywhere, it does not want to heal easily. Attacks of various skin diseases increase. Sexual ability gradually decreases in people with diabetes.

> Diabetic Diet Chart and Food List:- Every diabetic diet will be different. Age, weight and height, type of work, amount of manual labor, lifestyle, financial status are all taken into consideration in this list. If you have diabetes, you should not eat everything. However, you have to be careful and disciplined in choosing food. To avoid repetition and boredom, you should also try to have variety instead of eating the same food every day. Like any other normal person, a diabetic patient will consume all the food components i.e. Carbohydrates, Meat, Fats, Minerals, Vitamins etc. The first thing to do when diagnosed with diabetes is to avoid all foods containing white sugar. Sugars are also present in other foods, so there is no harm in cutting sugar outright. And for proper eating habits, only calories, type of sugar, meat, vegetables and oil-fat should be taken care ofSugary foods are harmful for diabetics because they increase blood glucose levels, so sugary foods should be reduced in the diet. Some sugary foods that raise blood glucose levels quickly, such as sugar, sweets, over-refined rice, flour bread, should be eaten less.
Foods like red rice (with bran), wheat flour bread (with bran), vegetables, nuts, butter and kale raise blood glucose levels slowly, so these foods should be eaten more. However, you must keep a count of calories. For diabetics, 20% of total calories should come from meat, 30% should come from fat, and 50% should come from carbohydrates.

Here is a sample diet chart or food menu of 1600 kcal requirement for a diabetic patient. Let's take a closer look at the diabetic diet chart and food list.

> Diabetic diet chart

Breakfast (7.30 am - 8 am)
Bread (1 serving) 1 wheat flour loaf (medium)
Milk (1 serving) 1 glass fat-free milk or skim milk
Eggs (1 serving) 1 chicken or duck egg (boiled or poached)
Vegetables (1 serving) 1 cup leafy greens or 1/2 cup vegetables

Lunch (1.30pm - 2pm)
Rice (3 servings) One and a half cups of rice
Fish or meat (2 servings) 60 grams of cooked fish or meat (without fat)
Vegetables (4 servings) 1 cup leafy greens, of course, the remaining 1.5 cups other vegetables.
Dal (1 serving) 1 cup medium thick lentils

Afternoon Snack (5.30pm - 6pm)
Seasonal Fruit (1 serving) 1 serving seasonal fruit of your choice
Nuts, Nuts and Nuts (1 serving) 1/4 cup Nuts or Nuts or Nuts

Dinner (9 pm - 9.30 pm)
Bread or rice (1 serving) 1/2 cup rice or 1 flour bread
Fish or meat (2 servings) 60 grams of cooked fish or meat (without fat)
Vegetables (2 servings) 1 cup of leafy greens, of course, the remaining 1/2 cup of other vegetables
Seasonal fruit (1 serving) 1 serving of seasonal fruit.

> Homeopathy:- The patient is treated, not the disease. For this, if the experienced homeopath can select the complete symptoms of the patient and give the metal treatment, then by the grace of God, homeopathic treatment of diabetes is possible. Initially, all the medicines that are selected by experienced doctors are Abroma Augusta, Cephalanda Indica, Cygium, Acid Phos, Arsenic Bromide, Acid Lactic, Uranium Nitre, Nux Introduct, Acid Acetic, Calcarea Phos and many other medicines can come on the symptoms so without an experienced doctor. Diseases if you use medicine yourselfCan reach more complex forms.Finally, weight is a very important issue for diabetic patients. If the weight is high, it must be reduced through diet and exercise. Avoid sugary and sweet foods. Foods containing fiber should be included in the diet. It is best to follow a diet plan. If a person is taking insulin or other medications regularly, meals should be taken regularly. Because if you skip a meal, its reaction can be severe. If you live a healthy and regular life, diabetes can be controlled. Today, diabetes has taken a terrible shape. For this reason, it is essential to spread awareness among all. Because awareness can keep us away from this horror.

The writer is a, Founder and Chairman, Jatiya Rogi Kallyan Society Columnist and researcher