In the past years the burden of health in Kenya has been from communicable diseases which were mostly affecting the under five children. This is a battle we are yet to win in eradicating some of these communicable and non-communicable diseases as we look forward to achieving the millennium development goals vision 2030.
In the recent years the public health problem has shifted to non-communicable diseases (NCDs), also known as chronic diseases that include lifestyle diseases such as obesity, diabetes, hypertension, cardiovascular problems, drug and substance abuse among others. Of all the major threats to emerge none has challenged the very foundations of public health as profoundly as the rise of non-communicable diseases. Heart disease, cancer, diabetes, hypertension and chronic respiratory diseases such as asthma, unfortunately today being a global problem with women being the most venerable.
The rise of non-communicable diseases in Kenya and throughout the world poses a threat to the human health and a drain to the economy. NCDs such as cancers, diabetes and others account for 27 per cent of the total deaths and over 50 per cent of total hospital admissions in Kenya. This has warranted new approaches for prevention, diagnosis, treatment and cure of such afflictions.
It is a metabolic disease that causes high blood sugar. With diabetes, your body either doesn’t make enough insulin or can’t effectively use the insulin it does make.
- Type 1 diabetes is an autoimmune disease. The immune system attacks and destroys cells in the pancreas, where insulin is made. It’s unclear what causes this attack. About 10 percent of people with diabetes have this type.
- Type 2 diabetes occurs when your body becomes resistant to insulin, and sugar builds up in your blood.
- Gestational diabetes occurs during pregnancy whereby the blood glucose levels rise above the normal and it is diagnosed through prenatal screening rather than through reported symptoms.
The normal blood glucose level is:
Between 4.0 to 5.4 mmol/L (72 to 99 mg/dL) when fasting
Up to 7.8 mmol/L (140 mg/dL) 2 hours after eating
The general symptoms of diabetes include:
- Increased hunger
- Increased thirst
- Weight loss
- Frequent urination
- Blurry vision
- Extreme fatigue
- Sores that don’t heal
Treatment of diabetes involves diet and physical activity along with lowering of blood glucose and the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications.
- Blood glucose control, particularly in type 1 diabetes. People with type 1 diabetes require insulin, people with type 2 diabetes can be treated with oral medication, but may also require insulin.
- blood pressure control; and
- Foot care (patient self-care by maintaining foot hygiene; wearing appropriate footwear; seeking professional care for ulcer management; and regular examination of feet by health professionals).
- High blood sugar damages organs and tissues throughout your body. The higher your blood sugar is and the longer you live with it, the greater your risk for complications.
Complications associated with diabetes include:
- heart disease, heart attack, and stroke
- neuropathy which is nerve damage
- nephropathy which is kidney damage
- retinopathy and vision loss which is damage the eyes
Hypertension is when blood pressure is too high.
Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days is ≥140 mmHg and/or the diastolic blood pressure readings on both days is ≥90 mmHg.
What are the risk factors for hypertension?
Risk factors include:
- Unhealthy diets (excessive salt consumption, a diet high in saturated fat
- Physical inactivity
- Consumption of alcohol and tobacco
- Being overweight and obese
- Family history of hypertension
- Age over 65 years
- Coexisting diseases such as diabetes or kidney disease
What are the common symptoms of hypertension?
Hypertension is called a “silent killer”. Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms. For this reason, it is essential that blood pressure is measured regularly.
When symptoms do occur, they can include:
- Early morning headaches
- Irregular heart rhythms
- Nose bleeding
- Vision changes
- Chest pain
What are the complications of uncontrolled hypertension?
- Chest pains called angina
- Heart attack
- Heart failure
- Kidney failure
- Reducing salt intake
- Avoiding use of tobacco
- Reducing alcohol consumption
- Limiting foods high in saturated fats
- Being physically active on regular basis
- Reducing and managing stress
- Regularly checking blood pressure
- Treating high blood pressure
- Managing other medical conditions
Cardiovascular diseases are the leading causes of death globally. They are a group of disorders of the heart and the blood vessels. They include:
- Coronary heart disease – a disease of the blood vessels supplying the heart muscle;
- Cerebrovascular disease – a disease of the blood vessels supplying the brain;
- Peripheral arterial disease – a disease of blood vessels supplying the arms and legs;
- Rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
- Congenital heart disease – birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth; and
- Deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.
Heart attack and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain.
What are the risk factors for cardiovascular diseases?
- Unhealthy diet
- Tobacco use
- Physical inactivity
- Harmful use of alcohol
What are common symptoms of cardiovascular diseases?
- Pain or discomfort in the center of the chest; and/or
- Pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.
- Severe headache with no known cause; and/or
- Fainting or unconsciousness.
MANAGEMENT and TREATMENT OF CARIDIOVASCULAR DISEASES
These may include:
- Treatment and management of underlying conditions such as hypertension.
- Sometimes, surgical operations are required to treat CVDs.
- Management of lifestyle.
- Medical devices are required to treat some CVDs. Such devices include pacemakers, prosthetic valves, and patches for closing holes in the heart.
In a nut shell the general prevention of non-communicable diseases is lifestyle modification and embracing frequent medical checkups for early diagnosis and treatment. Strict adherence to medications to prevent complications that are related to these diseases.