Diabetes in Mauritius

What is diabetes?

Diabetes is a disorder of metabolism—the way the body uses digested food for growth and energy. Most of the food people eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.  After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When people eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

What are the types of diabetes?

The three main types of diabetes are

• type 1 diabetes
• type 2 diabetes
• gestational diabetes

Type 1 diabetes

Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection—the immune system—turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes, must take insulin daily to live.

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Type 2 Diabetes

  The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.

 The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms.

Gestational Diabetes

 Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.

Diabetes is a major concern in the health sector of Mauritius. The government spends about 93 million rupees annually for the treatment of diabetes and its complications.

 In the population group of 25 years and over, 12.7% (i.e. 52,000 individuals) have diabetes and a further 17.5% (or 83,000 individuals) have impaired glucose tolerance, whereas in the population group of 45 years and over, 23% (or 42,000 individuals) have diabetes and a further 22% (or 40,000 individuals) have impaired glucose tolerance.

Thus amongst Mauritian adults aged 45 years and over, approximately 1 in 2 people have diabetes, or have a high risk of developing it. 

Age specific prevalence of diabetes according to gender

Source: Central Statistical Office

The chart above shows the prevalence of diabetes in 2009 in the Mauritian population. It has been noted that the prevalence of diabetes increases with age for both men and women. The prevalence of diabetes has increased by over 60% since 1987 in Mauritian population aged 25-74 years. Among those people known to have diabetes, control of their diabetes as judged by  blood glucose levels was poor (47% had HbA1c  9.0%), indicating very high risk of developing diabetic complications. There are an estimated 172,400 people between the ages of 25 and 74 years with diabetes in Mauritius. For every known case of diabetes, there was one newly diagnosed case.

Complications due to diabetes

• Renal failure
• Cardiovascular diseases
• Amputations
• Eyesight problems

Currently out of 800 patients who are undergoing dialysis, 60% are diabetics. Every year about 400 amputations are practiced and out of these 80% are diabetics. Concening eyesight problems, about 1500 diabetic patients follow treatment the Moka eye hospital. 

 Causes of Diabetes in Mauritius

• Unhealthy eating habits
• sedentary lifestyle
• Heredity factors
• Obesity

Prevention

• Education and sensitization at childhood
• A balanced diet and changes in eating habits
• Physical activities and yoga exercises