Mr. Moh’d Jaradat, Idna, July 2011
70 year old, Mr. Moh’d Jaradat, lives in the village of Idna, near Hebron, with his wife, five daughters and two sons. He has a history of diabetes mellitus stretching back 17 years.
Overweight and a smoker, when Mr. Jaradat first presented at our Outreach Clinic in Idna, it was no surprise to our team that the septuagenarian was complaining of poor eyesight!
However, Mr. Jaradat came to us despite having been seen at the PA’s Alia Hospital in Hebron. Although he had undergone laser treatment several times there, he complained that his eyesight was continuing to deteriorate. Indeed, it had now become so poor that it was affecting his ability to carry out basic, daily activities.
It was also discovered that Mr. Jaradat had suffered from high blood pressure for seven years.
Upon examination, Mr. Jaradat was found to have raised intraocular pressure in his left eye, with severe diabetic retinopathy in both eyes. His Hba1c test result showed 11%. This test indicates the amount of glucose that is being carried by the red blood cells in the body. In order to minimise the risk of developing diabetic complications – such as eye disease – the HbA1c target rate is below 6.5%.
In the oPt, there is a real lack of professional leadership in acknowledging and understanding the import of diabetes and diabetic retinopathy. The St John Eye Hospital Group has been aware of this for some time and has already begun to address this blight on Palestinian health. In partnership with UNRWA (United Nations Relief and Works Agency for Palestine Refugees) and WDF (World Diabetes Foundation), we are about to initiate the first screening programme for retinopathy in the West Bank. This is why it was so important – and fortuitous – that Mr. Jaradat did think to come to our Outreach Clinic for a second opinion.
Our Doctor warned Mr. Jaradat that his eyes were in such bad condition because he was making no attempt to control his blood sugar levels and blood pressure. We informed him that, in order to prevent further deterioration of his sight, as well as needing urgent, intensive laser therapy and a referral to our Jerusalem Hospital, he would also need to start trying to look after his own health!
As it is the world over, diabetes is on the rise in the West Bank – yet most cases are preventable with a few healthy lifestyle changes. The reality is that we have more control over our health than we think. A shrewd nutrition regime, keeping weight in check and taking a little exercise can all make a really big difference!
Here are a few basic tips that Mr. Jaradat might use to prevent his eyesight deteriorating further:
- Eat a healthy diet:
A diet rich in fruits, vegetables, whole grains, and low-fat dairy products, and low in refined carbohydrates and sugary drinks, will help reduce blood sugar levels and lower blood pressure.
- Establish regular eating habits:
Regular eating habits are especially important for diabetics. The body is better able to regulate blood sugar levels—and weight—when a regular meal schedule is maintained. Aim for moderate and consistent portion sizes for each meal or snack.
- Maintain a healthy weight:
Being overweight is especially harmful for diabetes sufferers as excess body fat makes the body more resistant to insulin. In addition, people with diabetes are more likely to develop heart disease, so it is even more important to work towards a healthy weight.
Being overweight also adds to the risk of high blood pressure.
- Exercise every day:
Moderate exercise can help control your weight and lower your blood sugar level.
- Don’t smoke.
Smoking, too, makes the body more resistant to insulin. Insulin resistance often leads to the development of diabetes.
Smoking amongst those already suffering from diabetes increases the risk of complications, including heart disease, stroke and circulation problems. It also damages blood vessels and, in this respect, there are direct links between smoking and diabetic retinopathy!
In the oPt, the prevalence of diabetes mellitus already stands at between 12 to 15% of the population. (State of Palestine, Ministry of Health statistics) This is three times higher than in the West and makes it one of the most prevalent non-communicable diseases in the region.
Diabetic retinopathy affects up to 80% of all patients who have had diabetes for ten years or more and our 2008 epidemiology study confirmed that diabetic retinopathy was the third largest cause of blindness in the West Bank (8% of all cases) and the second largest cause of severe visual impairment (14% of cases).(Chiang, F. et. al., 2010).
It is doubly important that West Bank citizen, Mr. Jaradat – and thousands like him – take steps to control his own health as well as relying on health services. Sadly, in the oPt, these are not always the best available.
- Case Studies
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