In the fight against diabetes, a little goes a long way
Fifty-eight year old Zainab Yassin was diagnosed four years ago with diabetes. “I attended one of UNRWA’s health centres for a normal condition, when the nurse said that I had to take some blood tests, including tests for blood sugar levels. I was shocked and I went through a state of denial when she told me that my blood sugar was around 200 mg/dl,” she says. “I was shocked but not surprised, because my mother and two brothers were diabetic and I was aware that I might have this disease, but I used to deny it.”
When Zainab learned that she was diabetic, she went through a series of lab tests to evaluate her condition. “My doctor prescribed the proper medicines for me, and I started the journey to control my condition, knowing that it can never be reversed,” explains Zainab. “I am grateful to the UNRWA health centre staff for following up on my condition and offering me the health education on how to live with it. They taught me about healthy diets and balancing my meals, the importance of physical exercise, and being compliant with taking my prescribed medicines timely as directed.” She adds, “I was lucky to join the diabetes campaign that UNRWA conducted at its health centres for diabetic patients, and I was very lucky to be further educated and to modify my lifestyle practices. This also benefited my family members, as I started to make healthier food for them and to offer them advice.”
Non-communicable diseases, including diabetes, represent an increasing health challenge among Palestine refugees and are the leading cause of death in the region. However, thanks to the generous support of donors like the United States, the UNRWA health programme is able to provide patients like Zainab with advance screening, specialized treatment, and the latest medicines to help them manage their conditions.
Currently, Zainab is controlling her disease. Her latest blood glucose readings are around 100 mg/dl, her most recent HbA1c test result was 6.8, and her weight has gone down. She urges people with normal conditions or who may potentially become diabetic to “attend early check-ups and blood tests, especially if they feel something wrong with their health." She adds, “In addition, they should learn how to eat healthy food, reduce their sugar and carbohydrate intake, and walk. After some time, they will be able to take control of their health status.” Zainab expresses her gratitude to UNRWA and the health centre staff for taking care of her health condition and the health of Palestine refugees. “I have learned that diabetes is like a boat that you ride,” she says. “If you row very well to where you want to go, you will arrive safely; otherwise, you might get drowned.”
Forty-seven-year-old Ayman al-Khatib is another diabetic patient who attends an UNRWA health centre to manage his condition. Ayman was diagnosed with diabetes in 2013 when he visited the health centre after having lost nearly 20 kg in one year and suffering from symptoms that affected his normal life, including continuous fatigue. A blood test for glucose showed that he had very high levels of sugar in his blood – he was shocked to learn that his blood sugar level was 585 mg/dl. In response, the UNRWA health centre offered him health education about his condition, as well as suitable treatments. He recalls: “At that time, I immediately followed a programme prescribed by my doctor, which required that I measure and record my blood sugar test results for 10 days. I had to measure it before and after each meal. The readings were between 285 and 300 mg/dl. My doctor advised me to take insulin, but I strongly refused, and after some discussion, we agreed to make lifestyle modifications instead.” He adds, “I started to walk daily as much as I could and control my diet. I ate more cooked green vegetables and various types of salads, with less carbohydrates and fats. In addition, I took my medicines exactly as prescribed for me. I was able to keep my weight constant and I started to feel my health improve. Most importantly, I could control my blood sugar levels, which have not exceeded 100 mg/dl since then; my latest HbA1c result one week ago was only 6.4.”
Ayman expresses his appreciation to the UNRWA health staff for their help and support in controlling his condition and helping him get back to normal life conditions. As a message to others, he says: “Diabetes is not the end of the world for you, but ignorance about your health might lead to the end of your normal life. Just a little control of your diet, doing physical exercise such as walking, no stress, no smoking, and enjoying your life will make you feel happy all the time and will be a strong barrier against diabetes.”
 Standard values for fasting blood sugar are, for normal levels, 100 mg/dl or less; for pre-diabetic levels between 101 and 125; and for diabetic patients 126 and higher. For the HbA1c test, normal values are below 6, pre-diabetic levels are between 6 and 6.4, and diabetic levels are 6.5 and higher. For controlled diabetic patients, the HbA1c results should be below 7.
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