World Diabetes Day

There are 240 million diabetics world-wide. In many developing countries, diabetes can be a death sentence. Access to insulin or medical advice is often rare. Nov. 14 is UN World Diabetes Day. Across the world, campaigners are calling for an end to the disease. But many diabetics haven't heard about the campaign. For instance in Pakistan.

11-year-old Saif Mushtaq lives in a remote village in North Pakistan and suffers from Type 1 diabetes. He said that in the early stages he had to go to the toilet the whole time, was constantly thirsty and had no appetite.

There is not much access to insulin or medical care in Saif’s village. There are diabetes specialists in Pakistan, but they are very costly. In Pakistan's northern earthquake-prone mountainous regions, parents often have to let their diabetic children die.

World-wide, diabetes kills one person every ten seconds. And in Pakistan, a diabetic dies every few minutes.

Type 2 diabetes

Most of the world's 240 million diabetics have Type 2. This form of diabetes usually begins with insulin resistance -- a condition in which fat, muscle, and liver cells do not use insulin properly. People who are overweight and inactive are more likely to develop Type 2 diabetes.

"It is spreading like wildfire throughout the whole world. It has taken on epidemic proportions in Pakistan, India, Bangladesh, China and Japan. Therefore, we need specialists like me to explain to the patients its danger and also, how to control the dangers the subsequent damage should the disease occur," said Dr Arif Ryiaz, a diabetes specialist based in Lahore.

But 10 percent of the world’s diabetics suffer from Type 1 diabetes, like Saif. This form develops when the pancreas gland does not produce enough insulin. Type 1 diabetics need insulin to survive.

Information and drugs

According to the UN, the most important part of the therapy is informing the patients as well as their relatives about the disease, followed by the distribution of the appropriate drugs. In Pakistan, every diabetic is legally entitled to free insulin. But in reality, patients in Baluchistan’s deserts and in the Himalayan villages are still dying of the lack of insulin.

Dr Ryiaz explained: "Insulin must be stored at between 2 and 8 degrees centigrade. This isn't possible in these small villages. Patients therefore have to travel long distances to get hold of good insulin from specialist shops."

One 10 millilitre ampoule is enough to last 15 days and costs 700 rupees," the doctor continued. "The doctor should simply advise the patient to buy two ampoules instead of one, and thus there will be no lack of insulin supply."

But for many, the costs are far too high. Saif Mushtaq's father is a day labourer -- he is lucky if he works ten days a month. Saif's treatment would cost a third of his monthly wages.

The state-provided insulin only suffices only for three injections a week -- not enough, complained Saif's mother who works as a cleaner.

Hopeful future

However, Saif struck lucky when his teacher at the village's Christian "Miracle School" noticed how weak he was and arranged for him to see a specialist, after raising some funds.

He said that without insulin, Saif would die within two years. Although he said he couldn't provide him with free insulin, he offered to give Saif’s family free medical advice.

Saif is still weak but he is optimistic about the future: "I want to be a doctor when I grow up, and live in Pakistan because I love my country," he said.

According to the UN’s estimation, there will be 350 million diabetics in only ten years world-wide.