News

World Diabetes Day falls on Nov 14, and I see the usual health advice, statistics and research data being circulated once again. A far more unpleasant discussion revolves around the horrible effects that are seen when such advice is ignored. It is time for society to have a heart-to-heart conversation instead. Kidney disease, or any other organ damage caused by diabetes, does not happen overnight. It is a slow process that takes years. Diabetes develops initially, and then causes damage to the organs. Eventually, kidney failure occurs, and the patient requires life support such as dialysis. Sadly, many patients have no clear idea what dialysis is all about. Some even think kidney failure is reversible. Diabetes and kidney failure are often the result of repeatedly making bad choices – dietary indiscretion, unhealthy lifestyles, addictions such as smoking, and non-compliance with medical advice. The results ultimately burden the individuals, families and the healthcare system. It is a heart-wrenching task to break the news of kidney failure to patients, as they and their family members reel in shock from what seems like a surreal, impending death sentence. Denial and dejection usually follow for many. A vicious circle can develop over the years – of changing care plans, further non-compliance with medical advice, visits to emergency rooms, financial stress, family trauma and periods of self-care with expectations of miracles. As a physician, this is something I do not wish on my worst enemies. Yet it happens in our very own communities. When a patient finally realises that the end is near, agony and frustration descend. They realise the missed opportunities of routine check-ups, weekly exercise, choosing less sugar or salt, eating in moderation and following medical advice. There is a desperate wish to somehow reverse time. Which brings us to the uncomfortable question: Was it worth it? Medical Director National Kidney Foundation