The Minister for Education, Dr. Matthew Opoku Prempeh has been awarded at Ninth Edition of The West African Regional Magazine (TWARM) Achievers Business and Leadership Awards 2020. Dr. Prempeh was given the Transformation Leadership in the Education Sector Award. READ ALSO: https://www.thinknewsonline.com/post/breaking-news-caf-president-ahmad-ahmad-banned-for-5-years-for-financial-misconduct The event took place at the Marriott Hotel in Accra over the weekend. A citation accompanying the award read, "This is recognition of your laudable performance in the Education Sector of Ghana, especially in the implementation of Free Senior High School education in the country, which has enabled more students to gain access to Senior High School education". READ ALSO: https://www.thinknewsonline.com/post/watch-sarkodie-kuami-eugene-jam-to-happy-day-at-233-bar-videos Announcing the Minister as the recipient of the Award, Ms. Rossette Aliu, Publisher of the West African Regional Magazine stated that the aim of the Awards was primarily to celebrate inspiring individuals on the African continent. She said it was also to motivate the collective African citizenry to follow in their footsteps. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo Ms. Aliu commended the Hon Minister for his achievements since his appointment to date. Story by: Joshua Kwabena Smith

"One of the great crimes of the industrialized world is never to think in terms of what is appropriate for the Third world. And one of the great crimes of some of the Third world is not to think through their problems, but to slowly copy the United States" Sometime in July, Ghanaian Journalist of International repute, Elizabeth Ohene authored an intriguing article which touched on the western media's narrative of the African continent, a narrative which ultimately informs their reportage of issues on the continent. that piece caught my attention. the headline of my article is culled from her article's headline, which read, 'how to report Africa'. I have only taken out Africa and replaced it with America. According to madam Ohene, she chanced upon an advertisement put out by the New York times sometime last year to find someone to occupy the position of their Nairobi Bureau chief. the criteria for the Job and relevant part of the advertisement as far as this article is concerned reads "... it (Africa), Is an enormous patch of vibrant, intense and strategically important territory with many vital storylines, including terrorism, the scramble for resources, the global contest with China and the constant push-and-pull of democracy versus authoritarianism. the ideal candidate should enjoy jumping on news, be willing to cover conflict, and also be drawn to investigative stories. READ ALSO: https://www.thinknewsonline.com/post/watch-sarkodie-kuami-eugene-jam-to-happy-day-at-233-bar-videos There is also the chance to delight our readers with unexpected stories of hope and the changing rhythms of life in a rapidly evolving region ". Oh really? So incredulous was the advertisement so much so that according to the respected Journalist she had to double-check to ascertain its authenticity. She posed the question, 'was this really what the New York times, in 2019 though of Africa? From deserts of Sudan to the pirate seas of the horn of Africa, down through the forests of the Congo to the shores of Tanzania ". Oh yes! that is how low western media houses perceive us! As the world watches with utter incredulity and bewilderment the happenings playing out in the United States in the wake of the now disputed elections in that country. One begins to appreciate how unfair the west has been to Africa when it comes to the practice of democracy. Spectacles like the one we are witnessing in America presently were until recently only reserved for us in the so-called third world. and that spiteful advert put out by the New York times gives sufficient expression to that mindset. For much of the twentieth century, the West led by America made a fetish of democracy, and in a one size fits approach sought to sell it wholesale to the larger world. Turning itself into something of a headmaster, with the right to punish countries that in its estimation fell short of the tenets of democracy. So convinced was the west of the potency of Liberal democracy that one of it's leading ideological lights, Francis Fukuyama famously wrote a book titled "The End of history and the last man standing", which extolled the virtues of Liberal democracy, with its an attendant feature of free enterprise. Fukuyama audaciously proclaimed that liberal democracy had triumphed over all others and that the quest for a viable ideology to guide humanity had ended. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo emboldened by such treatise, America virtually arrogated to itself the power to impose liberal democracy on the rest of the world without inhibition In complete disregard for the unique circumstances of especially African countries, multi-party democracy with its divisive tendencies became a precondition for advancing aid to third world countries. Countries that refused to play ball paid a heavy price, as evidenced in little Grenada where the Reagan administration sent in special forces into the country to impose democracy on the island nation, in complete violation of the country's territorial integrity. The west made it a point to constantly send in election observers whenever elections came up in Africa.the verdict of these observers as far as these elections were concerned virtually gave or deprived the polls of their legitimacy. African governments craved the endorsement of these observers. The first signs that America's invincibility as far as the organization of credible elections were concerned, had been broken were firmly registered during the 2000 elections between then Vice-president Al gore and President Bush, with the courts handing the presidency to Bush in a decision that still generates controversy. READ ALSO: https://www.thinknewsonline.com/post/entertainment-sister-derby-blasts-joy-fm-over-unprofessional-behaviour-picture With the coming into office of Donald John Trump in 2016, America's mythic image as far as democratic tenets are concerned to have been completely broken. from the use of state institutions to further the personal interests of the Head of state to the unleashing of state security operatives onto protesters by the president, the 2020 elections in America represents the latest chapter in a treat in anti-democratic tenets American style. As I write this article Donald Trump surges forward with his attempt to annul Joe Biden's victory in the courts to the utter chagrin of most U.S. politicians who believe he has done sufficient damage to America's invincibility as far as the practice of democracy were concerned. But for we in Africa the spectacle only betrays the unfair standards to which America has held the rest of us as far as the practice of democracy is concerned. No matter what happens the myth surrounding America as the world's best example of democracy has been completely shattered by the Trump presidency and going forward America would be less audacious in venturing into the third world and attempting to push down our throat a perfectionist brand of democracy. Because even they have proven how chaotic the practice of democracy can be at times. The narrative on how to report America has been altered forever! READ ALSO: https://www.thinknewsonline.com/post/breaking-news-caf-president-ahmad-ahmad-banned-for-5-years-for-financial-misconduct Credit: Rodney Tsenuokpor Disclaimer: The views/contents expressed in this article are the sole responsibility of the author(s) and do not necessarily reflect those of ThinkNews Online. ThinkNews Online will not be responsible or liable for any inaccurate or incorrect statements contained in this article.

Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders characterized by a high blood sugar level over a prolonged period of time. Symptoms often include frequent urination, increased thirst, and increased appetite. If left untreated, diabetes can cause many complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, damage to the nerves, damage to the eyes and cognitive impairment. Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced. There are three main types of diabetes mellitus: Type 1 diabetes results from the pancreas's failure to produce enough insulin due to loss of beta cells. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The loss of beta cells is caused by an autoimmune response. The cause of this autoimmune response is unknown. Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses, a lack of insulin may also develop. This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".The most common cause is a combination of excessive body weight and insufficient exercise. Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels. Type 1 diabetes must be managed with insulin injections. Prevention and treatment of type 2 diabetes involves maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco. Type 2 diabetes may be treated with medications such as insulin sensitizers with or without insulin. Control of blood pressure and maintaining proper foot and eye care are important for people with the disease. Insulin and some oral medications can cause low blood sugar. Weight loss surgery in those with obesity is sometimes an effective measure in those with type 2 diabetes. Gestational diabetes usually resolves after the birth of the baby. As of 2019, an estimated 463 million people had diabetes worldwide (8.8% of the adult population), with type 2 diabetes making up about 90% of the cases. Rates are similar in women and men. Trends suggest that rates will continue to rise. Diabetes at least doubles a person's risk of early death. In 2019, diabetes resulted in approximately 4.2 million deaths. It is the 7th leading cause of death globally. The global economic cost of diabetes-related health expenditure in 2017 was estimated at US$727 billion. In the United States, diabetes cost nearly US$327 billion in 2017. Average medical expenditures among people with diabetes are about 2.3 times higher. Signs and Symptoms Overview of the most significant symptoms of diabetes The classic symptoms of untreated diabetes are unintended weight loss, polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger). Symptoms may develop rapidly (weeks or months) in type 1 diabetes, while they usually develop much more slowly and maybe subtle or absent in type 2 diabetes. Several other signs and symptoms can mark the onset of diabetes although they are not specific to the disease. In addition to the known ones above, they include blurred vision, headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision changes. Long-term vision loss can also be caused by diabetic retinopathy. A number of skin rashes that can occur in diabetes are collectively known as diabetic dermadromes.[26] Diabetic emergencies People (usually with type 1 diabetes) may also experience episodes of diabetic ketoacidosis (DKA), a metabolic disturbance characterized by nausea, vomiting and abdominal pain, the smell of acetone on the breath, deep breathing known as Kussmaul breathing, and in severe cases a decreased level of consciousness. A rare but equally severe possibility is hyperosmolar hyperglycemic state (HHS), which is more common in type 2 diabetes and is mainly the result of dehydration. Treatment-related low blood sugar (hypoglycemia) is common in people with type 1 and also type 2 diabetes depending on the medication being used. Most cases are mild and are not considered medical emergencies. Effects can range from feelings of unease, sweating, trembling, and increased appetite in mild cases to more serious effects such as confusion, changes in behavior such as aggressiveness, seizures, unconsciousness, and (rarely) permanent brain damage or death in severe cases. Rapid breathing, sweating, and cold, pale skin are characteristic of low blood sugar but not definitive. Mild to moderate cases are self-treated by eating or drinking something high in sugar. Severe cases can lead to unconsciousness and must be treated with intravenous glucose or injections with glucagon. Complications Retinopathy, nephropathy, and neuropathy are potential complications of diabetes All forms of diabetes increase the risk of long-term complications. These typically develop after many years (10–20) but may be the first symptom in those who have otherwise not received a diagnosis before that time. The major long-term complications relate to damage to blood vessels. Diabetes doubles the risk of cardiovascular disease and about 75% of deaths in people with diabetes are due to coronary artery disease. Other macrovascular diseases include stroke, and peripheral artery disease. The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves. Damage to the eyes, known as diabetic retinopathy, is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and eventual blindness. Diabetes also increases the risk of having glaucoma, cataracts, and other eye problems. It is recommended that people with diabetes visit an eye doctor once a year. Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation. Damage to the nerves of the body, known as diabetic neuropathy, is the most common complication of diabetes.[34] The symptoms can include numbness, tingling, pain, and altered pain sensation, which can lead to damage to the skin. Diabetes-related foot problems (such as diabetic foot ulcers) may occur, and can be difficult to treat, occasionally requiring amputation. Additionally, proximal diabetic neuropathy causes painful muscle atrophy and weakness. There is a link between cognitive deficit and diabetes. Compared to those without diabetes, those with the disease have a 1.2 to 1.5-fold greater rate of decline in cognitive function. Having diabetes, especially when on insulin, increases the risk of falls in older people. Causes Diabetes mellitus is classified into six categories: type 1 diabetes, type 2 diabetes, hybrid forms of diabetes, hyperglycemia first detected during pregnancy, "unclassified diabetes", and "other specific types". The "hybrid forms of diabetes" contains slowly evolving, immunemediated diabetes of adults and ketosis-prone type 2 diabetes. The "hyperglycemia first detected during pregnancy" contains gestational diabetes mellitus and diabetes mellitus in pregnancy (type 1 or type 2 diabetes first diagnosed during pregnancy). The "other specific types" are a collection of a few dozen individual causes. Diabetes is a more variable disease than once thought and people may have combinations of forms.[41] The term "diabetes", without qualification, refers to diabetes mellitus. Type 1 Type 1 diabetes is characterized by loss of the insulin-producing beta cells of the pancreatic islets, leading to insulin deficiency. This type can be further classified as immune-mediated or idiopathic. The majority of type 1 diabetes is of the immune-mediated nature, in which a T cell-mediated autoimmune attack leads to the loss of beta cells and thus insulin. It causes approximately 10% of diabetes mellitus cases in North America and Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Although it has been called "juvenile diabetes" due to the frequent onset in children, the majority of individuals living with type 1 diabetes are now adults. "Brittle" diabetes, also known as unstable diabetes or labile diabetes, is a term that was traditionally used to describe the dramatic and recurrent swings in glucose levels, often occurring for no apparent reason in insulin-dependent diabetes. This term, however, has no biologic basis and should not be used. Still, type 1 diabetes can be accompanied by irregular and unpredictable high blood sugar levels, and the potential for diabetic ketoacidosis or serious low blood sugar levels. Other complications include an impaired counterregulatory response to low blood sugar, infection, gastroparesis (which leads to erratic absorption of dietary carbohydrates), and endocrinopathies (e.g., Addison's disease).[44] These phenomena are believed to occur no more frequently than in 1% to 2% of persons with type 1 diabetes. Autoimmune attack in type 1 diabetes. Type 1 diabetes is partly inherited, with multiple genes, including certain HLA genotypes, known to influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by one or more environmental factors, such as a viral infection or diet. Several viruses have been implicated, but to date there is no stringent evidence to support this hypothesis in humans.[ Among dietary factors, data suggest that gliadin (a protein present in gluten) may play a role in the development of type 1 diabetes, but the mechanism is not fully understood. Type 1 diabetes can occur at any age, and a significant proportion is diagnosed during adulthood. Latent autoimmune diabetes of adults (LADA) is the diagnostic term applied when type 1 diabetes develops in adults; it has a slower onset than the same condition in children. Given this difference, some use the unofficial term "type 1.5 diabetes" for this condition. Adults with LADA are frequently initially misdiagnosed as having type 2 diabetes, based on age rather than cause Type 2 Reduced insulin secretion and absorption leads to high glucose content in the blood. Type 2 diabetes is characterized by insulin resistance, which may be combined with relatively reduced insulin secretion. The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor. However, the specific defects are not known. Diabetes mellitus cases due to a known defect are classified separately. Type 2 diabetes is the most common type of diabetes mellitus. Many people with type 2 diabetes have evidence of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) before meeting the criteria for type 2 diabetes. The progression of prediabetes to overt type 2 diabetes can be slowed or reversed by lifestyle changes or medications that improve insulin sensitivity or reduce the liver's glucose production. Type 2 diabetes is primarily due to lifestyle factors and genetics. A number of lifestyle factors are known to be important to the development of type 2 diabetes, including obesity (defined by a body mass index of greater than 30), lack of physical activity, poor diet, stress, and urbanization. Excess body fat is associated with 30% of cases in people of Chinese and Japanese descent, 60–80% of cases in those of European and African descent, and 100% of Pima Indians and Pacific Islanders. Even those who are not obese may have a high waist–hip ratio. Dietary factors such as sugar-sweetened drinks is associated with an increased risk.The type of fats in the diet is also important, with saturated fat and trans fats increasing the risk and polyunsaturated and monounsaturated fat decreasing the risk. Eating white rice excessively may increase the risk of diabetes, especially in Chinese and Japanese people.[56] Lack of physical activity may increase the risk of diabetes in some people. Adverse childhood experiences (ACEs), including abuse, neglect, and household difficulties, increase the likelihood of type 2 diabetes later in life by 32%, with neglect having the strongest effect. Gestational diabetes Gestational diabetes resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2–10% of all pregnancies and may improve or disappear after delivery.[59] It is recommended that all pregnant women get tested starting around 24–28 weeks gestation.[60] It is most often diagnosed in the second or third trimester because of the increase in insulin-antagonist hormone levels that occurs at this time. However, after pregnancy approximately 5–10% of women with gestational diabetes are found to have another form of diabetes, most commonly type 2.[59] Gestational diabetes is fully treatable, but requires careful medical supervision throughout the pregnancy. Management may include dietary changes, blood glucose monitoring, and in some cases, insulin may be required. Though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital heart and central nervous system abnormalities, and skeletal muscle malformations. Increased levels of insulin in a fetus's blood may inhibit fetal surfactant production and cause infant respiratory distress syndrome. A high blood bilirubin level may result from red blood cell destruction. In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labor induction may be indicated with decreased placental function. A caesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia. Other types Maturity onset diabetes of the young (MODY) is a rare autosomal dominant inherited form of diabetes, due to one of several single-gene mutations causing defects in insulin production. It is significantly less common than the three main types, constituting 1–2% of all cases. The name of this disease refers to early hypotheses as to its nature. Being due to a defective gene, this disease varies in age at presentation and in severity according to the specific gene defect; thus there are at least 13 subtypes of MODY. People with MODY often can control it without using insulin. Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal, which is what separates it from type 2 diabetes); this form is very uncommon. Genetic mutations (autosomal or mitochondrial) can lead to defects in beta cell function. Abnormal insulin action may also have been genetically determined in some cases. Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, chronic pancreatitis and cystic fibrosis). Diseases associated with excessive secretion of insulin-antagonistic hormones can cause diabetes (which is typically resolved once the hormone excess is removed). Many drugs impair insulin secretion and some toxins damage pancreatic beta cells, whereas others increase insulin resistance (especially glucocorticoids which can provoke "steroid diabetes"). The ICD-10 (1992) diagnostic entity, malnutrition-related diabetes mellitus (MRDM or MMDM, ICD-10 code E12), was deprecated by the World Health Organization (WHO) when the current taxonomy was introduced in 1999. Pathophysiology The fluctuation of blood sugar (red) and the sugar-lowering hormone insulin (blue) in humans during the course of a day with three meals. One of the effects of a sugar-rich vs a starch-rich meal is highlighted. Mechanism of insulin release in normal pancreatic beta cells. Insulin production is more or less constant within the beta cells. Its release is triggered by food, chiefly food containing absorbable glucose. Insulin is the principal hormone that regulates the uptake of glucose from the blood into most cells of the body, especially liver, adipose tissue and muscle, except smooth muscle, in which insulin acts via the IGF-1. Therefore, deficiency of insulin or the insensitivity of its receptors play a central role in all forms of diabetes mellitus. The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of glycogen (glycogenolysis), the storage form of glucose found in the liver; and gluconeogenesis, the generation of glucose from non-carbohydrate substrates in the body. Insulin plays a critical role in regulating glucose levels in the body. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen. Insulin is released into the blood by beta cells (β-cells), found in the islets of Langerhans in the pancreas, in response to rising levels of blood glucose, typically after eating. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage. Lower glucose levels result in decreased insulin release from the beta cells and in the breakdown of glycogen to glucose. This process is mainly controlled by the hormone glucagon, which acts in the opposite manner to insulin. If the amount of insulin available is insufficient, or if cells respond poorly to the effects of insulin (insulin resistance), or if the insulin itself is defective, then glucose is not absorbed properly by the body cells that require it, and is not stored appropriately in the liver and muscles. The net effect is persistently high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as metabolic acidosis in cases of complete insulin deficiency. When glucose concentration in the blood remains high over time, the kidneys reach a threshold of reabsorption, and the body excretes glucose in the urine (glycosuria). This increases the osmotic pressure of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Lost blood volume is replaced osmotically from water in body cells and other body compartments, causing dehydration and increased thirst (polydipsia). In addition, intracellular glucose deficiency stimulates appetite leading to excessive food intake (polyphagia). Diagnosis Diabetes mellitus is characterized by recurrent or persistent high blood sugar, and is diagnosed by demonstrating any one of the following: Fasting plasma glucose level ≥ 7.0 mmol/L (126 mg/dL) Plasma glucose ≥ 11.1 mmol/L (200 mg/dL) two hours after a 75 gram oral glucose load as in a glucose tolerance test (OGTT) Symptoms of high blood sugar and casual plasma glucose ≥ 11.1 mmol/L (200 mg/dL) Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥ 6.5 DCCT %). A positive result, in the absence of unequivocal high blood sugar, should be confirmed by a repeat of any of the above methods on a different day. It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test. According to the current definition, two fasting glucose measurements above 7.0 mmol/L (126 mg/dL) is considered diagnostic for diabetes mellitus. Per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/L (110 to 125 mg/dL) are considered to have impaired fasting glucose. People with plasma glucose at or above 7.8 mmol/L (140 mg/dL), but not over 11.1 mmol/L (200 mg/dL), two hours after a 75 gram oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease. The American Diabetes Association (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/L (100 to 125 mg/dL). Glycated hemoglobin is better than fasting glucose for determining risks of cardiovascular disease and death from any cause. Prevention There is no known preventive measure for type 1 diabetes.[2] Type 2 diabetes—which accounts for 85–90% of all cases worldwide—can often be prevented or delayed by maintaining a normal body weight, engaging in physical activity, and eating a healthy diet. Higher levels of physical activity (more than 90 minutes per day) reduce the risk of diabetes by 28%. Dietary changes known to be effective in helping to prevent diabetes include maintaining a diet rich in whole grains and fiber, and choosing good fats, such as the polyunsaturated fats found in nuts, vegetable oils, and fish. Limiting sugary beverages and eating less red meat and other sources of saturated fat can also help prevent diabetes.[83] Tobacco smoking is also associated with an increased risk of diabetes and its complications, so smoking cessation can be an important preventive measure as well. The relationship between type 2 diabetes and the main modifiable risk factors (excess weight, unhealthy diet, physical inactivity and tobacco use) is similar in all regions of the world. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: globalization, urbanization, population aging, and the general health policy environment. Management Overview of the management of diabetes Diabetes management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with dietary changes, exercise, weight loss, and use of appropriate medications (insulin, oral medications). Learning about the disease and actively participating in the treatment is important, since complications are far less common and less severe in people who have well-managed blood sugar levels. Per the American College of Physicians, the goal of treatment is an HbA1C level of 7-8%. Attention is also paid to other health problems that may accelerate the negative effects of diabetes. These include smoking, high blood pressure, metabolic syndrome obesity, and lack of regular exercise.[89] Specialized footwear is widely used to reduce the risk of ulcers in at-risk diabetic feet although evidence for the efficacy of this remains equivocal. Lifestyle People with diabetes can benefit from education about the disease and treatment, dietary changes, and exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure. Weight loss can prevent progression from prediabetes to diabetes type 2, decrease the risk of cardiovascular disease, or result in a partial remission in people with diabetes. No single dietary pattern is best for all people with diabetes. Healthy dietary patterns, such as the Mediterranean diet, low-carbohydrate diet, or DASH diet, are often recommended, although evidence does not support one over the others. According to the ADA, "reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia", and for individuals with type 2 diabetes who cannot meet the glycemic targets or where reducing anti-glycemic medications is a priority, low or very-low carbohydrate diets are a viable approach.[94] For overweight people with type 2 diabetes, any diet that achieves weight loss is effective. Implementing a plant-based diet may help manage or prevent type-2 diabetes by lowering glycated hemoglobin levels.[97] In addition, improvement in health may reduce the need for or number of medications needed by people who adopt a plant-based diet. Medications Glucose control Most medications used to treat diabetes act by lowering blood sugar levels through different mechanisms. There is broad consensus that when people with diabetes maintain tight glucose control – keeping the glucose levels in their blood within normal ranges – they experience fewer complications, such as kidney problems or eye problems. There is however debate as to whether this is appropriate and cost effective for people later in life in whom the risk of hypoglycemia may be more significant. There are a number of different classes of anti-diabetic medications. Type 1 diabetes requires treatment with insulin, typically with a combination of regular and NPH insulin, or synthetic insulin analogs.[citation needed] Type 2 diabetes may also be treated with insulin at later stages. Some medications for type 2 diabetes are taken by mouth, such as metformin, while others are only administered by injection, such as GLP-1 agonists. Metformin is generally recommended as a first-line treatment for type 2 diabetes, as there is good evidence that it decreases mortality. It works by decreasing the liver's production of glucose. Several other groups of drugs, mostly given by mouth, may also decrease blood sugar in type 2 diabetes. These include agents that increase insulin release (sulfonylureas), agents that decrease absorption of sugar from the intestines (acarbose), agents that inhibit the enzyme dipeptidyl peptidase-4 (DPP-4) that inactivates incretins such as GLP-1 and GIP (sitagliptin), agents that make the body more sensitive to insulin (thiazolidinedione) and agents that increase the excretion of glucose in the urine (SGLT2 inhibitors). When insulin is used in type 2 diabetes, a long-acting formulation is usually added initially, while continuing oral medications. Doses of insulin are then increased until glucose targets are reached. Berberine hydrochloride has shown not only to lower blood glucose levels under a fasting state, but hemoglobin A1c and insulin levels as well: having an effect similar to that of metformin. Blood pressure lowering Cardiovascular disease is a serious complication associated with diabetes, and many international guidelines recommend blood pressure treatment targets that are lower than 140/90 mmHg for people with diabetes. However, there is only limited evidence regarding what the lower targets should be. A 2016 systematic review found potential harm to treating to targets lower than 140 mmHg, and a subsequent systematic review in 2019 found no evidence of additional benefit from blood pressure lowering to between 130 - 140mmHg, although there was an increased risk of adverse events. 2015 American Diabetes Association recommendations are that people with diabetes and albuminuria should receive an inhibitor of the renin-angiotensin system to reduce the risks of progression to end-stage renal disease, cardiovascular events, and death. There is some evidence that angiotensin converting enzyme inhibitors (ACEIs) are superior to other inhibitors of the renin-angiotensin system such as angiotensin receptor blockers (ARBs), or aliskiren in preventing cardiovascular disease. Although a more recent review found similar effects of ACEIs and ARBs on major cardiovascular and renal outcomes. There is no evidence that combining ACEIs and ARBs provides additional benefits. Aspirin The use of aspirin to prevent cardiovascular disease in diabetes is controversial. Aspirin is recommended in people at high risk of cardiovascular disease, however routine use of aspirin has not been found to improve outcomes in uncomplicated diabetes. 2015 American Diabetes Association recommendations for aspirin use (based on expert consensus or clinical experience) are that low-dose aspirin use is reasonable in adults with diabetes who are at intermediate risk of cardiovascular disease (10-year cardiovascular disease risk, 5–10%). Surgery Weight loss surgery in those with obesity and type 2 diabetes is often an effective measure. Many are able to maintain normal blood sugar levels with little or no medications following surgery and long-term mortality is decreased. There is, however, a short-term mortality risk of less than 1% from the surgery. The body mass index cutoffs for when surgery is appropriate are not yet clear. It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control. A pancreas transplant is occasionally considered for people with type 1 diabetes who have severe complications of their disease, including end stage kidney disease requiring kidney transplantation. Support In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. In other circumstances, general practitioners and specialists share care in a team approach. Home telehealth support can be an effective management technique. Credit: Wikkipedia

The Leadership of the National Democratic Party (NDP) has confirmed that its Flagbearer, Nana Konadu Agyemang Rawlings has not withdrawn from contesting as a Presidential Candidate in the upcoming December Elections. According to the NDP, the publication was false and untrue. READ ALSO: https://www.thinknewsonline.com/post/entertainment-sister-derby-blasts-joy-fm-over-unprofessional-behaviour-picture Addressing Journalists in Accra, the Secretary-General of the NDP Party, Alhaji Frimpong "Allow our Flagbearer to mourn in peace. She has not spoken to anyone about withdrawing from the December polls. The publication which was making waves on Monday was fake" Alhaji Frimpong also stated that the NDC party is panicking adding they still cannot come to terms with Nana Konadu contesting despite the demise of her husband. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo He further explained that no matter whatever the NDC plans, it will not deter Nana Konadu Agyemang Rawlings from contesting in the December polls. "Those babies with sharp teeth were the same people bashing Rawlings when he was alive now, they are the same people crying because he is dead. Such people are two-faced individuals" he fumed. READ ALSO: https://www.thinknewsonline.com/post/december-polls-the-election-will-be-fair-and-transparent-jean-mensa-pledges "We will make sure we get the true Cadres to desert the NDC party and come to NDP so win the December election" he added. Background On Monday, November 23, news broke of the Flagbearer of the NDP party, Nana Konadu Agyemang Rawlings had withdrawn from the December polls. READ ALSO: https://www.thinknewsonline.com/post/breaking-news-caf-president-ahmad-ahmad-banned-for-5-years-for-financial-misconduct It emerged that the withdrawal was a sign of respect for her late husband. Story by: Joshua Kwabena Smith

The Chairperson of Ghana's Electoral Commission (EC), Jean Mensa has pledged that the upcoming December election will be fair and transparent. According to her, her outfit will not leave any stone unturn adding all is set for the big day. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo Speaking at AGLOW, an Intercessionary prayer at the Black Star Square on Saturday, she said "We declare that the elections of 2020 will be orderly, fair, credible, transparent, peaceful and glorious in Jesus' name " She explained her outfit is working tirelessly to ensure that the December polls becomes peaceful and credible outcome of the election. READ ALSO: https://www.thinknewsonline.com/post/lifestyle-how-to-naturally-avoid-pregnancy-without-using-contraceptives-photos Jean Mensa also noted that her organization is working closely with the various political parties for a free and fair election. Watch videos and pictures below: Story by: Joshua Kwabena Smith

President Akufo-Addo has said he is seeking a second term based on the Conviction that he had fulfilled his promises to the people of Ghana. The President said this while addressing traditional and religious leaders as well as party faithful during the manifesto launch of John Peter Amewu, the New Patriotic Party (NPP) Parliamentary Candidate for the Hohoe Constituency. "I cannot come to you just for promises, I have to come to you on my records. What I have done in these four years as President of the Republic ". READ ALSO: https://www.thinknewsonline.com/post/opinion-dr-obu-nyarkotey-raphael-nd-as-your-prostate-cancer-planner-in-ghana The president said the question Ghanaians had to ask themselves was " have I remained faithful to you and stood by my commitment to you? And if so that I have done these, then you can look upon me as a man of integrity ". "You can look upon me as a man who keeps his word, a man who fulfills his promises, you can continue to trust me that the next four years is even going to be better than what we have gone through ". President Akufo-Addo said, "I will not make any commitments to you that I cannot fulfill. I will never do that to the people of Ghana". READ ALSO: https://www.thinknewsonline.com/post/watch-sarkodie-kuami-eugene-jam-to-happy-day-at-233-bar-videos Mr. John Peter Amewu, the parliamentary candidate of the New patriotic party for the Hohoe constituency in this year's elections, called on the electorate to endorse his candidature and that of president Akufo-Addo in this year's polls for more development and transformation of lives of women, the youth and children. Deputy Minister of Information, Pius Enam Hadzide, said the president had justified the confidence reposed in him in 2016 and it was only fitting that he is given another term to continue the development projects in the country. "On December 7, when you get to the ballot box, vote for president Akufo-Addo on number one, and when you are done, pick the parliamentary form and vote for Mr. John Peter-Amewu". READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo Story by Rodney Tsenuokpor

The Electoral Commission of Ghana will on Monday, November 23, hold a press conference to update the nation on its preparedness ahead of the December 7 elections. With two weeks to the polls, the Commission is expected to let Ghanaians know the plans put together to have a successful presidential and parliamentary election The press conference is expected to start at 4pm. READ ALSO: https://www.thinknewsonline.com/post/opinion-how-to-go-on-a-peaceful-aworshia-without-being-caught Commission Chair, Jean Mensah last Friday told the Council of the state that the commission is 98 percent ready for the polls. Mrs. Mensah said almost all electoral materials have been distributed to the Commission's regional offices, including the upper East Regional office of the commission where confusion greeted the arrival of the materials, for onward distribution to the constituencies and polling stations, on election day. READ ALSO: https://www.thinknewsonline.com/post/lifestyle-how-to-naturally-avoid-pregnancy-without-using-contraceptives-photos She also indicated that a robust and efficient system has been put in place to ensure that election results are declared within 24 hours of the close of polls. The Commission was recently challenged by some citizens in court over the creation of an exemptions and multiples list of some 32,000 voters. These are persons who are said to have breached regulations regarding the new registration conducted this year. READ ALSO: https://www.thinknewsonline.com/post/entertainment-sister-derby-blasts-joy-fm-over-unprofessional-behaviour-picture Story by Rodney Tsenuokpor

The International Federation of Association Football (FIFA) has banned the President of Confederation of African Football (CAF), Ahmad Ahmad for financial misconduct. According to FIFA, the CAF President had been on their radar for some time now. READ ALSO: https://www.thinknewsonline.com/post/entertainment-sister-derby-blasts-joy-fm-over-unprofessional-behaviour-picture It is emerging that the ban will deny Mr. Ahmad Ahmad cannot contest for the next CAF elections. Ahmad Ahmad took over from the longest-serving CAF President Issa Hayatou some years ago. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo President Ahmad Ahmad is yet to complete his first term of office as President. ThinkNews Online will keep readers updated on new developments. READ ALSO: https://www.thinknewsonline.com/post/watch-sarkodie-kuami-eugene-jam-to-happy-day-at-233-bar-videos Story by: Joshua Kwabena Smith

The Member of Parliament for Ablekuma West Constituency, Ursula Owusu-Ekuful says see is confident, the Ghanaian electorate will maintain, the ruling New Patriotic Party in office after the December Election. According to her, the good works of the ruling government has been accepted by the populace adding she believes, the NPP will be given a second chance to continue with what it has started. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo Speaking on Accra-based Television station on Monday, she said "There are a lot that has been done. Some of these include the Free Senior High School programme. With the interventions that the government has put in place, particularly, the Free Senior High School (SHS) has taken huge burden off women" Stressing on education for all, the Ablekuma West MP hinted that she will ensure children of mothers and single mothers have access to the 'Free SHS' programme. READ ALSO: https://www.thinknewsonline.com/post/lifestyle-how-to-naturally-avoid-pregnancy-without-using-contraceptives-photos "Now they can rest so long as they know their children are doing well in school. But there is still a lot more work to be done,” she hinted. Sharing her thoughts on the upcoming December polls, Madam Owusu-Ekuful revealed that she is confident Ghanaians will retain the NPP into power. READ ALSO: https://www.thinknewsonline.com/post/entertainment-sister-derby-blasts-joy-fm-over-unprofessional-behaviour-picture "Ghanaians will go to the polls on December 7 to elect President Akufo-Addo and myself to steer affairs of our country for the next four years" Story by: Joshua Kwabena Smith

Chairperson of Ghana's Electoral Commission (EC), Jean Mensa has joined AGLOW Ghana, a women prayer group to pray for peace before, during, and after the December Elections at the Black Star Square, Accra. According to her, the 2020 election will fair and transparent. READ ALSO: https://www.thinknewsonline.com/post/opinion-how-to-go-on-a-peaceful-aworshia-without-being-caught Addressing the gathering at the Black Star Square, Accra, she said "We declare that the elections of 2020 will be orderly, fair, credible, transparent, peaceful and glorious in Jesus' name " She further revealed that her outfit is working tirelessly to ensure the peaceful and credible outcome of the election. Jean Mensa also noted that her organization is working closely with the various political parties for a free and fair election. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo On her behalf, the National Prayer Director of AGLOW, Madam Gifty Afenyi-Dadzie hinted despite the tension building up ahead of the December polls, Ghanaians will not relent but continue to project God's name before, during, and after the general election. She mentioned that although some evildoers have planned to cause chaos in the upcoming election, God will save his children. "Lord, take over this nation. Be Lord over Ghana. Despite the rising tension, Ghanaians will not relent but continue to project God's name before, during, and after the general election" READ ALSO: https://www.thinknewsonline.com/post/lifestyle-how-to-naturally-avoid-pregnancy-without-using-contraceptives-photos Prophesying against evildoers and their demonic activities, the National Prayer Director of AGLOW Ghana hinted that no weapon formed against Ghana will prosper. Watch videos and pictures: Story by: Joshua Kwabena Smith

Deputy Special Prosecutor Ms Jane Cynthia Naa Torshie Lamptey, has been asked to act as Special Prosecutor until a substantive one is appointed by President Nana Addo Dankwa Akufo-Addo following the resignation of Mr Martin Amidu from the post. Ms Lamptey is a lawyer of over 30 years standing at the Ghana Bar and former acting Director of Public Prosecutions. Commenting on her new assignment, Chairman of the Civil Society Platform on Oil and Gas, Dr Steve Manteaw said “Mad. Cynthia Lamptey, Acting SP I salute you. It’s a difficult task, we know, but we trust you to fulfil our aspirations.” READ ALSO: https://www.thinknewsonline.com/post/opinion-how-to-go-on-a-peaceful-aworshia-without-being-caught Her former boss, Mr Amidu resigned on Monday, November 16, citing a number of reasons for his resignation. He said in his letter to the president that “It is essential for me to state for the purpose of the records, and contrary to public perceptions, that my appointment letter was received on 5th February 2020 (almost two (2)-years after my appointment). “The copy addressees made no efforts to honour any of the conditions of appointment in terms of emoluments and benefits of the appointment ever since my warrant of appointment was issued on 23rd February 2018 to the date of my letter of resignation. The Deputy Special Prosecutor has also not been paid any emoluments since her appointment, and there is the need to redress that situation for her now that I am out of the way. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo “The events of 12th November 2020 removed the only protection I had from the threats and plans directed at me for undertaking the Agyapa Royalties Limited Transactions anti-corruption assessment report and dictates that I resign as the Special Prosecutor immediately. “I should not ordinarily be announcing my resignation to the public myself but the traumatic experience I went through from 20th October 2020 to 2nd November 2020 when I conveyed in a thirteen (13) page letter the conclusions and observations on the analysis of the risk of corruption and anti-corruption assessment on the Report On Agyapa Royalties Limited Transactions and Other Matters Related Thereto to the President as Chairman of the National Security Council cautions against not bringing my resignation as the Special Prosecutor with immediate to the notice of the Ghanaian public and the world. “The reaction I received for daring to produce the Agyapa Royalties Limited Transactions anti-corruption report convinces me beyond any reasonable doubt that I was not intended to exercise any independence as the Special Prosecutor in the prevention, investigation, prosecution, and recovery of assets of corruption. My position as the Special Prosecutor has consequently become clearly untenable.” READ ALSO: https://www.thinknewsonline.com/post/lifestyle-how-to-naturally-avoid-pregnancy-without-using-contraceptives-photos President Nana Addo Dankwa Akufo-Addo has, however, vehemently denied interfering with the work of Mr Amidu. “Your accusation of interference with your functions simply on account of the meeting the president held with you is perplexing. “In exercise of what you considered to be your powers under Act 959, you had voluntarily proceeded to produce the Agyapa Report. “The president had no hand in your work. Without prompting from any quarter within the Executive. you delivered a letter purporting to be a copy of you report to the president. READ ALSO: https://www.thinknewsonline.com/post/entertainment-sister-derby-blasts-joy-fm-over-unprofessional-behaviour-picture “The purpose of presenting a copy of the Agyapa report to the president is decipherable from paragraph 32 of your letter to the president in which you indicated that you hoped the report will be ‘used to improve current and future legislative and executive actions to make corruption and corruption-related offences very high-risk enterprise in Ghana’,” the president said in a statement responding to the accusation against him by Mr Amidu who resigned from his post on Monday. Source: Ghanaweb

The Executive Secretary of the Small Arms Commission has appealed to politicians to ensure that ballots are counted in the elections and not bullets. Jones Applerh urged them to be measured in their language and the electioneering to ensure they did not incite anyone into violence to trigger the use of guns. Mr. Applerh said this during the “Ballots without Bullets” campaign in the Jirapa Municipality of the Upper West Region. READ ALSO: https://www.thinknewsonline.com/post/opinion-how-to-go-on-a-peaceful-aworshia-without-being-caught “Ballots without Bullets” is a campaign being championed by the Small Arms Commission to get parliamentary candidates of hot-spot constituencies to publicly pledge their commitment to peace and urge their supporters to follow suit. Mr Applerh said the campaign was born out of the violence associated with elections in developing countries, particularly in Africa. Ghana won the reputation as the beacon of democracy in Africa and in the Africa Peace Index, she ranked number one in West Africa and number three in the whole of Africa, he said. READ ALSO: https://www.thinknewsonline.com/post/entertainment-actress-martha-ankomah-flaunts-handsome-son-on-instagram-photo “This is a reputation we don’t want to lose and so judging from what we saw during the registration; the confusion and the gun incidents, we decided as a Commission, who contribute to peace, safety and public security through the controlling of the proliferation of small arms, to get to these constituencies for the candidates themselves to publicly commit to peace and urge their supporters to follow suit,” Mr Aplerh said. He encouraged politicians to endeavour to solve conflicts peacefully, without the use of guns, adding; “we don’t want guns at all in this election.” The National Democratic Congress (NDC) parliamentary candidate for Jirapa, Mr Cletus Seidu Dapilah, pledged his commitment to ensuring peace before, during and after the December 7 polls. READ ALSO: https://www.thinknewsonline.com/post/lifestyle-how-to-naturally-avoid-pregnancy-without-using-contraceptives-photos “I’m urging all my supporters and sympathizers that they should not fight anybody – if you are provoked, report to the appropriate authorities,” he said. Mr Dapilah said he was once the Jirapa District Chief Executive and his opponent was also an Independent Member of Parliament for the area, saying that gave them the leverage to campaign peacefully on ideas and track record. The Regional Police Command and the Electoral Commission both indicated their preparedness to deliver on their mandate and discharge their duties fairly and professionally to contribute to peace in the coming elections. READ ALSO: https://www.thinknewsonline.com/post/entertainment-sister-derby-blasts-joy-fm-over-unprofessional-behaviour-picture Credit: GNA