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The Armenian Eye Care Project's mobile hospital fights eye diseases including those caused by diabetes.

It was during the procedure that Petrosyan learned she has diabetes. It is a common phenomenon in Armenia that diabetes reveals itself, and, untreated, can lead to a condition known as diabetic retinopathy. Ophthalmologists from abroad – particularly those from the Armenian Eye Car Project – say they have been alarmed over the many cases of the disease they have found in more than a decade of eye care here.

Nina lives in Gyumri, where, as she says, she “has lived really hard days after the damn earthquake.”

Experts say that genetic factors, non-dynamic life and unhealthy food play a big role in the onset of diabetes. And, though there is only anecdotal evidence to support the theory, some doctors in Gyumri are convinced of a stress-related strain of diabetes.

Republic wide, the number of diabetics has increased – from 30,000 in 1990, to 40,000 in 2005.

Family doctor and endocrinologist Marieta Kurghinyan says the number of people suffering from diabetes in Gyumri increased considerably after the earthquake.

“From my work experience I can say that the increased number of diabetics in Gyumri is conditioned not only by poor social conditions but also by heavy stresses caused by those very conditions and especially the earthquake,” says Kurghinyan.

This opinion is shared by the Head of Endocrinology department of Armenia Republican Medical Center Eduard Toromanyan. He was among the group of doctors that carried out a survey on the prevalence of diabetes in the disaster areas initiated by the Ministry of Health of Armenia.

“Our investigation has revealed that during five years (1987-1992) the number of diabetics in the disaster areas had doubled. This is explained by the fact that stress plays a big role in developing diabetes.”

Doctors told Nina that she had had diabetes before her sight deterioration started, but because she wasn’t examined she wasn’t aware of it. Nina underwent 5 eye surgeries in 7 years, but no surgery has been able to fully recover her sight.

“I start seeing better right after the surgery, but then my blood sugar increases and everything darkens again and my vision gets blurred,” says Nina.

The Head of the mobile hospital of the Armenian Eye Care Project Asatur Hovsepyan says the prevalence of eye diseases among diabetics is noticeably higher than among those not suffering from diabetes.

Among diabetics receiving first ophthalmologic treatment within the framework of Eye Care Project in 2003-2005, 46 percent were diagnosed to have cataract, 40.5 percent troubles with fundus of eye, 10.4 percent cornea, and 13.7 percent suspected glaucoma.

Toromanyan says diabetes in itself is not so dangerous if it were not for its complications.

“Insular diabetes is a vascular disease, and depending on which vessels are affected the person can go blind, develop kidney deficiency, have heart attack, and gangrene. These are the complications that make it grievous with high rate of mortality,” he says.

Diabetes is considered to be not only medical but also a serious social problem. That’s why many states provide those suffering from it with medication proper and opportunities to get free consultation.

Since 1999 in Armenia diabetes treatment has become a priority of the Ministry of Health. All the registered diabetics receive insulin and syringes, tabs, an opportunity to take medical examination and to measure their blood sugar level. Patients receive some medications from humanitarian aids to Armenia.

Till the 20th century diabetes had been regarded as a disease of the rich, as they had more to eat, and tended to be more sedentary. The situation has changed now. Especially in new developing countries the socially vulnerable class of people is more likely to develop diabetes than wealthy people.

Diabetes International Federation experts predicted that by 2025 the highest indicator of growth in diabetes would be registered in the developing countries.

“This is connected to westernization of our lifestyle, the introduction of so called ‘fast food’, rich in fat, poor quality food and unhealthy diet that provoke the disease. We realize that high quality food is expensive,” says Toromanyan.

Armenian experts think it’s too early to talk about diabetes prevention in Armenia.

“People should be taught from early age that if there have been diabetics in their family, they should be very cautious and try to lead a healthy lifestyle, for example, do not eat more than one candy a day. They don’t do that even in highly developed countries as it’s very hard to make people live following special rules. Consequently, in Armenia it is more reasonable to put emphasis on the treatment,” concluded Toromanyan.

The head of the Yerevan Endocrinology Dispensary Anush Buniatyan disagrees that treatment should be expected rather than emphasizing prevention.

“Diabetes prevention is more important and should be paid more attention to. The state allocates huge amounts to purchasing medication to treat diabetes. Instead, we should only have appropriate educational programs, by means of which patients would realize the necessity of leading a healthy lifestyle, not getting overweight, and constantly keeping a balanced diet. This mostly depends on patient’s will and the treating doctor. I am convinced that disease prevention would be much more cost-effective both for the state and patients.”