Kaushik Bharati, PhD
The World Health Day is celebrated on 7th April every year. This year’s theme is “Beat Diabetes”. Diabetes mellitus is a “silent” pandemic that is spreading like wildfire. WHO estimates indicate that a staggering 350 million people worldwide suffer from diabetes. This figure is likely to double in the next 20 years. As per 2012 data, diabetes was directly responsible for 1.5 million deaths worldwide, with the majority occurring in low- and middle- income countries (LMIC). Indeed, as per WHO predictions, diabetes will be the 7th leading cause of death by 2030.
What is Diabetes?
Diabetes is a chronic disease where the pancreas either does not produce enough insulin or the body can’t utilize this insulin. Insulin is a hormone that helps the body to utilize blood glucose. In diabetes, the body can’t utilize the blood glucose, which accumulates in the blood vessels giving rise to a condition called hyperglycemia, simply meaning elevated blood sugar. Uncontrolled diabetes can cause severe complications by damaging nerves (Neuropathy), kidneys (Nephropathy), and eyes (Retinopathy). It also damages the blood vessels and causes heart disease.
What are the Major Types of Diabetes?
• Type 1 diabetes: This was formerly called insulin-dependent or juvenile or childhood-onset diabetes. This arises as a result of insufficient insulin production by the pancreas. Therefore, this condition requires daily administration of insulin.
• Type 2 diabetes: This was formerly called non-insulin-dependent or maturity-onset diabetes. It accounts for ~90% of all diabetes cases, where the body can’t utilize the insulin that is secreted by the pancreas. Type 2 diabetes arises largely due to physical inactivity and increased body weight. With increasing sedentary lifestyle, unhealthy food habits, Type 2 diabetes and obesity are spreading rapidly.
Another type of diabetes is gestational diabetes, which occurs during pregnancy and is usually transient and generally resolves after child-birth.
Conditions such as impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are indicative of progression from non-diabetic phase to diabetic phase.
What are the Major Symptoms of Diabetes?
The cardinal signs and symptoms of diabetes include:
• Intense thirst (polydipsia)
• Increased hunger (polyphagia)
• Excessive urination (polyuria)
These can occur suddenly in case of Type 1 diabetes, while in case of Type 2 diabetes, the symptoms are milder.
What are the Major Complications of Diabetes?
• Diabetes increases the risk of heart disease and stroke by up to 50%. The overall risk of dying in case of diabetics is twice that of normal individuals.
• Another major complication of diabetes, particularly in old age, is kidney failure, in which case the patient has to be put on hemodialysis for life.
• Reduced microcirculation, coupled with neuropathy in the feet can result in ulcers that are difficult to heal and may even lead to amputation of the affected limb.
• Diabetic retinopathy leading to blindness accounts for 1% of total blindness worldwide. Therefore, this is becoming a serious issue, and it results from long-term damage to the blood vessels supplying the retina.
How Can You Live with Diabetes Yet Lead a Normal Healthy Life?
Diabetes can be tackled when you make friends with the disease. If you learn about the disease, its causes, pathogenesis, progression and prognosis, you can adapt your lifestyle in a way that you can slow down disease progression. Some of these strategies are highlighted below:
• Eat a healthy and balanced diet, with less carbohydrates, more proteins, fruits and vegetables. Go for fresh green salads. Avoid saturated fats and sweet food items.
• Eat in small quantities and at regular intervals to keep the blood sugar from fluctuating.
• Exercise daily and maintain an active lifestyle. Walk briskly for at least 30 minutes regularly.
• Maintain normal body weight with respect to height.
• Tobacco and diabetes is a dangerous combination! Therefore, avoid tobacco at all costs.
• Take good care of your feet. Foot care is very important for diabetics and increases microcirculation and reduces chances of development of foot ulcers.
• Get your eyes tested annually, so than any retinal changes can be detected early.
Blood Sugar Monitoring
• Check your blood sugar regularly and keep a log book to track changes in the level of blood sugar over a period of time.
• Go for self-monitoring of blood sugar (SMBG) using a glucometer if your budget permits. Measure fasting blood sugar (FBS) and post-prandial (PP) blood sugar regularly.
Glycated Hemoglobin and Lipid Profile Monitoring
• Test for glycated / glycosylated hemoglobin (HbA1C) every 3-4 months, as this gives the average blood sugar levels over a longer period, where the daily blood sugar fluctuations are not reflected. Try to attain a target level of 7% or less.
• Check your lipid profile regularly as advised by your doctor.
Blood Pressure Monitoring
• Check your blood pressure regularly for early detection of hypertension.
• Take your medications regularly and follow your doctor’s advice regarding all prescribed drugs.
In this way, you can keep the complications of diabetes in check and lead a normal, healthy and happy life.