BENGALURU: Diabetes is a condition which is commonly known as ‘Sugar Diabetes’, and medically as ‘Diabetes Mellitus’. People with this health problem have blood glucose/sugar levels higher than normal, causing symptoms such as increased thirst, frequent urination, unexplained weight-loss, fatigue, boils on the skin and delayed wound-healing.
In India, there are over 73 million adults who are detected with diabetes; one in two who have diabetes do not even know they have this condition. The detection rates can be increased by raising awareness of this problem/the symptoms, and by increasing screening opportunities for ‘high-risk’ individuals who are overweight/obese, lead a sedentary lifestyle, indulge in unhealthy food habits. Apart from this, those who are from a family that has had a history of diabetic conditions, and women with previous Gestational Diabetes and polycystic ovaries, need more attention.
More than 90 per cent of cases are Type 2 Diabetes
Pancreas, the organ in the body that produces insulin to control blood glucose level, is affected due to diabetes. Of the different kinds of diabetes, Type 2 or ‘adult-onset’ diabetes contributes to more than 90 per cent of the cases. Here, the body does not use insulin properly (‘insulin resistance’), and over time, insulin production also declines. Type 1 diabetes that usually affects children, occurs when one’s immune system mistakenly attacks insulin-producing cells in pancreas, leading to severe insulin deficiency; they need lifelong insulin injections. Gestational or pregnancy diabetes, and other rarer forms of diabetes, contribute to remaining cases of diabetes.
The two goals of treating diabetes
1. To control the symptoms and make day-to-day life better
2. To reduce the risk of complications to eyes, kidneys, feet, heart and other organs.
Healthy lifestyle involves eating a balanced diet, and doing regular exercise, and it forms the corner stone for the management of any type of diabetes. Thirty minutes/day of moderate exercise, at least five days a week, is the minimum recommended – it improves physical fitness, burns calories, promotes weight-loss, reduces insulin resistance, and gives a sense of ‘well-being’. Some patients with Type 2 diabetes can improve the glucose levels with these measures alone, in the short-term but will need medications as the condition progresses. Various tablets, injectable medications including insulin, are used to control blood-glucose levels. Bariatric surgery or ‘weight reduction surgery’ may be necessary in carefully selected obese Type 2 Diabetes patients to achieve weight loss and improve glucose control. ‘ABC’ of diabetes treatment consists of normalising A = HbA1c; B = BP (blood pressure), C = Cholesterol levels. HbA1c refers to a blood test that indicates glucose control over past two to three months.
Can it be prevented?
Type 2 diabetes is increasing in numbers across the world, owing to rapid urbanisation, easy availability of high-calorie food, sedentary lifestyle, lack of adequate exercise, ageing population, and genetic risk. This so-called ‘lifestyle disease’ previously associated with adult life, is affecting obese children and adolescents too, and poses a serious socio-economic challenge. All is not lost though. Scientific research has shown that weight loss by following healthy active lifestyle can reduce the risk of getting diabetes – this concept should be emphasised and promoted since childhood – both at home and school.
The theme of the World Diabetes Day 2018 – 2019 is ‘The Family and Diabetes’. It is well recognised that diabetes not only affects the patient but also impacts on the psycho-socio-economics of the family too. Supportive family is known to improve health outcomes of the diabetes patients. Education and raising the awareness about diabetes in the family can positively contribute to ‘team effort’ at beating diabetes. It promotes healthy environment at home, and hence, a good lifestyle. Awareness about symptoms of diabetes amongst the family members can ensure that undetected cases get detected early, and reduce the risk of delayed treatment/complications.
– The author is the consultant endocrinologist &HOD, Manipal Hospitals