Diabetes

Diabetes is a common life-long health condition characterized by high blood sugar levels. Most of the food we eat is broken down into sugar (also called glucose) and released into our bloodstream. When our blood sugar goes up, it signals our pancreas to release insulin. Insulin acts like a key to let the blood sugar into our body’s cells for use as energy. Diabetes mellitus is a chronic disorder recognized by high blood sugar. It occurs either because of lack of insulin or because of the presence of factors that oppose the action of insulin

Types of Diabetes

Type I diabetes: A disorder in which the body makes little or no insulin at all because of beta cell destruction. It is thought to be caused by an autoimmune reaction (the body attacks itself by mistake). Symptoms of this type of diabetes often develop quickly. It’s usually diagnosed in children, teens and young adults. Insulin shots are needed daily for the treatment.

Type II diabetes

This is the most prevalent form of diabetes comprising 90 – 95% of all diabetics. The body makes less insulin or the cells are unresponsive to insulin. The body may have enough insulin and still the insulin response is ineffective because of the blockage of insulin receptors, also termed as insulin resistance. Overproduction of insulin initially exhausts the beta cells production of insulin, consequently leading to less insulin production thereby causing diabetes. Type II diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food and being active.

Gestational diabetes develops in pregnant women who have never had diabetes. It is important to diagnose and treat gestational diabetes because it severely affects the fetus. Gestational diabetes signals that the woman has a higher chance of developing Type 2 diabetes later in life, particularly if she is overweight / obese.

The baby is more likely to have obesity as a child or teen and more likely to develop type 2 diabetes later in life too.

Prediabetes

In Prediabetes blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Prediabetes raises the risk for type 2 diabetes, heart disease and stroke.

Prevention studies have proven that with intensive lifestyle interventions (ILS), there is a 58% risk reduction of being diabetic. ILS involved changes in diet and physical activity aimed at reducing weight. For every 1 kg decrease in weight, the risk of developing diabetes in future reduces by 16%.

Symptoms of diabetes

• Tiredness
• Frequent urination
• Increased thirst
• Increased appetite
• Unexplained weight loss and weight gain (especially around the belly )
• Numbness or tingling of feet
• Blurred vision
• Wounds that don’t heal

While many people with Type II diabetes present with increased urination & thirst, many others have a slow onset of high blood sugar & do not exhibit symptoms initially. This is particularly true in obese people, whose diabetes may be detected only after sugar is detected in urine or as high blood sugar.

Occasionally people may show neurological or cardiovascular complications because of disease presence for some time, most common being pain, numbness & weakness in extremities (more in legs), angina & strokes. Chronic skin infections are also common. Eye and kidney problem arise frequently.

Diabetes should always be suspected in those who have delivered large babies (more than 4 kg), presence of pre-eclampsia during pregnancy or unexplained fetal losses.

Risk factors for diabetes

Following conditions make you more susceptible to Diabetes:

• Being overweight (If a person has body weight classified as overweight and if the waist to hip ratio is more than 0.9 in men and more than 0.8 in women,
  he/she is classified as centrally obese)
• Being pre-diabetic
• Family history of diabetes
• Women having PCOS (Polycystic ovarian syndrome )
• Have had high sugar during pregnancy (Gestational Diabetes mellitus)
• Have delivered a baby weighing over 4 kgs
• Have a history of chronic pancreatitis, fatty liver and high triglycerides
• > 30 years of age
• Leading a sedentary lifestyle
• Have been an alcoholic

Some alarming facts…

• India is the Diabetes capital of the world.
• At least 50% of all people with prediabetes are unaware of their condition. In some
  countries this figure is as high as 84%.
• Even an increase in BMI by 1 can drastically increase the chances of getting diabetes.
• Upto 80% of Type II diabetes is preventable by adopting a healthy diet and increasing physical activity.
• Obesity can lead to gestational diabetes in pregnancy. This increases the risk for a primary caesarian and pre term birth in all women. Losing weight saves all the above risk.
• Obesity and Insulin resistance are reversible, but unchecked weight gain will lead to Type II Diabetes mellitus which is irreversible.
• There is a linear relationship between weight loss and HbA1c reduction, with an estimated mean HbA1c reduction of 0.1 percentage points for each 1 kg of reduced body weight.

Normal range of blood glucose control-

• Fasting Sugar: 70 – 100 mg/ dl
• Post Prandial (PP) sugar: 100 -140 mg/ dl

Prevention and Management of Diabetes

There is no cure for diabetes. However, you can manage or delay diabetes through diet, exercise, weight control and, if necessary, medication. Healthy lifestyle choices that help treat pre-diabetes, type 2 diabetes and gestational diabetes can also help prevent them:

• Prevent/treat overweight and obesity. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.
• Maintain a healthy body weight and avoid weight gain during adulthood. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Eat healthy foods. Choose foods lower in fat and calories and higher in fibre. Focus on fruits, vegetables and whole grains. Strive for variety to prevent boredom.
• Aim for about 30 minutes of moderate aerobic activity on most days of the week, or at least 150 minutes of moderate aerobic activity a week. Increasing physical activity and reducing sedentary behaviors such as prolonged TV watching are important both for maintaining body weight and improving insulin sensitivity

Prevention is better and inexpensive than cure. This proverbial saying fits well for diabetes. The disorder and its symptoms can be brought under control by following a well-planned diabetic diet and physical activity. This would also help to minimize the complications of the disorder.