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India has the largest diabetic population in the world, over 40 million. Each year a further 7 million people develop diabetes. Every 10 seconds two people develop diabetes. – International Diabetic Foundation Click here for more information on diabetes and take the test to check your risk for this life style disorder.

What is Diabetes?

Diabetes is a disorder where in the human body does not produce or properly use insulin, a hormone that is required to convert sugar, starch and other food into energy. Therefore the sugar levels in the blood are extremely high, which plays a role in destroying the small arteries of the heart, kidneys and eyes, and the body starts breaking down fats and protein to generate energy which leads to accumulation of toxic byproducts.

Causes of Diabetes:

There are two types of diabetes which are caused by different factors. Type I diabetes is due to complete destruction of the cells that produce insulin in the body. This can be caused by genetic diseases etc. Type I is relatively a rare form of diabetes and is usually present from childhood. The most common form of diabetes is type II diabetes, where body produces insulin which is either not sufficient or it is not able to utilize insulin effectively. The common causes of type II diabetes are hereditary factors, obesity, sedentary lifestyle and physical or emotional stress, where drug induced diabetes or infections are relatively rare.

What are the symptoms and complications of Diabetes?

In the initial stages, diabetes presents with the three Ps-Polydipsia, Polyphagia and Polyuria, which means increased appetite, increased thirst and increased urination. These symptoms are combined with increased fatigue and easy irritability due to poor supply of energy to the brain. Poor wound healing is a classic symptom of diabetes and is sometimes the first objective sign of underlying diabetes. Poorly controlled diabetes can also cause blurred vision, kidney damage and cardiac vessels damage resulting in heart attacks.

Detecting Diabetes

I have always thought that being chubby is a sign of prosperity! It is indeed a sign of affluence. It signifies that you have the means to eat well and does not signify good health! So, yes, while it is a sign of prosperity, it is not necessarily a sign of health! In fact, it is the opposite!

Treating Diabetes

There is no cure yet for diabetes. However, with the right diet, exercise and medications, diabetes can be optimally controlled to give you a near to normal life and protect you against any complications.

Complications of Diabetes

On an average, people with type 2 diabetes will die mostly due to cardiovascular disease 5-10 years before as compared to the people without diabetes. Every 10 seconds a person dies from diabetes-related causes. 10% to 20% of people with diabetes die of renal failure- International Diabetic Foundation.

What are the major complications of diabetes?

The major complications caused by diabetes are mostly to do with the damage of the blood vessels supplying the organs. The most common organs affected by this disorder are the kidneys, the heart, the eyes and the nerves.

What kidney problems can diabetes cause?

Kidney functions as a filtering machine in a human body by throwing out the waste in the form of urine. Uncontrolled diabetes damages the kidney and prevents it from carrying out its functions thus leading to accumulation of wastes in the body, which causes further problems. Early stage of kidney disease is known as microalbuminuria which can be detected by a simple urine test. Once detected to have microalbuminuria, your doctor will prescribe medications in addition to your regular diabetic medications to delay the damage of your kidneys. At the stage of microalbuminuria, the kidney damage is completely reversible and therefore gives you a good chance to get control of the diabetes and prevent long term damage.

What heart problems can diabetes cause?

Diabetes is one of the leading causes of heart attacks in the world, because it causes great damage to the blood vessels of the heart. This is probably the most dangerous complication of diabetes as it can cause immediate death too.

What eye problems can diabetes cause?

The most common eye complication of diabetes is known as diabetic retinopathy. In the early stages, it presents as blurred and distorted vision. In the most severe form, it can cause blindness. It is therefore essential to get your eyes checked by a competent eye doctor at least once a year.

What are the nerve problems caused by diabetes?

Nerves depend on multiple tiny vessels which carry nutrients and oxygen to keep intact all the segments of very long nerves. Damage to one small segment can result in loss of feeling, pain or burning sensation that bother the foot and leg which later on lead to loss of sensation. The loss of sensation causes injury to the leg to go without being noticed. Since diabetes already causes non healing wounds, these wounds tend to get infected. In later stages, surgery would be the only way to heal such wounds. It may result in removing of the affected toe, toes or even parts of the affected leg.

What are the other problems caused by diabetes?

Apart from the above, diabetes can cause infections of the skin, poor healing of other infections, worsening of asthma due to infections etc. Most of the complications of diabetes can be prevented by optimal control of blood sugar levels with diet, exercise and medications.

Living with diabetes

Optimum control of diabetes can help you lead a near normal life. Almost all complications of diabetes are preventable. Diabetes control is predominantly with Diet and Exercise.

What should I do to live healthy with diabetes?

Living with diabetes is not very difficult as people make it out to be. It involves regular blood sugar monitoring, eating healthy, and leading an active life with good compliance to diabetic medications.

Monitoring Diabetes

Diabetes can be monitored at home with the help of easy to use blood sugar monitoring machines. Fasting glucose levels and glucose levels 2 hrs after food are commonly used to check if the control of the disease is optimal.

What is HbA1C?

HbA1C is a kind of diabetes memory test. It tests the level of blood sugar control in the preceding three months, by detecting the level of glucose in the red blood cells and is an essential monitoring tool for diabetes control. Ideally HbA1C should be checked once in 6 months for those with optimal diabetes control.

What is an ideal diet for diabetics?

There is no one ideal diet that suits everyone, but there are certain basic principles for a healthy diet. The first principle is to eat small quantities in more frequent intervals. So instead of 3 heavy meals, eat about 5 small meals in a day with equal spacing between meals. Include large portions of boiled vegetables in your diet and have ONE fruit per day. Increase your consumption of oat meal and reduce eating fried oily food. Occasional splurge will not do much damage to your body, but that's the key-keeping it occasional so that you do not miss the smaller pleasures of life.

Why is exercise important?

Exercise helps by reducing obesity which is an important cause for improper utilization of insulin. Also exercising muscles use much less insulin to absorb glucose, thereby giving you a double benefit. Add to that, the fact that exercise will help you to burn fat and thus reduce its accumulation in the blood vessels, thereby preventing most complications of diabetes; this is indeed a wonder drug. Active exercise for 45 minutes a day, 5 days a week, will not only add years to your life, but will also add life to your years.

What drugs are available for diabetes and their side effects?

It is very essential to remember that drugs are only an add on to diet and exercise and not a replacement. The various groups or drugs available are Oral Hypoglycemic Drugs, which primarily stimulate the pancreas to produce more insulin. These drugs can cause the blood sugar levels to drop below normal levels, known as hypoglycemia and hence food should be consumed after drug intake. Hypoglycemia can be recognized by increased sweating, giddiness and extreme hunger. Always keep a pack of sugar handy in case you are hypoglycemic. Biguanides are drugs that increase the sensitivity of the tissues to the available insulin, while also helping in weight loss. These drugs do not cause the blood sugar values to drop below normal and are hence safer. Some patients have stomach upset in the early stages of treatment with these drugs but usually adapt quickly. There are other drugs that help to reduce the absorption of glucose from the stomach.

Insulin?

Insulin is the hormone that is lacking in a patient with diabetes. Patients who are not controlled with oral drugs have to be started on insulin to achieve optimal control of blood sugars.

Is Insulin safe?

Yes, absolutely. Insulin is the safest medicine for diabetics and has absolutely no inherent side effects. However, when your body secretes insulin, it does so according to the needs of your body. When it is supplemented from outside, the dose and timing are absolutely important. Irregular and improper administration of insulin is what causes the side effects, not the insulin per se!

My doctor asked me to take insulin for a short while and then brought me back to drugs- Is this right?

The demands of the body vary from time to time. In stressful conditions (stress to your body, not just the mind), such as infections, severe stress, pregnancy etc, the need for insulin is higher and therefore drugs are not enough to control your blood sugars. So your doctor would have advised insulin for a short course of time. Your doctor is the best person to decide on your diabetic medications.

Do other diseases have an effect on Diabetes?

Well, the relationship is not always the same between diseases. Apart from diabetics having a higher incidence of heart diseases and kidney failures, diabetics also have a higher chance of getting (or are already having) bad cholesterol levels, a high blood pressure and/or poor vision. Therefore it is extremely important to look for such diseases whenever you are getting checked for your sugar levels. Management of diabetes is beyond just having 'normal sugar levels'.

So to put it in a nutshell:

Eat well and eat right! Exercise! It can be swimming, jogging, cycling, aerobics – Take your pick! Check your fasting and post prandial blood sugar every three months and your HbA1c once in 6 months!

QUOTES

America's health care system is in crisis precisely because we systematically neglect wellness and prevention.

- Tom Harkin

The ability to be in the present moment is a major component of mental wellness.

- Abraham Maslow

There are six components of wellness: proper weight and diet, proper exercise, breaking the smoking habit, control of alcohol, stress management and periodic exams.

- Kenneth H. Cooper

Water is a only drink for a wise man

- Henry David

Your stomach is not a waste basket

- Anonymous

The ground work of all happiness is good health

– Leigh Hunt

"To insure good health: Eat lightly, breathe deeply, live moderately, cultivate cheerfulness, and maintain an interest in life

– William Londen

Improved diet and physical activity are more effective than medication in reducing the occurrence of Type 2 diabetes.

- New England Journal of Medicine