From the ancient physicians Charaka And Sushruta first describing the implications of Diabetes Mellitus to India being tagged as the "Diabetic Capital of the world" , India Seems to be well known for Its association with diabetes. Every fifth Diabetic in the world is an Indian. Yes. You read it right. As per a Study by WILD AND ASSOCIATES on the 'Global prevalence of Diabetes' the estimated number of people with diabetes by the year 2030 is expected to go as high as 151% as compared to what was in the year 2000. These alarming figures highlight the need towards understanding the basis of the disease and the intervention for its prevention.
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| Preventing and Managing Diabetes |
So what really is diabetes?
Diabetes Mellitus is described as a clinical syndrome characterized by hyperglycemia (high blood sugar) and glycosuria (blood sugar in urine) due to defects in secretion and/or action of insulin or insulin resistance. (Insulin is a hormone which maintains the sugar level in the body by taking the sugar out of the bloodstream and into the organs like liver and muscle where it can be used for energy.)
Clinical classification of diabetes mellitus :
1. Type 1 : ( Insulin dependent diabetes mellitus)
Seen in patients less than 20-30 years with insulin deficiency. These patients are non obese with a strong genetic basis and a poor family history.
2. Type 2 : ( Non Insulin dependent diabetes mellitus)
Seen in the 35-65 age group with insulin resistance. These patients are obese with a strong family history.
When do you say a person has diabetes?
When a person who's blood sugar levels are as follows:
1. Random blood sugar more than or equal to 200 mg /dl.
2. Fasting blood sugar more than or equal to 126 mg /dl.
3. HbA1C more than 6.5%
How does a patient with diabetes Mellitus present?
Patient can present with either the classical 3Ps - polyphagia, polydipsia and polyuria or a variety of symptoms including recurrent boils,abscess,UTI,stye, delayed wound healing or undue tiredness. Many times patients present to various specialists for eg to an ophthalmologist with complains of frequent change in glasses or with
cataract presenting early.
What are the consequences of diabetes mellitus?
Over a period of time diabetes can affect any organ starting from the vessels of the brain to the toes. It has now become the leading cause of end stage renal disease and a major cause of non traumatic limb amputations. Diabetic retinopathy is responsible for 30% of the preventable causes of blindness. CHD and stroke are more common in diabetics making it a leading cause of cardiovascular mortality. Metabolic disorders in pregnant Diabetic women or those caused by gestational diabetes pose a risk to both mother and foetus.
Understanding the disease would be incomplete without understanding the basis and the ease with which the disease and its complications may be prevented.
What is screening of diabetes mellitus?
It is the early detection and effective control of hyperglycaemia in the asymptomatic diabetics in order to reduce morbidity associated with it.
Who should be screened?
Screening with urine test for glucose or blood sugar testing is applied to high risk groups which include -
1. A person aged 40years or more.
2. Family history of diabetes Mellitus.
3. Obese
4. Woman with baby more than 4.5 kg
5. Woman with excess weight gain during pregnancy.
6. Patient developing premature atherosclerosis.
Can diabetes be prevented?
Diabetes Mellitus is easily prevented and so is its onset delayed by ensuring simple lifestyle modifications in the form of -
1. 30 mins of regular, moderate intensity activity like brisk walking on 6 days of the week and preferably all 7 days.
2. Increasing the consumption of fruits, vegetables, legumes.
3. Decreasing the intake of saturated fats And sugar.
4. Improving fiber uptake.
5. Achieving and maintaining the ideal body weight.
6. Avoiding tobacco use And smoking.
Can diabetes be treated?
Once a person is diagnosed with diabetes the treatment is based on diet, insulin, oral anti-hypoglycaemic drugs, exercise and patient education.
What care should a diabetic take?
Once diagnosed, the Diabetic should ensure routine checking of blood sugar, urine for proteins and ketones, blood pressure, visual acuity and weight. The feet should be checked for any defective circulation,
loss of sensation and health of the skin. Glycosylated haemoglobin provides a long term index of glucose control and should be estimated periodically.
Prevention is always better than cure. And diabetes is no exception to this old adage. The greatest challenge that lies in preventing diabetes, and the related morbidity and mortality, is the immense need of dedicated self-care behaviors in multiple dimensions including food choices, physical activity, proper medications and regular blood glucose monitoring from the patients.
Nice article from Dr. Rufiat Kazi. Your advice will certainly help Diabetic patients to take care of their health.
ReplyDeleteCertainly a very insightful article. It has clarified a load of myths about the same. The articulation done by Dr. Kazi is on the dot with respect to preventive measures, diagnosis & treatment for diabetes
ReplyDeleteThank you Dr Kazi, this article is well written.
ReplyDeleteVery informative article Dr.kazi...certainly very helpful for diabetics as well as others..
ReplyDeleteA complete health care guide of diabetes for the common man!
ReplyDelete