INTRODUCTION
According to the World Health Organization, a few decades back diabetes was an uncommon disease, in both developed and developing countries. It is currently estimated that over 143million people worldwide are affected by the disease. This figure is ever increasing, by 2020 over 220million people are expected to be living with diabetes, if the current trend continues.
In the United States alone, there are 18.2 million people (6.3% of the population) living with diabetes. While another 13million people have been diagnosed with diabetes. The figure for Nigeria is not readily available, but it is estimated that over 1.5million people have diabetes in Nigeria. In developed countries, most patients of diabetes are over sixty, but in developing countries, diabetes is found to affect people in their prime.
WHAT IS DIABETES?
Diabetes Mellitus (or simply diabetes) is derived from the Greek word ‘Diabeinein’, meaning ‘To pass through’ describing copious urination, and Mellitus from the Latin word meaning ‘Sweetened with honey’. These two words signify sweetened urine or sugar in urine.
Diabetes is a disease in which the body does not produce or properly use Insulin. Insulin is a hormone that is needed, in the body, to control the rate at which sugar, starch and other food are converted into glucose required as energy for daily life. The hormone is produced and released into the blood by an organ called ‘Pancreas’. This insulin help to maintain the blood glucose level within a normal range. The World Health Organization (WHO) puts this normal range between 60 – 100mg/dl (Before taking any food for the day, hence this value is called Fasting Blood Glucose). In health, despite several demands for glucose in different situations, the blood glucose rarely exceeds this value.
After a meal the liver stores the glucose from the meal as glycogen and releases it into the blood in between meals. The role of insulin is the control of this storage and release of glucose.
TYPES OF DIABETES.
According to the World Health Organization (WHO), five classes of diabetes are recognized, these are; Insulin Dependent Diabetes Mellitus (IDDM) or Type I Diabetes, Non Insulin Dependent Diabetes Mellitus (NIDDM) or Type II Diabetes, Gestational Diabetes, Diabetes Insipid us and Bronze Diabetes.
INSULIN DEPENDENT/TYPE I DIABETES: This type of diabetes was initially called Juvenile onset diabetes because it affects adolescents and young adults. It is, therefore, an acute disease, presenting with thirst, polyuria (passing large amount of urine), and dieresis and weight loss. Type I diabetes is not common, it accounts for less than 10% of all diabetes cases.
NON-INSULIN DEPENDENT/ TYPE II DIABETES: This is the most prevalent type of diabetes, accounting for more than 80% of all diabetic cases. This type of diabetes develops gradually over a long period of time (unnoticed) and is characterized by insufficient insulin, deficient insulin in the blood or the inability of the body to utilize the insulin resent (Insulin resistance). Unlike in Type I Diabetes, the Insulin in the blood of a Type II diabetic may be normal or even high, but lacks the desired effect, due to insulin resistance, and this is prevalent among obese people.
GESTATIONAL DIABETES: This type of diabetes occurs during pregnancy and disappears after delivery, within 3weeks. An estimated 3% of all pregnancies are accompanied by gestational diabetes and almost half of these patients are prone to developing permanent diabetes later in life.
WHAT CAUSES DIABETES.
As with hypertension and other non communicable diseases, no clear cut cause(s) can be attributed to the most prevalent type of diabetes (Type II Diabetes, Type I diabetes being secondary to failure of the pancreas). However, some factors are known to increase one’s chances of becoming diabetic and these are called risk factors. For example, indolent and well-fed populations are 2 – 20times more likely to develop type II diabetes than active and lean population of the same race. Some other factors known to increase one chances of getting diabetes include:
OBESITY: It is estimated that three quarter (¾) of all Type II diabetes patient are obese. Indolent and affluent lifestyles tend to contribute to this. It is believed that a 10kg loss of weight can reduce fasting blood sugar level by almost 50md/dl. An active lifestyle with frequent exercise is also known to increase Insulin sensitivity.
The International standard for measuring overweight and obesity is based on a value called BODY MASS INDEX (BMI). This value is derived by dividing the body weight (in Kilograms) by the square of height (in meters).
I.e. BMI = Body weight (Kg) / Height2 (Meters).
Note: 1ft = 0.305metres.
For adults, a BMI less than 25kg/m2 is preferred.
25 – 29kg/m2 are considered overweight and above 30kg/m2 is Obesity.
FAMILY HISTORY: A family history of diabetes increases one’s chances of getting the disease. In such a situation, leading a healthy lifestyle and constant monitoring of one’s blood sugar level becomes very important.
AGE AND RACE: Most Type II diabetes patient is over 40yrs at presentation of the disease. Moreover, diabetes tends to be more prevalent among Africans, African Americans, Latinos, Native Americans and Asian Americans. HISTORY OF GESTATIONAL DIABETES: in a woman also increases her chances/possibility of developing permanent diabetes later in life.
YOU CAN PREVENT/DELAY DIABETES!
Diabetes have no permanent cure once it develops, it is managed al through life. But you can prevent ever falling into this life long pain. Before diabetes present in people, it is almost always preceded by a situation called PRE DIABETES. A situation where the blood glucose is higher than normal, but not yet enough to be diagnosed as diabetes. Saddening, however, you cannot know when you fall into this category, if you have not being monitoring your blood glucose regularly.
Pre Diabetes is itself a serious medical situation, though can still be reversed by making changes in diet pattern and increasing physical activity. To determine one’s blood sugar a test called Fasting Blood Glucose has to be conducted. This test measures the amount of glucose (sugar) in one’s blood before taking any meal for the day. It is measured in milligrams per deciliter (mg/dl).
A value below 100mg/dl is generally accepted to be normal, while a value greater than 100mg/dl but less than 120mg/dl is not full diabetes yet, so it is regarded as Pre diabetes. An individual with a pre diabetes blood glucose level need to take urgent steps to reduce his blood glucose or risk life long diabetes.
It should be emphasized, however, that the racial and genetic factors predisposing to diabetes are still beyond human comprehension and control. It makes common sense, therefore, to reduce all human controllable factors to the barest minimum. Most of these factors have to do with social occupational and diet habits.
The following tips can help reduce your diabetes risk:
* Reduce weight. Obesity seems to be the single most significant factor in diabetes. Reducing body weight and fat and maintaining an average body weight is very essential. To this end a body mass index (BMI) less than 25kg/m2 for males and less than 24kg/m2 for females is recommended.
* Increase Physical Activity. It is an established fact that diabetes is more common among people that lead a sedentary affluent lifestyle. Exercise reduces bodyweight and fat, increases functionality of the heart, reduces the chances of diabetes and also boosts emotions and healthy living.
* Cut down or cut out alcohol. Alcoholic intake of more than 2units per day has been shown to adversely affect the body. It is better therefore to strive to cut out alcohol completely.
* Avoid Smoking. Cigarette smoke has been shown to contain several poisonous substances. Cigarette smoking and alcohol have been related to several disease. Stopping smoking will definitely reduce the chances of several other ailments apart from diabetes.
* Lean good eating habits, such as;
* Cut down on fatty food and junks
* Garlic reduces blood pressure cholesterol; add it to your meal plan once in a while.
* Reduce salt intake to less than 5.8 grams daily.
* Eat more of vegetables and fiber rich food, especially fruits.
CONCLUSION
Diabetes and Hypertension being so interlinked requires a comprehensive plan of care, and this revolves round one’s dietary habits, social and environmental factors. Several lifestyle changes like regular exercise, maintaining a moderate body weight, reduction of fat intake and high fiber diet all help to live a normal healthy life. These measures are known to increase insulin sensitivity and also reduce blood pressure.
Moreover, preventive health cannot be divorced from regular medical checks, as this two go hand in hand. There is no way to detect several non-communicable diseases without undergoing regular medical checks.
Be alive to your health. Know your Blood glucose values and live a healthier life free from the pains of diabetes.
Facts about Diabetes
Before people develop type 2 diabetes, they almost always have "pre-diabetes" -- blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. There are 54 million people in the United States who have pre-diabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes.
The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. There are two major types of diabetes. Type 1 diabetes results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes. Type 2 diabetes results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.
There is also pre-diabetes which is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 54 million Americans who have pre-diabetes, in addition to the 20.8 million with diabetes.
Diabetes symptoms may vary from person to person but most of the time anyone with diabetes will experience some or all of these symptoms. Some symptoms are: going to the restroom more often, staying thirsty, fatigue, blurred vision, stomach pain and occasionally people suffer from weight loss.
Type 1 diabetes is normally only found in children and type 2 diabetes is found mostly in adults but not always. There are some cases where children are being diagnosed with type 2 diabetes. Some people may be diagnosed with being borderline diabetic, which normally ends up turning into full blown diabetes but not always.
Some of the most important things people with diabetes should know are a healthy, nutritional diet and a regular exercise program can help in treating the disease. Speak with your doctor about what kind of diet you should consider following, along with a moderate exercise program.
Myth #1 you can catch diabetes from someone else. Although we don't know exactly why some people develop diabetes, we know diabetes is not contagious. There seems to be some genetic link in diabetes, particularly type 2 diabetes. Lifestyle factors also play a part.
Myth #2 People with diabetes can't eat sweets or chocolate. If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more "off limits" to people with diabetes, than they are to people without diabetes.
Myth #3 eating too much sugar causes diabetes. Diabetes is caused by a combination of genetic and lifestyle factors. However, being overweight does increase your risk for developing type 2 diabetes. If you have a history of diabetes in your family, eating a healthy meal plan and regular exercise are recommended to manage your weight.
Myth #4 People with diabetes should eat special diabetic foods. A healthy meal plan for people with diabetes is the same as that for everyone – low in fat (especially saturated and Trans fat), moderate in salt and sugar, with meals based on whole grain foods, vegetables and fruit. Diabetic and "dietetic" versions of sugar-containing foods offer no special benefit. They still raise blood glucose levels, are usually more expensive and can also have a laxative effect if they contain sugar alcohols.
Myth #5 if you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta. Starchy foods are part of a healthy meal plan. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. The key is portions. For most people with diabetes, having 3-4 servings of carbohydrate-containing foods is about right. Whole grain starchy foods are also a good source of fiber, which helps keep your gut healthy.
Myth #6 People with diabetes are more likely to get colds and other illnesses. You are no more likely to get a cold or another illness if you have diabetes. However, people with diabetes are advised to get flu shots. This is because any infection interferes with your blood glucose management, putting you at risk of high blood glucose levels and, for those with type 1 diabetes, an increased risk of ketoacidosis.
Myth #7 Insulin causes atherosclerosis (hardening of the arteries) and high blood pressure. No, insulin does not cause atherosclerosis. In the laboratory, there is evidence that insulin can initiate some of the early processes associated with atherosclerosis. Therefore, some physicians were fearful that insulin might aggravate the development of high blood pressure and hardening of the arteries.
Myth #8 Insulin causes weight gain, and because obesity is bad for you, insulin should not be taken. Both the UKPDS (United Kingdom Prospective Diabetes Study) and the DCCT (Diabetes Control & Complications Trial) have shown that the benefit of glucose management with insulin far outweighs (no pun intended) the risk of weight gain.
Myth #9 Fruit is a healthy food. Fruit is a healthy food. It contains fiber and lots of vitamins and minerals. Because fruit contains carbohydrate, it needs to be included in your meal plan. Talk to your dietitian about the amount, frequency and types of fruits you should eat.
Myth #10 you don't need to change your diabetes regimen unless your A1C is greater than 8 percent. The better your glucose control, the less likely you are to develop complications of diabetes. The ADA goal is less than 7 percent. The closer your A1C is to the normal range (less than 6 percent), the lower your chances of complications. However, you increase your risk of hypoglycemia, especially if you have type 1 diabetes. Talk with your health care provider about the best goal for you.
There is no cure right now for diabetes but there are several different forms of treatment available for you. Do not give up hope on feeling better and living a long, healthy, happy life.
