What is diabetes? A group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced, a condition called insulin resistance. The resultant high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).
The Main Types Type 1 – disease that results in autoimmune destruction of insulin-producing beta cells of the pancreas. Type 2 – metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Disease of affluence – type 2 diabetes is one of the “diseases of affluence”, which include mostly chronic non-communicable diseases for which personal lifestyles and societal conditions associated with economic development risk factors. Pre-diabetes – the medical stage in which not all of the symptoms required to label a person as diabetic are present, but blood sugar is abnormally high. This stage is often referred to as the “grey area” .
Signs and symptoms Symptoms of type II diabetes mellitus include:
- Constant hunger
- Unexplained weight loss
- Weight gain
- Flu-like symptoms, including weakness and fatigue
- Blurred vision
- Slow healing of cuts or bruises
- Tingling or loss of feeling in hands or feet
- Recurring gum or skin infections
- Recurring vaginal or bladder infections
- Family history of diabetes
- Cardiovascular disease
- Hypertension (high blood pressure)
- Increased triglycerides levels
- Low levels of good cholesterol (HDL)
- Overweight or obesity
- Sleep disorders
Women who have had gestational diabetes, had high birth weight babies (greater than 9 lbs.), and/or have polycystic ovarian syndrome (PCOS) These are associated with insulin resistance and are risk factors for the development of type 2 diabetes mellitus. Those in this stratum (IGT or IFG) are at increased risk of cardiovascular disease. Of the two, impaired glucose tolerance better predicts cardiovascular disease and mortality. In a way, pre-diabetes is a misnomer since it is an early stage of diabetes. It now is known that the health complications associated with type 2 diabetes often occur before the medical diagnosis of diabetes is made.
Risk Factors Diabetes mellitus type 2 can be controlled with diets, medication and health living. Diabetes mellitus type 1 can have higher risk factors.
Below are some of the main key factors of Diabetes Complications:
- Cardiovascular disease (CVD)
- Kidney disease
- Neuropathy or nerve damage
- Eye disease associated with diabetes
Prevention The American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) have developed lifestyle intervention guidelines for preventing the onset of type 2 diabetes: Healthy meals (a diet low in saturated fat, sugars, and refined carbohydrates, as well as limited sodium and total calories). Physical exercise (45 minutes of exercise per day, five days a week). Reducing weight by as little as 5-10 percent may have a significant impact on overall health Onset of type 2 diabetes can be delayed or prevented through proper nutrition and regular exercise. Intensive lifestyle measures may reduce the risk by over half. The benefit of exercise occurs regardless of the person’s initial weight or subsequent weight loss. Evidence for the benefit of dietary changes alone, however, is limited, with some evidence for a diet high in green leafy vegetables and some for limiting the intake of sugary drinks. In those with impaired glucose tolerance, diet and exercise either alone or in combination with metformin or acarbose may decrease the risk of developing diabetes. Lifestyle interventions are more effective than metformin. While low vitamin D levels are associated with an increased risk of diabetes, correcting the levels by supplementing vitamin D3 does not improve that risk.
Management Management of type 2 diabetes focuses on lifestyle interventions, lowering other cardiovascular risk factors, and maintaining blood glucose levels in the normal range. Self-monitoring of blood glucose for people with newly diagnosed type 2 diabetes may be used in combination with education, In those who do not want to measure blood levels, measuring urine levels may be done. Managing other cardiovascular risk factors, such as hypertension, high cholesterol, and microalbuminuria, improves a person’s life expectancy. Decreasing the systolic blood pressure to less than 140 mmHg is associated with a lower risk of death and better outcomes. It is recommended that all people with type 2 diabetes get regular ophthalmology examination. Treating gum disease in those with diabetes may result in a small improvement in blood sugar levels.
Lifestyle A proper diet and exercise are the foundations of diabetic care, with a greater amount of exercise yielding better results. Aerobic exercise leads to a decrease in HbA1c and improved insulin sensitivity. Resistance training is also useful and the combination of both types of exercise may be most effective.A diabetic diet that promotes weight loss is important. While the best diet type to achieve this is controversial, a low glycemic index diet or low carbohydrate diet has been found to improve blood sugar control. Culturally appropriate education may help people with type 2 diabetes control their blood sugar levels, If changes in lifestyle in those with mild diabetes has not resulted in improved blood sugars within six weeks, medications should then be considered.
Further information: Dibetes uk – www.diabetes.org.uk Nhs – www.nhs.uk/diabetes International diabetes federation – www.idf.org/about-diabetes U.S Department of health – www.niddk.nih.gov/diabetes Contact your local GP for further help and information