Numbers of diabetes patients are increasing alarmingly in Sri Lanka during past few years. Overall prevalence, which was 6.5% in year 2000, has risen up to 10.2% by 2006. Condition is worsened among urban population were nearly one in 5 persons is suffering from the disease. Therefore it is very important to pay a special attention to over come this problem by all of us.
Diabetes is a disease where you get a high blood glucose level in your body than the normal range. This is mainly due to inadequate secretion of the hormone insulin from the pancreas, which is the organ responsible for the production of insulin. Ti could also be due to insulin resistance in which you get insulin in the body but due to the ineffective action of the hormone the sugar level in the blood are not properly controlled. Insulin is the hormone that helps glucose from the digestion of carbohydrates in food; move in to body’s cells where it is used for energy. When insulin is not present or is ineffective, glucose build up in the blood.
Diabetes could be of several types.
Type 1
Diabetes type 1 diabetes develops when the insulin producing cells in the pancreas have been destroyed. Nobody knows for sure why these cells have been damaged but most likely cause is the body having an abnormal reaction to the cells.
Type 2
Diabetes type 2 diabetes is usually appears in middle aged or older people, although more frequently now diagnosed in younger people and children the main cause is that the insulin that the body produces doesn’t work properly. Some people wrongly describe type 2 diabetes as ‘mild’ diabetes. There is no such thing as mild diabetes. All diabetes should be taken seriously and treated properly.
Gestational Diabetes
This is a type of diabetes which develops during pregnancy.
Symptoms of Diabetes
The excess glucose stays in the blood and isn’t being used as fuel for energy. Patients with untreated diabetes often can fell tired, thirst and dry mouth, passing more urine than usual, blurred vision, weight loss and itching around genitals. However majority with diabetes may not have any of these symptoms and their diabetes is only picked up during a routine testing. Some people may put down these symptoms down to ‘getting older’ or ‘over work’
Some individuals are at higher risk of developing diabetes. Such high risk persons are persons whose close members of his family have type 2 diabetes. Also, if a person is overweight and having high blood pressure, cholesterol, heart attack or a stroke he is at risk of developing diabetes. If an individual is having impaired glucose tolerance or impaired fasting glucose are also at risk. In some females, if they are suffering from polycystic ovarian syndrome or had gestational diabetes, they too are at a high risk of developing diabetes.
Diagnosis of Diabetes
Diagnosis can be made by a 10-12 hours fasting blood sugar or blood sugar testing after 2 hours of the main meal. If a person is diagnosed to have diabetes, further blood testing is needed.
Managing Diabetes
Although diabetes cannot be cured, it can be managed very successfully. The aim of diabetes management is to keep blood glucose levels as near to normal as possible. Healthy eating and regular physical activity are extremely important to manage your diabetes properly other than your medication.
Patients with type 1 diabetes need insulin injection to control blood sugar while patients with type 2 diabetes need tablets. Most patients with type 2 diabetes may need insulin when blood sugars are not properly controlled with tablets. Both, tablets and insulin are safe methods of treating diabetes to avoid its complication.
Some patients believe that being on insulin means that they are at the last stage of their diabetes. This is not true. Starting insulin at the appropriate time is one of the best options to control diabetes to avoid its complications.
Healthy eating is important to control diabetes properly. What you eat directly affects your blood glucose levels. By choosing healthy foods and being active you will help manage your blood glucose levels and your weight. The diet for people with diabetes is not a special diet. It is the normal healthy diet recommended for every body. A diet containing low fat, sugar and salt, plenty of vegetables and moderate amounts of starchy foods are good for every body. Hence, there is no need to prepare separate meals for you at your home if you have diabetes. You do not need to buy special foods either, so relax, and learn how to enjoy a varied balance diet. Eat three regular meals a day, avoid skipping meals and spread your breakfast, lunch and dinner over the day. This will not only help to control your appetite but also will help in controlling your blood glucose levels.
Being active is good for all of us but it is especially important for people with diabetes. Regular physical activity can help to improve your diabetes control, help prevent some complications of diabetes, reduce the chances of you getting a heart attack or stroke, improve your blood pressure and cholesterol, strengthen your bones to help prevent osteoporosis (brittle bones), help treat arthritis and back pain. Many people enjoy being active not just for their health but because it makes them feel better and helps stop their weight creeping up. You can select the appropriate physical activity suitable for you such as walking, running, jogging, cycling and swimming. The recommended minimum amount of activity for adults is 30 to 45 minutes on at least five days of the week. Before you starting your physical activity it is always advisable to take advice from your doctor.
It is also important to control your blood pressure and cholesterol, consider stopping smoking, weight management and regular medical cheek-ups for complications.
Prevention of Diabetes
You can prevent or delay the onset of diabetes if you eat a healthy diet and have an active life. It is also important to maintain an appropriate weight for you height.
Diabetes in Pregnancy
Diabetes in women no longer means amenorrhea, inability to conceive, inability to deliver healthy children or death during pregnancy.
If a woman has type 1 or type 2 diabetes it is very important that she talks to her doctor when she is planning pregnancy. This is because her blood glucose has to be stable and as near normal as possible when she becomes pregnant.
If her blood glucose levels are not controlled in the first few weeks of pregnancy, the risk of miscarriage is high and the baby’s development too could be affected. Uncontrolled diabetes in first few months of pregnancy could cause teratogenic effects such as fetal malformations (cardiac, neural tube defects) and abortions.
If the woman is already a diabetic patient, she should discuss her current medicine her doctor. She may have to stop or change medicines if she takes them for type 2 diabetes, blood pressure or cholesterol. She has to have her eyes checked, and asses her kidney functions prior to become pregnant. She should start taking folic acid 5 mg daily and have a healthy and balanced diet from the beginning.
Gestational Diabetes
Approximately 10% of women develop diabetes during their pregnancy. This is called gestational diabetes. It happens when body cannot control its own glucose level.
It is important to control level of glucose in the blood during pregnancy. If there is too much sugar in the blood, baby’s body may start to make insulin to try to cope with it. This extra insulin can make the baby grow larger, making delivery more difficult and potentially cause injury to both mother and baby.
Also, the baby who is making extra insulin may have low blood glucose when he or she is born, which can affect him or her in the first few hours of life. Therefore, it is important to monitor them during first 24 hours.
When managing the gestational diabetes mellitus, it is important to give them a proper dietary advice to get appropriate calorie intake and appropriate exercises if there are no contraindications. If the blood glucose levels are not controlled with these measures it is important to start insulin in order to achieve the target blood sugar levels. It is vital to check blood glucose levels regularly and increase the insulin dosage according to the need with the progression of the pregnancy. It is equally important to check blood pressure in each visit as they are more prone to get pregnancy induced high blood pressure.
Women who had gestational diabetes are more likely to develop diabetes again in future pregnancies. They also have a higher chance of getting type 2 diabetes in future. Therefore, they should be encouraged to have regular exercises, healthy eating patterns and annual blood sugar checkups for early detection of diabetes.
