By Dr Rajesh Kumar Bhatt
Diabetes is one of the most common diseases in the Middle East with startling statistics. As much as 16.7% of the local population is diabetic. The International Diabetes Federation (IDF) states that there were 282,530 cases of diabetes in Qatar in 2013.
The prevalence of diabetes is dramatically increasing in Qatar as well as other GCC countries. It is the fastest growing long-term disease affecting millions of people around the world. Diabetes not only affects adults, but even kids below the age of 5. Statistics show that children below the age of 5 affected by diabetes (type 1) constitute 28.8%.
What is diabetes?
Explaining the medical condition Dr Rajesh Bhat says: “Diabetes is a group of metabolic diseases, wherein the body fails to utilise the ingested glucose properly. This is because your pancreas doesn’t produce any insulin, or not enough insulin, to help glucose enter your body’s cells – or the insulin that is produced does not work properly (known as insulin resistance).” Diabetes is of two types — Type 1 and Type 2. Type 1 diabetes known as insulin-dependent diabetes mellitus and occurs at a younger age or childhood. It is usually caused by an auto-immune reaction where the body’s defence system attacks the cells that produce insulin. People with type 1 diabetes produce very little or no insulin.
Type 2 diabetes is called non-insulin dependent diabetes or adult-onset diabetes, and accounts for at least 90% of all cases of diabetes. It is characterised by insulin resistance and relative insulin deficiency, either or both of which may be present at the time diabetes is diagnosed. The diagnosis of type 2 diabetes can occur at any age.
Dr Bhat added: If diabetes is not treated, it can lead to a number of different health problems. Diabetes affects many major organs, including heart, blood vessels, nerves, eyes and kidneys. Controlling blood sugar levels can help prevent these complications. Although long-term complications of diabetes develop gradually, they can eventually be disabling or even life-threatening.
Medical complications
Heart and blood vessel disease: Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of arteries (atherosclerosis) and high blood pressure. If you have diabetes, you are up to five times more likely to develop heart disease or have a stroke. Cardiovascular diseases are the most common cause of death for people with diabetes. Strokes are twice as likely in people with diabetes and high blood pressure compared to those with high blood pressure alone.
Prolonged, poorly controlled blood glucose levels increase the likelihood of atherosclerosis (a condition involving the furring and narrowing of your blood vessels). This may result in a poor blood supply to your heart, causing angina (a dull, heavy or tight pain in the chest). It also increases the chance that a blood vessel in your heart or brain will become blocked, leading to a heart attack or stroke.
Nerve damage (neuropathy): High blood glucose levels can damage the tiny blood vessels in your nerves. This can cause a tingling or burning pain that spreads from your fingers and toes up through your limbs. It can also cause numbness which can lead to ulceration of the feet. If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhoea or constipation.
Kidney damage (nephropathy): The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system in rare, severe cases, kidney disease can lead to kidney failure and a kidney replacement treatment with dialysis (or sometimes kidney transplantation) will be necessary.
Eye damage: Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma. Annual eye checks are usually organised by a regional photographic unit. If significant damage is then detected, you may be referred to an ophthalmologist (a doctor who specialises in treating eye disease). The better you control your blood sugar levels, the lower your risk of developing serious eye problems. Diabetic retinopathy can be managed using laser treatment if it is caught early enough. However, this will only preserve the sight you have; it will not improve it.
Foot damage: Nerve damage in the feet or poor blood flow to the feet, increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections. About 1 in 10 people with diabetes get a foot ulcer, which can cause serious infection. Severe damage might require toe, foot or even leg amputation. If you have diabetes, look out for sores and cuts that do not heal, puffiness or swelling and skin that feel hot to the touch. If poor circulation or nerve damage is detected, check your feet every day and report any changes to your doctor, nurse or podiatrist (foot care specialist).
Sexual dysfunction: In men with diabetes, particularly smokers, nerve and blood vessel damage can lead to erection problems. This can usually be treated with medication. Women with diabetes may experience:
p A reduced sex drive
p Reduced pleasure from sex
p Vaginal dryness
p A reduced ability to orgasm
p Pain during sex
Miscarriage and stillbirth: Pregnant women with diabetes have an increased risk of miscarriage and stillbirth. If your blood sugar level is not carefully controlled during the early stages of pregnancy, there is also an increased risk of the baby developing a birth defect. Pregnant women with diabetes will usually have their antenatal check-ups in hospital or a diabetic clinic, ideally with an obstetrician (a doctor who specialises in pregnancy care).
Infections: Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. Gum infections also may be a concern, especially if you have a history of poor dental hygiene.
Osteoporosis: Diabetes may lead to lower than normal bone mineral density, increasing your risk of osteoporosis.
Alzheimer’s disease: Type 2 diabetes may increase the risk of Alzheimer’s disease and vascular dementia. The poorer your blood sugar control, the greater the risk appears to be. So what connects the two conditions? One theory is that cardiovascular problems caused by diabetes could contribute to dementia by blocking blood flow to the brain or causing strokes. Other possibilities are that too much insulin in the blood leads to brain-damaging inflammation, or lack of insulin in the brain deprives brain cells of glucose.
Hearing problems: Diabetes can also lead to hearing impairment.
There is a lot of fear and some amount of stigma attached to being a diabetic. Although it is true that genes play a role in your state of health; it does not necessarily mean that the same fate will befall you. Lack of physical workout and poor eating habits play a major role in high diabetic rates of Qatar.
Traditional and nutritional food has slowly been replaced by industrial and canned food in the Middle East. Due to the extreme climatic conditions, people do not go out and engage in physical workout. The good news is that even people at high risk can reduce their chance of getting diabetes by over 50% through lifestyle changes.
- Dr Rajesh Kumar Bhatt is a General Practitioner at Aster Medical Centre in Industrial Area.
INDICATOR: Blood glucose levels can be determined through a glucometer. If you have diabetes, you are up to five times more likely to develop heart di
