Understand and control diabetes
November 12 2015 08:24 PM
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By Dr Abdulrazac KV

Every seven seconds one person dies from diabetes across the world, says the International Diabetes Federation (IDF), as to mark World Diabetes Day on November 14. There were 4.9mn deaths from diabetes last year. This year, the campaign has focussed on healthy eating as the key factor in the fight against diabetes. Diabetes is considered as one of the most dangerous and silent killer disease in the world.
Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience frequent urination; they will become increasingly thirsty and hungry because the excess sugar is excreted out in the urine. Since the food eaten is not absorbed well, then feel very weak.
There are three main types of diabetes:

Type 1 diabetes
The body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years.
Type 1 diabetes is nowhere near as common as type 2 diabetes. Approximately 10% of all diabetes cases are type 1.
Patients with type 1 diabetes will need to take insulin injections for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet.

Type 2 diabetes
The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance). Approximately 90% of all cases of diabetes worldwide are type 2.
Some people may be able to control their type 2 diabetes symptoms by following a healthy diet, doing plenty of exercise, being physically active and monitoring their blood glucose levels. However, type 2 diabetes is typically a progressive disease — it gradually gets worse — and the patient will probably end up taking insulin.
Overweight and obese people have a much higher risk of developing type 2 diabetes compared to those with a healthy body weight. People with a lot of visceral fat, also known as central obesity, belly fat, or abdominal obesity, are especially at risk. Being overweight/obese causes the body to release chemicals that can destabilise the body’s cardiovascular and metabolic systems.

Gestational diabetes
This type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose. Diagnosis of gestational diabetes is made during pregnancy.
The majority of gestational diabetes patients can control their diabetes with proper exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth.

What is prediabetes?
The vast majority of patients with type 2 diabetes initially has prediabetes. Their blood glucose levels would be higher than normal, but not high enough to merit a diabetes diagnosis. The cells in the body are becoming resistant to insulin.
Studies have indicated that even at the prediabetes stage, some damage to the circulatory system and the vital organs may occur undetected for a long period of time.
Complications linked to badly controlled diabetes:
Below is a list of possible complications that can be caused by badly controlled diabetes:
l Eye complications - glaucoma, cataracts, diabetic retinopathy, and some others.
l Foot complications — neuropathy, ulcers, and sometimes gangrene which may require that the foot be amputated.
l Skin complications — people with diabetes are more susceptible to skin infections and skin disorders
l Heart problems — such as ischemic heart disease, when the blood supply to the heart muscle is diminished.
l Hypertension — common in people with diabetes, which can raise the risk of kidney disease, eye problems, heart attack and stroke.
l Mental health — uncontrolled diabetes raises the risk of suffering from depression, anxiety and some other mental disorders.
l Hearing loss — diabetes patients have a higher risk of developing hearing problems.
l Gum disease — there is a much higher prevalence of gum disease among diabetes patients.
l Gastroparesis — the muscles of the stomach stop working properly.
l Ketoacidosis — a combination of ketosis and acidosis; accumulation of ketone bodies and acidity in the blood.
l Neuropathy — diabetic neuropathy is a type of nerve damage which can lead to several different problems.
l HHNS (Hyperosmolar Hyperglycaemic Nonketotic Syndrome) - blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition.
l Nephropathy — uncontrolled blood pressure can lead to kidney disease.
l PAD (peripheral arterial disease) — symptoms may include pain in the leg, tingling and sometimes problems walking properly.
l Stroke — if blood pressure, cholesterol levels, and blood glucose levels are not controlled, the risk of stroke increases significantly
l Erectile dysfunction - male impotence.
l Infections — people with badly controlled diabetes are much more susceptible to infections.
l Healing of wounds — cuts and lesions take much longer to heal.

How to determine whether you have diabetes prediabetes or neither
It is crucial to consult a General Physician to determine whether you have an impaired metabolism, prediabetes or diabetes to detect and control the disease at the earliest stages.
Three essential steps to maintain a healthy metabolism
Proper exercise
Exercise is an absolutely essential factor and without it, you are unlikely to get this devastating disease under control. It is one of the fastest and most powerful ways to improve insulin sensitivity and to control high blood glucose. Skeletal muscle being the largest reservoir of glycogen (Stared Glucose) proper exercise showed involve safe building and maintenance of almost all major and minor muscle group of the body. Regular physical activity is mostly beneficial side effect of a proper exercise programme and occurs spontaneously as the body begins to function better. Chronic pain of lack of time are the two major reason why inactivity than becomes the form of modern society.
 Several new studies in the research field of exercise science than shown that it may require only very little time to acquire the so called benefits of exercise when exercise in performed correctly.

Good food awareness
Limit intake of processed and packaged food than shown to be highly beneficial in maintaining good health.
Refined flour, high fructose contained in commercial juices, hydrogenated vegetarian oils that contain trans-fat are best be avoided (biscuits, cakes etc) due to the harm caused by them to the organs of the body.
In addition to that, controlled calorie diet portions such as grains, other starches and sugar would be absolutely recessing in the management of post meal hyperglycaemia. In layman term — high blood sugar strikes after the meal.

Disease awareness
Educate and update yourself with the latest findings and informations available on diabetes management through studying, collecting and sharing information also attending and learning from diabetes awareness programs conducted by Qatar’s highly committed healthcare system.

♦ Dr  Abdulrazac KV is a a General Physician- Internal Medicine at Aster Medical Centre, Old Al Ghanim

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