On account of the celebration of “World Diabetes Day” this November 14th, let’s try and understand this extremely widespread lifestyle disease that we are dealing with and look into how we might just escape its grasp.
World Diabetes Day is celebrated in order to create awareness about the disease and give the general population an idea about the extreme prevalence of diabetes in today’s world. The attention is given to type two diabetes given that it is preventable while explaining the ways by which it can be prevented by anyone.
Every year on November 14, The International Diabetes Federation along with the World Health Organisation celebrates the World Diabetes Day to propagate the above-mentioned features for public benefit.
November 14th is the day chosen to celebrate this because it is the birthday of one of the founders for the treatment of the disease- the co-founder of insulin- Frederick Banting. This day was first initiated in 1991.
On this day every year, various programs including campaigns via different media- television, radio and newspapers, screening programs free of charge, marathons and other awareness methods such as skits, street plays, flash mobs, etc take place worldwide to ensure maximum knowledge is created about the disease.
Every year, a different theme is focused upon so as to cover every aspect of this disease. This year the theme is Women and Diabetes- our right to a healthy feature. Previous themes have covered healthy eating, care for the eyes and so on.
What is Diabetes?
Diabetes is a chronic (long-lasting) disease of the metabolic system- the one that works to convert the food you eat into energy. The most important feature of diabetes is the increased level of sugar(glucose) present in the blood.
The increased glucose levels in the blood are known as hyperglycemia- which isn’t a disease and is a natural phenomenon unless it lasts for long durations- hence diabetes can be defined as a condition of prolonged hyperglycemia.
The organ called pancreas produces a hormone called insulin– the main function of which is to reduce the blood glucose levels in the body.
Why is insulin Important?
The function of insulin is to make sure that the cells in the body take up the glucose from the blood so that it is used to produce energy- a process that can be otherwise called burning calories.
Diabetes is of two types, Type I and Type II.
In Type I diabetes, due to ineffective functioning of the pancreas, decreased amounts or no insulin is produced in the body. This condition is otherwise known as juvenile diabetes and requires lifelong treatment with insulin. It is an autoimmune condition- wherein the pancreatic cells that produce insulin are destroyed by the immune system of the body and hence it isn’t preventable.
Type II diabetes also is known as secondary diabetes is the focus of our article- it is a lifestyle disease that can be prevented- if the cause is removed or avoided- the disease is preventable unlike in case of Type I Diabetes.
Why Does Diabetes Occur?
Type Two Diabetes Mellitus occurs due to many reasons that cause poor uptake of the insulin from the blood by the cells.
1- Obesity and Overweight-
Due to increased body mass index, the body continually accumulates more and more fatty tissue- which are formed when the carbohydrates are not used to produce energy by the cells- which then gets stored as fat/adipose. Owing to the increased body weight and increased amounts of fat tissue, the distribution of these play a role in the onset of diabetes.
People who have more stored fat in the lower part of the body- the abdomen, hips, and thighs have a much higher chance of acquiring type two diabetes than others who are evenly fat. A big belly is almost a sure shot sign of diabetes mellitus.
2- Poor imbalanced diet and Lack of Exercise–
A diet very rich in carbohydrates and fat and not balanced with proteins, vitamins, and minerals that are being followed constantly can lead to type two diabetes.
This when combined with inactivity- if you are of sedentary lifestyle allows no opportunity for the calories to burn and the glucose to get used up no matter how hard the insulin tries- hence gifting such people with diabetes.
3- Hormonal Imbalances due to other conditions-
in Polycystic ovarian syndrome- a disease that affects women who usually have a sedentary lifestyle with a fat-rich diet, an accompanying feature is usually diabetes.
Those who have Cushing Syndrome- due to uncontrolled secretion of the ACTH from the pituitary gland, are also subjected to suffering from diabetes mellitus.
Long-term treatment using corticosteroids also cause prolonged hyperglycemia in patients. Different hormones produced in the body act as either hyperglycaemic or hypoglycaemic which can be attributed to their various functions in the body by them.
4- Epidemiological Factors-
Age and ethnicity -People who are of the middle age and older are more prone to contracting diabetes mellitus as they develop insulin resistance over time due to conditions such as fatigue of the cells.
They also tend to carry out a more sedentary lifestyle when compared to the younger population which also leads to them not being as fit as before. However in today’s world of developing technology making sure people need to move less than before even younger adults and children are contracting diabetes at an alarming rate.
When we take race into consideration, studies have shown that particular races- such as African- Americans, and Asians are more vulnerable to becoming victims of diabetes than Caucasians.
Previous Short- Long-term Hyperglycaemic Conditions-
Such as Gestational Diabetes which occurs during pregnancy owing to the fluctuations in the hormone levels. The pregnancy usually ends with the delivery of an overweight (big) baby. Such mothers are sure to have Diabetes Mellitus later on in their lives.
In some patients, a constant state of raised sugar levels is present that is not too high but borderline high and such people to have high chances of being diabetics.
Prevalence- Who Does It Affect?
Long story short, diabetes type two can affect anyone- old or young, male or female, thin or fat. It all depends on the lifestyle and all the above-mentioned factors. Let’s take a look at a few numbers that shall give us an idea as to how prevalent the disease is in the modern world.
World Health Organisation reports as of 2015
A number of people worldwide suffering from type two diabetes in 2014- 422 million.
Diabetes-related deaths in 2015-3.8 million.
The World Health Organisation has declared that studies have shown that in less than twenty years diabetes will be the seventh leading cause of death worldwide among all ages of the population.
What Happens In This Disease?
We already know what causes the disease and have an idea about what happens at the cellular level. Let’s see now how this affects different organ systems in the body.
Diabetes affects almost all the organ systems in the body.
- The EYES. It causes diabetic retinopathy which is the most common cause of blindness in older adults. Features that are seen are- microaneurysms (blood vessels that burst), consecutive hemorrhages following new blood vessels being formed. It also causes cataracts that can be prematurely occurring.
- KIDNEYS- Long-standing diabetes can affect the kidneys by leading to end-stage renal failure which is a fatal condition. Renal function continues to decline with age but is accelerated because of diabetes.
- THE NERVOUS SYSTEM-in the peripheries- ends- there is the loss of sensation of pain and touch: noticed by the patients wearing tight shoes but not feeling them to be constricting. There is a pin and needles sensation- a tingling type of pain in the feet and hands. This is followed by complete loss of sensation which is dangerous because, in case of injuries, there is a chance that the injuries left unnoticed can develop into gangrene of the foot which has to be then removed, that is amputated.
- IMMUNITY- Diabetes also causes slow healing due to a state of immunodeficiency. Diabetics and more prone to infection given that the hyperglycemia forms a culture medium for all kinds of bacteria and other microorganisms. This loss of immunity leaves the patient vulnerable to many infections that do not affect normal people with an intact immune system.
- THE HEART- diabetes affects the coronary circulation and hence is a leading cause of myocardial infarction. Diabetes is often accompanied by hyperlipidemia and hypertension. They restrict blood flow to and from the muscles and walls of the heart thus leading to cell death- causing a heart attack.
- THE BRAIN– when the blood flow is cut down from the brain at certain regions, this can lead to a condition known as transient ischaemic attack also known as a stroke. There are many complications that follow a stroke attack including permanent paralysis of one side of the body.
This is a condition where a diabetic patient who struggles levels are way above the normal, go into a state of altered sensorium also known as a coma.
Symptoms Of Diabetes
The symptoms of diabetes can be explained using Images and three features that are most commonly seen-
- Increased appetite the patients who suffer from diabetes are often seen eating Way more than they should be at very frequent intervals.
- Increased thirst and Frequent urination- which form a sort of a cycle.
- Loss of weight- which is noticeable given the increased appetite would mean in normal cases they should be gaining weight rather than experiencing a moderate rate of weight loss with no other explanations. However, this isn’t a sure symptom like the first two.
- The complications that are mentioned earlier can present as symptoms.
Diagnosis Of Diabetes
A detailed medical history comprising of family history and lifestyle practices is obtained following that a detailed physical examination is done to look for any signs of diabetes such as rapid weight loss, cataracts, etc.
Depending on the obtained information the diabetes is then classified as type one or two.
Random Blood Glucose Test– that can be done at any time. If sugar levels exceed 200mg/dl then the patient may have diabetes.
Fasting Plasma Glucose Test– done after twelve hours of fasting- if sugar levels exceed 126 mg/dl. This test is confirmatory if associated symptoms are present.
If no symptoms are present the patients undergo an Oral Glucose Tolerance Test where the following fasting the patients are made to drink glucose solutions at periodic intervals following which their blood is tested repeatedly for levels of glucose present in them.
HBA1C Test also known as Glycated Haemoglobin Test. This test measures the amount of glucose that is present in the hemoglobin over a period of at least a month. This test is it done to check the prognosis of the disease and to know whether the patient is following the advice to lifestyle and diet practices.
Tests are done in the urine to check for the levels of sugar. Along with this ketones and proteins are also tested to ensure proper functioning of the kidneys as albuminuria can occur- the presence of excess proteins in the urine due to impaired uptake.
Preventing Diabetes Mellitus
The following alterations to an unhealthy lifestyle have been proved effective in the prevention of diabetes.
- Consumption of more proteins and fewer carbohydrates.
- Consumption of small frequent meals rather than one big meal at regular intervals.
- Drinking more water helps in weight loss and decreases appetite.
- Adding more fibers to the diet to improve digestion.
- Including more physical activity in the daily routine such as cardio or weight training
- Ensuring infrequent yet steady weight loss that is healthy and it’s maintained.
- Studies have shown that improving your sleep patterns reduces stress and this can help in weight loss.
- Consumption of more antioxidants such as green tea, other sources of vitamin E and selenium.
- Activities such as meditation to reduce stress levels have been shown effective.
Tips For Weight Loss At Home
- Remember to always take the stairs whenever possible and walk more to places that are nearby rather than using a vehicle.
- Consume more salads and cook at home whenever possible.
- Drink at least two liters of water a day.
- Sleep at fixed times. Do not sleep immediately following a meal.
- Do not consume weight loss pills as they have a lot of side effects unless recommended by a doctor.
- Oral Hyperglycaemic Agents- such as metformin.
- Insulin- that are available in many varieties and recommended in case oral medication is not enough.
- A strict diet plan and exercise regimen.
- Treatment for all the complications that occur due to diabetes.
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