World Diabetes Day: Information on the silent killer

World Diabetes Day is observed around the world on 14^th November. The objective of this day is to spread the awareness about increasing number of people being affected by diabetes. This day emphasises the need to have proper education on the risk factors of diabetes along with its prevention and treatment. World Diabetes Day is also celebrated as the birthday of Sir Frederick Banting who co-discovered insulin and used it on humans for the first time.

Diabetes is slowly becoming a silent killer across the globe and it is spreading its roots at an alarming pace in India (65 million diabetics). In 2010, this figure was 50.8 million. According to the World Health Organisation, by 2030, diabetes will be 7th leading cause of death. The occurrence of diabetes for all age-groups around the world is estimated to be 4.4% in 2030, a rise from 2.8% in 2000. Increase in the number of diabetics is because of population growth, ageing, urbanisation, lack of exercises and increase in obese people.

Three forms of diabetes

Type 1 diabetes or Juvenile Diabetes

In this type of diabetes, the body does not produce insulin. Type 1 Diabetes, also referred to as Insulin-Dependent Diabetes is the most common disorder diagnosed in children. A balanced diet, regular exercise and timely insulin intake can help lead a normal life.

Type 2 Diabetes or Adult Diabetes

In this type of diabetes, the body does not produce insulin in appropriate measure which is known as insulin resistance. In the beginning, your pancreas makes extra insulin to make up for it. But, over time it will not be able to make enough insulin to keep your blood sugar levels at bay. Typically, type 2 diabetes is the result of excess body fat and physical inactivity. Healthy diet, regular physical activity and shedding extra body weight helps in maintaining normal blood sugar levels.

Gestational Diabetes

This type of diabetes affects women during pregnancy, normally around the 24^th week. In gestational diabetes, pancreas work extra to produce insulin, but the insulin does not lower your blood glucose levels. So the extra blood glucose goes through the placenta giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. 

Treatment for all types of diabetes is available. Type 1 diabetes lasts a lifetime, there is no known cure. Type 2 usually lasts a lifetime; however, some people have managed to get rid of their symptoms without medication, through a combination of exercise, diet and body weight control. 

One thing that every diabetic need to do is to undergo regular tests and monitoring to ensure that all the vital parameters are normal. However, a strict approach is needed to address the diabetes epidemic.

Diabetes Mellitus: Everything you want to know

Why should we care about Diabetes?

Diabetes is a very common disorder to an extent that up to 12% of population in Delhi is diabetic and another 15-20 % is pre-diabetic. Diabetes is a disorder with very serious consequences if not treated well. And it is very costly to treat diabetic complications than to prevent them. The problem with diabetes is that it affects quality of life much more than quantity of life.

What causes Diabetes?

Diabetes occurs when the pancreas, a gland behind the stomach, does not produce enough of the hormone insulin, or the body can’t use insulin properly due resistance to its action.

What is pre-diabetes?

In Pre-diabetes, person's blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. Pre-diabetes is also known as Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG)

What are different types of Diabetes Mellitus?

Type 1

Diabetes occurs when the pancreas makes very little or no insulin. This form of the disease is most often seen in children. 

Type 2

Body is resistant to the action of insulin, meaning it cannot use insulin properly, so it cannot carry sugar into the cells.

Other types

Gestational Diabetes (occurring in pregnant females) and secondary forms of diabetes like pancreatic DM.

What are the Risk factors for developing Diabetes Mellitus?

Main risk factors for developing diabetes are:

• Being overweight
• Sedentary lifestyle
• Family history of diabetes
• History of gestational diabetes
• Age
• Ethnic/racial background
• African
• Hispanic/Latino
• Native American
• Asian

What are the symptoms that should alert you to see your doctor?

• Increased thirst
• Increased urination
• Constant hunger
• Weight loss
• Blurred vision
• Fatigue, or a feeling of being tired
• Frequent fungal infections
• Very slow healing of wounds or sores 

What can be the serious long-term problems due to diabetes?

Diabetes can affect your entire organ systems including:

• Eyes: Decreased vision and even blindness.
• Kidney disease: Change in size and function of kidneys which can result in decrease in urine output and swelling of body.
• Nervous system: Diabetes can result in stroke (weakness of some part of body like left/right hand or leg), abnormal sensation in both feet which can extend to arms also and eventually lead to complete loss of sensations.
• Heart: Diabetes, if uncontrolled, can lead to heart attacks.
• Diabetic foot: Diabetes is leading cause of non-traumatic foot amputations. A combination of loss of sensation and decreased blood supply to your feet make it more prone to trauma and subsequent infection.

Why should I treat my Diabetes?

Keeping your glucose levels close to normal will greatly lower your chances of developing long-term complications.

If you already have complications, keeping your glucose levels close to normal will help keep these problems from getting worse.

What are goals of Diabetes Treatment?

Goals of treatment in Diabetes are two-fold

• Control of your blood sugar, so that you do not have symptoms like weight loss, increased urination etc.
• Early identification and treatment of diabetic complications like eye disease, heart disease and kidney disease.

What is HbA1c?

HbA1c stands for Glycosalated haemoglobin or Glycated haemoglobin. HbA1c is also called as the blood test with a memory. It gives a person’s average blood glucose control for 2-3 month period before the test.

What are the tests that are required to monitor Diabetes progression?

Tests for Diabetes can be divided into three tiers according to frequency:

• On Daily basis: Blood sugar with glucometer
• Every Three Monthly: HbA1c, Blood glucose from lab, Lipid profile
• Every yearly: Haemogram, LFTs, KFTs, Urine evaluation, HbA1c, Lipid Profile, Eye checkups, Foot examination

How should I manage my Diabetes?

Management of diabetes involves three main components:

• Diet
• Exercise
• Medication (oral or insulin)