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.

When you're a diabetic, healthy eating is the key

Because most people with type 2 diabetes are overweight, weight management and reduction should be the major consideration. The good news is, if you are overweight, you benefit from even a small weight loss. Weight loss markedly reduces the risk of developing type 2 diabetes and prevents the progression of pre-diabetes to type 2 diabetes. It can also reverse the failure to respond to drugs for diabetes that develops after responding at first weight loss can increase life expectancy, help lower blood pressure and improve energy levels and mobility.

The benefits of weight loss are seen rapidly, even when relatively little weight has been lost. A rapid fall in blood glucose occurs as soon as the energy intake of the diet is reduced. Over time, the blood pressure declines and the cholesterol falls. The triglycerides drop and the good cholesterol (HDL) rises. Even a modest reduction of 10 per cent of body weight has a significant positive effect on your coronary artery disease risk.

Unfortunately, your genetic make-up has a significant influence on your ability to lose weight and on the amount of weight you lose. Several studies have shown that people with type 2 diabetes lose less weight than people without diabetes. This can be disheartening and frustrating — especially when trying to explain not being able to lose weight to less-than-sympathetic workmates, family, friends or diabetologists. But, hang in there — even when weight loss isn’t possible, weight maintenance is an excellent goal, and you can certainly implement measures to improve the quality of your diet, weight loss or not.

Considering Carbohydrates

Diabetologists recommend that carbohydrate that’s high in fibre and low in fat should contribute between 40 and 50 per cent of your total daily kilojoule intake. An important part of achieving this target is avoiding the sources of carbohydrates that contain lots of kilojoules, but offer little nutritional value.

You probably already have some idea about which carbohydrates only provide ‘empty’ kilojoules. Some examples include cakes, biscuits, sweet pastries, honey, jam, ice-cream and sweet yogurt, chocolate, soft drinks, cordials and sugar added to drinks and breakfast cereal.

The best carbohydrate choices for you are those that are highest in fibre and lowest in fat — studies have shown that a diet featuring these types of foods can lower blood glucose and cholesterol levels.

Fibre is the part of a food that’s not digestible and so adds no kilojoules but has health benefits. Fibre is found in all fruits, vegetables and cereal grains, and the more unprocessed the grain (or fruit or vegetable), the higher the fibre content.

Choosing Proteins

Protein is used by the body for growing and repairing tissues. For this reason, it was thought that you could build your own muscle by eating lots of protein (actually, you build up muscle by exercising). Although children and young adults need more protein because they’re growing, adults need relatively little in order to maintain their current level of muscle.

Protein in your diet comes from chicken, pork, beef, eggs, milk and other dairy foods, nuts and legumes (or pulses). The protein component of these foods doesn’t raise blood glucose levels.

For most adults, two moderate-sized serves of protein per day are sufficient. Because milk, yogurt and legumes are sources of protein and carbohydrate, they can be included in the diet to satisfy your requirements for both food types.

If you’re unsure about the mix of carbohydrates and proteins that’s right for you, see your specialist diabetologist for an individualised assessment.

Tracking your blood sugar levels

The aim of diabetes management is to control blood glucose levels and to screen and treat related conditions such as high blood pressure, high bad cholesterol, and other complications of diabetes. This means that you will need to learn how to monitor your blood glucose levels, and you will also have to undergo recurrent laboratory tests and visits to your diabetologist than people without diabetes. This blog tells you how you will monitor your glucose levels.

Monitoring Diabetes

When you have diabetes, your glucose levels fluctuate much more than those of people without diabetes. In people without diabetes, fasting glucose levels in the morning are usually between 60 and 100 mg/dl. Before each meal, the levels are below 100 mg/dl. The peak values one to two hours after a meal are in the 120s and usually stay below 140, even after a meal rich in carbohydrates.

Conceptualising Home Monitoring

Blood glucose monitoring at home is an important part of diabetes management and serves a number of purposes. First, monitoring at home makes it easier to detect low blood glucose reactions, because you cannot rely on how you feel to detect low glucose levels. Many people with diabetes develop hypoglycemic unawareness meaning they can have glucose levels in the 40s and 50s and still feel quite fine. For this reason, measuring glucose levels frequently allows detection and treatment before the glucose levels fall too low. This monitoring is particularly relevant when exercising or performing activities such as driving or operating machinery, when you need to be alert.

Second, home monitoring allows you to detect high glucose levels. Elevated glucose levels may reflect dietary indiscretion or failure to take or to adjust diabetes medications. If you are on an insulin pump, there is not a big depot of insulin in the subcutaneous tissues, and if for any reason the insulin delivery gets interrupted, glucose levels can go very high and DKA can develop over a few hours. Persistently elevated high glucose levels increase the risk of developing long term complications of diabetes.

Finally, home monitoring allows you to adjust medication doses, particularly insulin. If you’re an insulin-treated patient, check your blood glucose levels at least four times or more a day. If you have type 2 diabetes controlled with diet only or are on medications that do not cause low glucose levels (like metformin, rosiglitazone, or exenatide), checking blood glucose levels a few times a week may suffice. However, if you have type 2 diabetes and are taking oral medicines that can cause low glucose levels (sulfonylureas, repaglinide, and nateglinide), one or two blood glucose checks per day are necessary.

For more information, book an appointment with qualified diabetologists. They will assist you monitor your blood sugar levels in a more secured way. 

Don’t Allow Diabetes to Let You Down

Diabetes is a chronic condition in which blood sugar (also called glucose) accumulates in your blood. The full name of the disease, diabetes mellitus, literally means “honey diabetes.” Since the time of ancient Greece, people have noticed a sweet or honeyed smell in the urine of those affected by the disease.

There is no cure for diabetes. However, diabetes can be controlled. Controlling diabetes means keeping your blood sugar at levels that are the same as—or close to—those of a person who does not have diabetes.

There are two primary kinds of diabetes, and the cause of your elevated blood sugar depends on which kind of diabetes you have.

TYPE-1 DIABETES

Type 1 diabetes used to be called “juvenile diabetes” because it normally occurs in people under the age of 30. If you have type-1 diabetes, your pancreas no longer produces insulin, a vital hormone that helps your body turn sugar into energy. Without this essential hormone, the sugar in your system accumulates in your blood. Type 1 diabetes is considered to be an “auto-immune” disease. It occurs when the immune system mistakenly attacks the pancreas and destroys its ability to make insulin.

Although family history plays a role in the development of type 1 diabetes, 90 percent of the people who get it have no family history of the disease at all. No one knows for sure why it strikes some people and not others. People with type 1 diabetes have to take insulin to control their blood sugar. Consultation with diabetologists is particularly helpful because of their expertise in diagnosing diabetic patients. 

TYPE-2 DIABETES

Type 2 diabetes used to be called “adult onset” because it normally occurs in people over the age of 30.

Type 2 diabetes is more likely if you have a family history of diabetes. It is closely related to excess weight and a lack of physical activity. African-Americans, Latinos, Pacific Islanders, Asians, and Native Americans are all at high risk for type 2 diabetes.

Although type 2 diabetes normally strikes people over the age of 30, it is on the rise among children. Diabetologists think this is directly related to a lack of physical activity and the increase in obesity among the young.

If you have type 2 diabetes, your pancreas still makes insulin. But it may not make enough, or your body may have become resistant to it. The first line of treatment for type 2 diabetes is exercise and weight loss—many people can control their blood sugar levels with exercise and diet alone. There are also oral medications that can be used to treat the disease. Type-2 diabetes tends to be progressive and a substantial number of people with type 2 diabetes ultimately need to take insulin to control their blood sugar.

  

World Health Day 2016: Beat the hell out of diabetes

World Health Day is observed on April 7^th every year and this year it’s focused on slowing the rise of diabetes worldwide. In both Type 1 and Type 2 diabetes, individuals have trouble producing insulin, potentially causing dangerous results if left unmanaged.

The World Health Organization has time and again published relative information about beating diabetes, as well as organised fun quizzes and put posters aimed at raising awareness. The disease disproportionately impacts poor countries.

Here are some facts about diabetes, which is expected to become the seventh leading cause of death globally by 2030.

The Numbers

About 350 million people worldwide have diabetes and about 1.5 million people die from it each year. More than 80 percent of diabetes deaths occur in low- and middle-income countries, the World Health Organization reported. Ninety percent of diabetes cases are Type 2. 

Type 1 vs. Type 2

In Type 1 diabetes, the body’s immune system destroys cells that release insulin, ultimately preventing the body from producing any. Cells are unable to absorb glucose without insulin, which is needed to produce energy. Type 1 occurs in children.

Type 2 diabetes is most common among adults, although it’s also on the rise among youth. It occurs when the body is unable to use insulin the right way, called “insulin resistance.” As it intensifies, the pancreas may produce a deficient amount of insulin.

What are the symptoms?

Hunger, fatigue, needing to use the bathroom more often than usual, dry mouth, itchy skin and blurred vision are all symptoms of both Type 1 and Type 2 diabetes, according to leading diabetologists. Individuals with Type 2 diabetes may also experience yeast infections, slow-healing cuts and pain or numbness in the feet or legs. Those with Type 1 might experience unexplained weight loss or nausea and vomiting.

What are the risks?

Both Type 1 and Type 2 diabetes can be dangerous if left untreated or poorly managed. Monitoring the disease can help significantly reduce risk, as both types increase risk of blindness, kidney failure, heart disease and stroke. People with diabetes are also at risk of needing amputations.

How is diabetes managed?

The discovery of insulin in 1921 offered new hope for those with diabetes, who used to be expected to die within the first few years after diagnosis. It’s not a cure, but it helps manage the disease. Insulin injections or an insulin pump help manage Type 1. The amount of insulin is determined from the amount of food consumed and daily activity. Those who use insulin regularly monitor their blood glucose level. With both Type 1 and Type 2 diabetes, healthy eating, physical activity and blood glucose testing are important.

When to see a diabetologist?

It’s a good idea to see your diabetologist if you have to urinate frequently, if you’re feeling weak or constantly thirsty or if you have a bad stomach-ache. Breath that smells like nail polish remover is a sign of high ketones and is a good indicator that you should head to the diabetologist.