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Diabetes

  • Diabetes is when your blood glucose, also called blood sugar, is too high. Blood glucose is the main type of sugar found in your blood and your main source of energy. Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries glucose to all of your body’s cells to use for energy.

    Your pancreas—an organ, located between your stomach and spine, that helps with digestion—releases a hormone it makes, called insulin, into your blood. Insulin helps your blood carry glucose to all your body’s cells. Sometimes your body doesn’t make enough insulin or the insulin doesn’t work the way it should. Glucose then stays in your blood and doesn’t reach your cells. Your blood glucose levels get too high and can cause diabetes or prediabetes.

    Over time, having too much glucose in your blood can cause health problems.

    Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease.

     

    In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live long, healthy lives.

     

    Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel.

     

    With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level.

    More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy.

     

    Type 1 diabetes

    Type 2 diabetes

    Usually < 30 years, but not

    always

    Usually older, but prevalence

    in children, adolescents and

    young adults increasing

    Usually lean weight

    Mostly overweight or obese,

    with acanthosis nigricans

    Onset is acute

    Onset is insidious/gradual

    Almost always symptomatic

    (i.e. polyuria, polydipsia,

    weight loss)

    Often asymptomatic

    Prone to ketosis, often

    ketoacidosis at diagnosis

    Not usually prone to ketosis,

    but ketoacidosis may be

    present at diagnosis

    Diagnosis: usually

    has unequivocal

    hyperglycemia

    Diagnosis often during

    routine screening

    Insulin necessary, as of

    diagnosis, for survival

    Usually controlled with non-insulin therapies, or may need insulin for symptom control

    Otherwise normally healthy

    Often have co-morbidities*

    or diagnosed after

    emergency admission for

    myocardial infarction or

    stroke

     

  • The onset of Type 2 diabetes is often slow, however there are a few symptoms that individuals should be aware of. Some of the symptoms that are common to diabetes include: 

     

    Urinating often

     

    Feeling very thirsty

     

    Feeling very hungry - even though you are eating

     

    Extreme fatigue

     

    Blurry vision

     

    Cuts/bruises that are slow to heal

     

    Weight loss - even though you are eating more (type 1)

     

    Tingling, pain, or numbness in the hands/feet (type 2)

     

    Detecting and treating diabetes early can help decrease the chances of developing further complications. 

  • You should not self-diagnose Diabetes. Just because you are experiencing one or more of the symptoms does not mean that you are Diabetic and the lack of these symptoms does not ultimately rule out the disease.  Testing for diabetes should be carried out in a healthcare setting and usually requires a repeated test on a second day to diagnose diabetes. However, if your Doctor determines that your blood sugar level is very high and if you have symptoms with one positive test, your doctor may not require a second test to diagnose diabetes.

     

    Some of the tests used to diagnose diabetes are discussed below:

     

    Fasting Plasma Glucose (FPG)

    This test checks for the level of sugar in your blood after not having anything to eat for at least 8 hours. For best results, it is recommended that this test be done first thing in the morning before having breakfast.

    Diabetes is diagnosed with a level greater or equal to 7.0mmol/l or 126 mg/dl

    Normal: 3.9 to 5.5 mmols/l (70 to 100 mg/dl)

    Prediabetes or Impaired Glucose Tolerance: 5.6 to 7.0 mmol/l (101 to 126 mg/dl)

     

    Hemoglobin A1C (HbA1c)

     The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months.

    Normal                 less than 5.7%

     Prediabetes      5.7% to 6.4%

     Diabetes             6.5% or higher

    Some people of African heritage may have a form of hemoglobin in their blood cells that affects diabetes care. Most people have only one kind of hemoglobin, called hemoglobin A. Some people have both hemoglobin A and another kind, such as hemoglobin S, C, or E. This can cause a false results for the HbA1c test. If the A1C test gives a false result, your health care provider may think your blood glucose, also called blood sugar, level is higher or lower than it really is.

     

    Oral Glucose Tolerance Test (also called the OGTT)

    The OGTT is a two-hour test that checks your blood glucose levels before and 2 hours after you drink a special sweet drink. It tells the doctor how your body processes glucose.

    Normal less than 140 mg/dl

    Prediabetes       140 mg/dl to 199 mg/dl

    Diabetes              200 mg/dl or higher

     

    Random (also called Casual) Plasma Glucose Test

    This test is a blood check at any time of the day when you have severe diabetes symptoms.

    Diabetes is diagnosed at blood glucose of greater than or equal to 200 mg/dl

  • Your healthcare provider will determine the best time to begin a medication management of your diabetes. Below are some lifestyle modifications for the prevention and management of type 2 diabetes. 

     

    Lifestyle Modifications

    Individuals with type 2 diabetes who are obese or overweight should work towards losing weight as this is a very important in the management of their condition. This can be achieved through implementing healthy lifestyle changes that include reducing caloric intake, consuming less saturated or Trans-fats, cholesterol, salts and increasing physical activity.

    Please avoid restrictive, carb –free, fat-free, low calories and high- protein diets as these may not offer any long term benefits over traditionally healthy eating plans.

     

    A.Follow a healthy balanced eating plan

    Eat a variety of fresh fruit and vegetables every day, but avoid fruit juices

    At least half of the grain intake must be from wholegrain products

    Consume low-fat dairy products and soya beverages fortified with calcium

    Use a variety of meat alternatives, including pulses, soya and tofu

    Consume fish at least twice per week

    Limit the intake of processed and convenience foods

    Increase the intake of water to meet daily fluid requirements

     

    B.Alcohol Consumption (Abstaining from alcohol is highly encouraged but If you choose to drink follow these guidelines)

    Practice caution when you are drinking alcohol, do not drink on an empty stomach or when your blood sugar is low.

    Do not replace your regular meals with alcohol

    Sip your drink slowly to make it last and enables you drink less

    Choose calorie free drink mixers like diet soda etc. when making or ordering mixed drinks

    Do not drive or plan to drive for several hours after you drink alcohol.

    Inform your doctor if you drink several times a week as this will determine your treatment of choice.

     

    C.Physical Activity

    Exercise can help you improve your blood sugar control

    Inform your healthcare provider before beginning any physical activities

    Perform at least 150 minutes of moderate aerobic physical activity

    Fast walking

    Lap Swimming

    Bicycling

     

    Test your sugar 30 minutes before exercise

    If lower than 100mg/dl (5.6mmol/L) – eat a carb-containing snack 

  • It is never too late to change your lifestyle. Sometimes prevention can be as basic as eating healthy foods, becoming more physically active, and losing weight. Even after being diagnosed with diabetes engaging in these lifestyle changes can reduce and often eliminate your chances of developing additional complications such as kidney, heart, nerve damage.

     

    Consider the latest general diabetes prevention tips from the American Diabetes Association.

     

    Tip 1: Get more physical activity

     

    There are many benefits to regular physical activity. Exercise can help you:

     

    Lose weight

    Lower your blood sugar

    Boost your sensitivity to insulin — which helps keep your blood sugar within a normal range

    Research shows that both aerobic exercise and resistance training can help control diabetes, but the greater benefit comes from a fitness program that includes both.

     

    Tip 2: Get plenty of fiber

     

    It's rough, it's tough — and it may help you:

     

    Reduce your risk of diabetes by improving your blood sugar control

    Lower your risk of heart disease

    Promote weight loss by helping you feel full

    Foods high in fiber include fruits, vegetables, beans, whole grains, nuts and seeds.

     

    Tip 3: Go for whole grains

     

    Although it's not clear why, whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your grains whole grains. Many foods made from whole grains come ready to eat, including various breads, pasta products and many cereals. Look for the word "whole" on the package and among the first few items in the ingredient list.

     

    Tip 4: Lose extra weight

     

    If you're overweight, diabetes prevention may hinge on weight loss. Every pound you lose can improve your health, and you may be surprised by how much. Participants in one large study who lost a modest amount of weight — around 7 percent of initial body weight — and exercised regularly reduced the risk of developing diabetes by almost 60 percent.

     

    Tip 5: Skip fad diets and just make healthier choices

     

    Low-carb diets, the glycemic index diet or other fad diets may help you lose weight at first, but their effectiveness at preventing diabetes isn't known nor are their long-term effects. And by excluding or strictly limiting a particular food group, you may be giving up essential nutrients. Instead, think variety and portion control as part of an overall healthy-eating plan.

     

    When to see your doctor

     

    If you're older than age 45 and your weight is normal, ask your doctor if diabetes testing is appropriate for you. The American Diabetes Association recommends blood glucose screening if:

    You're age 45 or older and overweight

    You're younger than age 45 and overweight with one or more additional risk factors for type 2 diabetes — such as a sedentary lifestyle or a family history of diabetes

     

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    1. Should you only eat small amounts of starchy foods if you have diabetes?
    2. How will I know whether I have a hemoglobin variant?
    3. What is Prediabetes?
    4. I noticed a lot of areas of darkened skin, do I have diabetes?
    5. What causes blurred vision in people with diabetes?
    6. Why am I always thirsty and why do I urinate often?
    7. Can I eat a lot of fruits since fruit is a healthy food?
    8. Can you can catch diabetes from someone else?
    9. Can people with diabetes eat sweets or chocolate?
    10. Should people with diabetes eat special diabetic foods?
    11. Does eating too much sugar cause diabetes?
    12. Is it true that diabetes is not that serious of a disease?
    13. Will every obese or overweight individual eventually develop diabetes?

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