Know Diabetes, Live Healthy, Live Longer

Dr. Noble Zachariah Al Dhamer Center for Medical Specialties

Diabetes Mellitus is a disease in which the blood sugar (glucose) is raised. It is a major health problem world wide, more so in Kuwait as one out of five suffers from diabetes here. In 2000 there were an estimated number of 150million diabetics in the world, which is expected to increase to 335million by 2025. The developing countries especially India account for the majority of new diabetics. Diabetes is the major cause of many of the illnesses like blindness, kidney failure, heart disease, paralysis and non traumatic amputations. The quality of life is reduced in diabetics with complications. It is estimated that more than 50% of male diabetics above 50years suffer from erectile disorder. It is unfortunate that as per WHO’s estimates about 50% of the diabetics in the world do not know that they have the disease. Even in a developed country like the USA, 1/3 of the diabetics are undetected. They go on to develop complications that could have been avoided to a large extent with early detection and proper treatment. How does diabetes occur? Diabetes results from either a deficiency of Insulin, a hormone produced in the pancreas, a gland situated in the abdomen (Type1 diabetes) or from decreased response of the tissues to the insulin (Insulin Resistance) or both (Type 2 diabetes). About 95% of the Indian diabetics are Type 2. The diagram below explains the development and progress of Type2 diabetes

(IGT= Impaired Glucose Tolerance, a pre-diabetic state) What are the symptoms of diabetes? The classical symptoms of excessive urination, excessive thirst and hunger occur with very high blood sugar. In a good proportion there may be no symptoms or nonspecific symptoms like tiredness and weight loss. Frequent infections also should arouse the suspicion. How to detect diabetes early? Simple blood tests can detect diabetes before it becomes symptomatic or even in the pre-diabetic state. An improperly done blood test can be misleading and those at risk of the disease should discuss the tests with the doctor. Diagnostic levels of Blood Sugar Plasma Glucose(mmol/l)- Normal - Impaired Fasting Glucose - Impaired Glucose Tolerance - Diabetes Fasting                            <6.1                >6.1- <7.0                                                              > 7.0 2hr after 75gm Glucose     < 7.8                                                           >7.8 - <11.1               > 11.1 Who are at risk of diabetes? 1.Those with a diabetic parent or sibling 2. Obese and Overweight 3. Those who do not exercise 4. Those with high blood pressure 5. Those with high cholesterol or other lipid abnormality 6. Women who gave birth to heavy babies or had raised blood sugar during pregnancy. 7. Those above 40years of age, more so if they are stressed. When to treat diabetes? The complications of diabetes start even before the blood sugar is elevated and therefore it is appropriate that diabetes is treated effectively as soon as it is detected. There is evidence to show the long term complications are less in those treated early and aggressively. Management of Diabetes Medical Nutrition Therapy (Diet) Food is probably the most important factor in the treatment of diabetes. It involves consumption of the correct amount of calories as estimated by one’s build and activity. Programs are available with which this can be calculated. Food with a low Glycemic Index and low Glycemic Load (measurements related to blood glucose elevation after food) leads to better control. With the knowledge of GI, GL and food exchanges, one can enjoy a wide variety of food. The food intake is advised be as per the food pyramid

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