Prevention and Management of Diabetes

What Is Diabetes Mellitus?

Diabetes is slow in onset and is an iceberg disease. By little awareness of its symptoms, one can detect the disease in an early stage. Most of the time, 60% of patients are accidentally diagnosed, and only 40% feel the symptoms of the disease.

What Are the Types of Diabetes?

a)Type 1 - Formerly known as insulin-dependent diabetes mellitus (IDDM): People with this type of diabetes produce a very low amount or no insulin in their bodies need regular insulin injections to survive and manage diabetes. It can occur at any age but usually starts in childhood. This usually happens before the age of 40.

b) Type 2 (DM2) - Earlier known as non-insulin-dependent diabetes mellitus (NIDDM). Type 2 DM is strongly related to genetic tendency and obesity. The body produces normal or high insulin levels, but certain factors make its utilization ineffective (insulin resistance). The common causes of type 2 DM are a sedentary lifestyle, unhealthy diet, and obesity. It will usually start in adulthood, but it can also be seen in adolescents who are obese.

c) Gestational Diabetes Mellitus - Gestational diabetes is also called pregnancy-induced diabetes, where the blood glucose level is raised during pregnancy. It occurs in 5 % of all pregnancies and usually disappears when a pregnancy is over. Women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.

d) Prediabetes - Prediabetes state can increase the risk of developing type 2 diabetes, heart disease, and stroke. In a prediabetes state, blood sugar levels are higher than normal but not high enough to diagnose type 2 diabetes. But the prediabetic state can be reversed by following healthy steps and lifestyle changes.

What Are the Symptoms of Diabetes?

Symptoms are frequent urination, increased thirst, increased hunger, tingling in the feet, fatigue, weakness, delayed healing, diminished vision, itching in the private parts, and repeated abortion. Those who have these symptoms along with a family history of diabetes, aged more than 35 years, overweight, suffering from a heart attack, blood pressure, or TB (tuberculosis) should undergo a diabetes checkup annually.

What Are the False Beliefs About Diabetes?

Despite advanced and extensive diagnostic facilities available, almost 50% of people with type 2 diabetes remain undiagnosed in most parts of the world. A 9 to 12 years gap exists between the onset of type 2 diabetes and its clinical diagnosis. And those who know that they have diabetes because of ignorance, superstition, false belief, and carelessness not taking proper treatment. Studies showed that almost 70% of diagnosed patients have uncontrolled blood sugar according to their HbA1C level.

More than 80% of patients do not follow the advice to change their health behavior. Factors like inadequate knowledge, initial non-acceptance, rebellion when diagnosed, and no physical discomfort in the early stages can prevent patients from understanding diabetes as a severe disease. Trusting the myths prevalent in the community about the disease makes the patient fail to take treatment for diabetes. Instead of asking the doctor, they take advice from relatives and friends and follow their advice.

What Are the Complications of Diabetes?

1. Up to 50% of diabetic patients have complications at the time of diagnosis.

2. Diabetic retinopathy can cause blindness in young adults.

3. 10%-21% of all people with diabetes develop severe kidney diseases.

4. 60%-70% of people with diabetes have mild to severe forms of neuropathy.

5. There is a 15 to 40 fold increased risk for leg amputation in diabetes compared to the non-diabetic population.

6. People with diabetes are 2 to 4 fold more likely to have coronary heart disease and stroke.

How to Manage Diabetes?

Diabetes mellitus cannot be cured but it can be controlled very successfully. The main aim of treating all types of diabetes is to control blood glucose, blood pressure, and cholesterol levels as normal as possible. Medication along with a healthy lifestyle can improve normal wellbeing and protect against long-term complications.

1) Stay Active:

Being active is good and important for people with diabetes. Physical activity, with a healthy diet and medication, can help you manage your diabetes and prevent long-term complications.

2) Medications:

People with diabetes usually need additional medication treatment and making lifestyle changes to control their Blood Pressure and blood cholesterol level. The physician will prescribe medication for diabetes according to your body condition, and stopping them on your own can create lots of problems.

How to Keep Diabetes Under Control?

People with diabetes should undergo a regular physical examination, including consultation with a doctor, fundus examination, electrocardiogram, stress test, foot examination for blood circulation, sensation and vibration perception, ulcer prone areas, and necessary laboratory investigations.

• 30% of people with type 2 diabetes can control diabetes by proper diet, regular exercise, and yoga alone. In other cases, medicines and, in some cases, insulin may be required.

• No restriction in diet is required in diabetes. Patients with diabetes should be advised to take a healthy and balanced diet.

• Sweet substances and fatty foods such as ice cream, sweets, cakes, biscuits, chocolate, etc., should be avoided.

• Green vegetables and salads can be taken freely. Meals should be divided into 4 to 6 times a day.

• Eating fruits are beneficial for diabetes patients. More sweet and ripe fruits like mango, sapodilla, custard apple, banana, etc., should not be taken if your diabetes is not under control.

• Diabetic patients should make regular exercise and physical activity or yoga a routine part of their life. Generally, exercising should be done early in the morning. One should keep sweets handy during exercise for any emergency conditions like hypoglycemia.

• Patient education program and counseling is a must for every person with diabetes for total management of diabetes. It helps the patient to comply with drugs and lifestyle modification more effectively.

Conclusion

The clinical management of diabetes now has significantly more options than ever before, and every year new molecules and technologies are coming into the market for better diabetes management. With proper diagnosis and appropriate treatment, one can live a long, healthy, and cheerful life without developing diabetes complications. But, everything will fail if the lifestyle does not adhere.