Diabetes — The time to fight is now!

By Dr. Nalaka Gunawansa

It has been estimated that in the last three decades, the total number of people affected by diabetes worldwide has quadrupled. At present, 1 out of 11 individuals on the planet are affected by diabetes. It is one of the commonest causes of death, blindness, kidney failure, heart attacks, amputation (limb loss) and stroke.

So, what’s the reason behind this sudden surge in diabetes? This is where it becomes disconcerting; as much as 95% of diabetes can be avoided. The rapid rise in diabetes is largely attributable to the life style changes associated with modern life. Unhealthy food habits and lack of exercise has not only contributed to the surging numbers of diabetics but also caused more and more younger people to be affected by the disease.

What is diabetes?

Diabetes is caused by inadequate quantities of abnormal function of the hormone called insulin. Insulin is the chief regulator of sugar levels in the body. There are two types of diabetes. Type 1 and type 2. Type I diabetes is where the body does not produce enough insulin. Type 2, is commoner and is associated with adequate quantities of insulin which is ineffective. Here, the body cells are unable to utilize the insulin in the proper way, leading to defective sugar control. The rapid increase in the incidence of diabetes all over the world has largely been due to the increased incidence of this Type 2 diabetes.

The effects of diabetes

In the presence of diabetes, the body loses its ability to keep blood sugar levels under control. The excess levels of sugar in the blood has multiple implications, including detrimental damage to nerves and blood vessels. The damage caused to the nerves results in numbness and weakness on the hands and feet.

The damage caused to the blood vessels has much more widespread implications depending on the location of the damage. Damage to blood vessels in the heart can lead to heart attacks. What is interesting is some of these heart attacks can be ‘silent’ in that they cause no pain due to the pain causing nerves also being affected. There can be sudden fatal heart attacks that come without prior warning. Similarly, damaged blood vessels to the brain can lead to debilitating stroke or blindness. Damages vessels in the kidneys can have serious effects on the function of the kidneys. Therefore, diabetes is also considered the commonest cause of chronic kidney damage worldwide.

The combination of nerve and blood vessel damage can also have serious effects on the health of one’s legs. Long standing diabetes causes numbness and weakness of the feet along with physical deformities in the toes, soles and skin of the foot. When this is coupled with damaged blood vessels, it leads to dangerous ulcers (wounds), which can end up in amputation of toes or even the entire leg. It has been estimated that diabetes is the leading cause of limb amputation all over the world.

Symptoms to look out for

Symptoms of Type 1 diabetes include a frequent need to urinate, frequent thirst and hunger, tiredness, unexplained weight loss and blurred vision. Symptoms of Type 2 are similar but milder, so it is often not caught until you develop a complication such as nerve damage to the feet — to the point where 50% of people with Type 2 diabetes don’t even know they have it.

Top tips to keep diabetes at bay

Type I diabetes is often unavoidable. However, the good news is that there’s plenty you can do to avoid Type 2 diabetes. Awareness of its existence and precipitating causes is half of the battle. The rest depends on simple life style changes that we can make to avoid getting it.

  • Keep your weight in the healthy BMI (Body Mass Index) range. Always watch your weight and keep it under control.
  • Keep your waist measurement below 31.5in (women), 35in (men).
  • Have at least 30 minutes of exercise on at least 3 days of the week. This has to be more intense and more frequent if you are already overweight and need to reduce weight.
  • Eat a diet low in sugar and saturated fats. Remember, the more sugar you eat, the more difficult it is for the body insulin to control it.
  • Avoid binge eating (eating large quantities at once, especially after skipping regular meals). Get used to small quantities of healthy food at regular intervals (every 4 hours).
  • If you smoke, stop. Smoking puts an additional burden on the blood vessels already under threat by diabetes.
  • If you notice any of the symptoms, go to your doctor.
  • If you already have diabetes, remember that diabetes can only be controlled and not eradicated. Therefore it is essential that you take your medication and control your diet long-term.
  • If you have diabetes, see a vascular surgeon at least once a year; to identify early signs of any risk to your feet to avoid an amputation.
  • Get used to wearing well fitting foot wear, even inside the house. Barefoot walking is one of the commonest ways diabetics get injuries in their benumbed feet.