A Silent Epidemic We Can’t Ignore: A 15-year-old With Type-1 Diabetes
During my early practice days in a public sector hospital, I encountered a patient who made me realize that we are not doing enough for our coming generations. While working in the outpatient department, a 15-year-old boy presented with shoulder and upper back pain.
I started taking history. When I reached the family history portion of the history taking, I asked, “Does any of your family members have diabetes or hypertension?” He replied, “I have diabetes.”
At first, I thought I misunderstood him, and I looked at her mother sitting beside him. She said, “He has diabetes.” It was my first case with early-onset diabetes mellitus. I didn’t imagine the early onset meant that early.
How does a hereditary disease manifest itself?
Any hereditary disease (Hereditary diseases are diseases that tend to run from one generation to the other) needs two things to manifest in the coming generation: a gene for that disease and an environmental trigger that activates the gene for a specific hereditary disease. So, only carrying a gene from parents might not be sufficient to cause the disease.
Let’s understand this by an example. If your immediate family member, like your father, mother, sister, or brother, had or has diabetes, then you might have the gene for diabetes.
But as discussed, merely having the gene for diabetes might not cause the disease on its own. Some kind of trigger is required to activate the gene for diabetes, like a high-sugar diet, lack of activity, sedentary lifestyle, etc.
What is pre-diabetes?
A term called pre-diabetes defines the people on the borderline between diabetics and non-diabetics. They might be on the verge of developing diabetes if they do not take appropriate measures to change their habits, diet, and lifestyle.
HbA1c is a test that shows the average blood glucose level over a period of three months. An HbA1c level of greater than 5.7 but less than 6.5 (HbA1c of 5.7 > 6.5) represents pre-diabetics.
How can we reduce the risk of developing diabetes?
The answer to this question is simple, and most of you might already know it. Physical activity and diet are the two most important adjunctive to diabetes medication (if you take any) that can significantly improve glycemic control and prevent complications associated with diabetes.
Physical activity
No one can deny the benefits of exercise and physical activity. Physical activity has tremendous benefits for cardiovascular and musculoskeletal fitness.
Exercise and physical activity can help reduce cardiovascular risk, improve glycemic control, and manage weight. All of these can increase the sensitivity of body tissue to insulin.
Patients with diabetes participate in 30–60 minutes of moderate-intensity aerobic exercises and moderate-intensity resistance training. People with diabetic retinopathy should avoid resistance training. Exercise can prevent the onset of comorbidities associated with diabetes.
Diet
Healthy nutrition and meal plans can help keep the blood sugar levels of diabetic patients under control. In diabetes, knowing what, when, and how much to eat makes a lot of difference.
Eating healthy and having a small regular chunk of meals can stabilize your sugar level and prevent large fluctuations in your blood sugar level.
Physical activity and diet combined can prevent or lower the risk of cardiovascular disease-the most common cause of death in patients with diabetes.
Let’s come back to the story
The boy was addicted to video gaming and had a sedentary lifestyle. On assessment, his upper back extensors were significantly weak, and he had a slightly hunched back posture.
I started exercises to strengthen the upper back muscles along with posture correction and counseling regarding the importance of physical activity. It took five sessions for the pain to go away, and after that, I put him on a home exercise program.\
Conclusion
In conclusion, you do not choose to have the gene for a hereditary disease, but you can choose whether you trigger it or not. Be responsible for what you eat and your lifestyle.
Thanks
