Diabetes is a chronic illness which occurs when there is inadequate insulin produced by the pancreas or the body is unable to utilize the insulin that is produced. Insulin is the hormone responsible for regulation and uptake of glucose (sugar) by various organs and tissues in the body. Without insulin, blood sugar from the diet is not absorbed by the target organs and tissues, resulting in an increase in the blood sugar level (hyperglycemia), and inadequate sugar levels in these organs which affects their functioning. The high blood sugar level over time causes damage to blood vessels and nerves, resulting in the complications associated with diabetes.
- Type 1 diabetes – this occurs due to lack of insulin production. This type of diabetes is often diagnosed in childhood, and requires daily use of insulin.
- Type 2 diabetes – this occurs when the body is not able to use the insulin that is produced. This type of diabetes is classified as a lifestyle disease since it is caused by overweight and obesity, and lack of physical exercise.
There are risk factors that increase the likelihood f developing type 2 diabetes. These include:
- Age – previously, type 2 diabetes occurred mainly in adults over the age of 45 years. However, it is now increasingly occurring in younger people.
- Family history of diabetes in the immediate family such as a parent or a sibling.
- Excessive body weight
- High blood pressure
- Elevated levels of blood cholesterol
- History of impaired blood glucose level in the past, including diabetes in pregnancy.
People with these risk factors should be on the lookout for the symptoms of diabetes which include excessive thirst, excessive passing of urine, excessive hunger, weight loss and fatigue. Though the symptoms of diabetes are the same for type 1 and type 2 diabetes, they are less marked in type 2 diabetes. This can lead to delay in the diagnosis since people may not recognize these symptoms immediately. In many cases, diabetes may be diagnosed at the time when a complication occurs. The complications of diabetes are mainly seen in the blood vessels, the nerves, the heart and the kidneys. The main complications are:
- Heart disease due to the effect on the blood vessels to the heart.
- Diabetic foot ulcers which increase likelihood of infection and amputation.
- Blindness due the damage to the blood vessels in the retina.
- Kidney failure, increasing the need for dialysis and/or kidney transplant.
To avoid these complications, early diagnosis and treatment is crucial. Diagnosis is made based on the clinical symptoms and the blood sugar levels. In addition, screening for complications is also done to diagnose these early and implement the control measures to avoid progression or development if none exist at the time of diagnosis.
Treatment of diagnosis begins with changes in the lifestyle that can improve the utilization of insulin in the body. Excess body weight should be controlled by increasing physical activity and adopting healthy diets. Weight loss increases the sensitivity of body tissues to insulin, which reduces the level of blood sugar. A reduction in body weight of between 5% and 10% is associated with a reduction in the risk of developing complications associated with diabetes. Smoking is another risk factor for the complications of diabetes and therefore cessation is advised. In some cases, these lifestyle and dietary changes are adequate to control the blood sugar. However, where these alone do not achieve blood sugar control, then the use of oral medications is warranted. In some cases, insulin may be required to control the blood sugar. In addition, it is important to screen and treat of any accompanying risk factors such as high blood pressure and high blood cholesterol.
The key message is that type 2 diabetes can be prevented by implementing simple lifestyle habits such as:
- Control body weight within the ideal range for ones height (BMI between 18.5 and 24.9 is considered ideal).
- Exercise regularly, with a minimum of 30mins of exercise atleast 5 days a week. To make this sustainable, include more physical activity in your daily routine such as walking.
- Eat a healthy diet, with five servings of fruits and vegetables daily and reduced intake of foods high in sugar and fats.
- Avoid or stop smoking.