Introduction to Diabetes

Diabetes is a disease that everyone talks about, how important it is and how we need to prevent it and treat it. But what is it? Why is it important and why do we need to prevent it from occurring.

To start at the beginning:

History of Diabetes

Although commonly referred to as Diabetes, the full name of the disease is Diabetes Mellitus. It has been known about for thousands of years, even since the time of the Ancient Egyptians, but the name for the disorder has varied in different cultures.1 The word ‘diabetes’ is actually Greek and means ‘a siphon’ because persons affected by the disease passed water very frequently. The second name ‘mellitus’ is Latin and translates to ‘honey,’ because it was noticed that the urine of diabetics actually tasted sweet and attracted ants.

As doctors began to learn about the disease, Diabetes Mellitus was discovered to be a disorder of the cells in an organ in the body known as the pancreas. These cells produce a hormone called insulin and it is responsible for controlling blood glucose (sugar) levels in the body.  Based on the manner in which insulin production is affected, the disease can be classified into two different types. The first Type 1, is known as insulin-dependent and is characterised by insufficient levels of insulin being produced by the pancreas. The body cannot manage the blood sugar levels and so insulin must be given in the form of injections for treatment. The cause is related to abnormal changes in the body’s own immune system and so is difficult to prevent.

Type 2 diabetes is the most common type and is non-insulin dependent. Here the pancreas produces enough insulin, but the body does not respond to the hormone and so the blood sugar is not controlled either. However, the most common causes of this type are an unhealthy diet, being overweight or obese and not getting enough exercise. All of these can be addressed and prevented.

How do you know if it’s Diabetes?

The origin of the name gives a lot of hints about the symptoms of Diabetes Mellitus. Patients usually experience passing a lot of urine through the day and go to the bathroom very often. Because so much water and sugar is being lost, you might feel very thirsty and hungry and eventually you may notice weight loss.  Other symptoms include feeling tired, having blurry vision and frequent infections.

While these symptoms are very suggestive of Diabetes, doctors will usually confirm the diagnosis by doing blood testing. A finger stick can be done to measure the blood sugar, but this can only definitely diagnose diabetes if the levels are very high (>200 mg/dl) on repeated checks. Therefore, most times doctors will request that a sample of blood be taken first thing in the morning when you are fasting. Then you are given a measured amount of glucose water mixture to drink. Another sample will be then taken two hours later. This oral glucose tolerance test can tell how your body responds to sugars, whether it is producing enough insulin and whether your body is responding to it. 

Why is it important to treat Diabetes?

The high blood sugars over time can actually damage the main organs in your body,  such as the heart , eyes, kidneys, nerves and blood vessels. Diabetics  have a higher chance of having heart attacks, strokes, as well as kidney failure.2 Poor circulation in the legs and feet can result in ulcers and even gangrene.

The disease can also affect the small blood vessels in the eyes which can result in vision problems and eventually blindness.

How is Diabetes treated?

The aim of treating Diabetes Mellitus is to ensure that the blood sugar levels remain at a level low enough to prevent organ damage. Type I Diabetes usually is managed by giving insulin injections. Type 2 Diabetes is managed by giving tablets and sometimes insulin in combination. The amount of medications vary from person to person depending on how much control is needed.

ALL Diabetics have to make lifestyle changes in addition to taking medication. This means eating a healthy diet, exercising regularly and stopping smoking. These changes help to control blood sugars and prevent complications. The medications cannot control the blood sugars on their own! 

How can I prevent Diabetes?

Looking at all the complications that can happen and the medications that are needed, it is better to try to prevent Diabetes Mellitus from happening in the first place. This can be done in the same way that was mentioned before, by making lifestyle changes. This would involve:

  • Maintaining a healthy weight
  • Exercising regularly: The World Health Organisation recommends a minimum of 30 minutes of moderate intensity aerobic physical activity at least five times a week for adults. The full recommendations for exercise can be seen here:

https://www.who.int/dietphysicalactivity/factsheet_adults/en/

  • Eating a healthy diet by avoiding sugar and saturated fats, while increasing fruit and vegetable consumption, The full advice can be seen here:

https://www.who.int/news-room/fact-sheets/detail/healthy-diet

  • Avoiding tobacco and tobacco products

If you or a relative are experiencing symptoms of Diabetes Mellitus, you can proceed to your nearest health centre to see the doctor and if necessary, have a blood glucose (sugar) check done.

REFERENCES:

  1. Ahmed AM. History of Diabetes Mellitus. Saudi Med J.2002 Apr;23(4):373-8.
  1. World Health Organisation. Diabetes [Internet]. 30 Oct 2018 [cited 2019 Jun 02]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes
  1. World Health Organisation. Physical Activity and Adults; Recommended levels of physical activity for adults aged 18-64 years. Available from: https://www.who.int/dietphysicalactivity/factsheet_adults/en/
  1. World Health Organisation. Healthy Diet [Internet]. 23 Oct 2018 [cited 2019 Jun 02]. Available from: https://www.who.int/news-room/fact-sheets/detail/healthy-diet
Published in NWRHA Service