Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. In recent times, Diabetes has become a major public health problem globally which is why the 14th of November is annually observed as World Diabetes Day. The day is led by the International Diabetes Federation focusing on diabetes mellitus. This year, in honour of the World Diabetes Day, we got in touch with Dr Abhay Inderjit Ahluwalia, the Head of Endocrinology at Venkateshwar Hospital, Dwarka, to explain to us what diabetes is, its causes, symptoms and more. Read on!
Can you explain to us briefly what exactly is diabetes, it’s different types & why does it happen?
Diabetes Mellitus is defined as “a metabolic disorder characterized by high blood glucose resulting from either the deficiency in insulin secretion or the action of insulin.” The poorly controlled diabetes can lead to damage to various organs, especially the eyes, kidney, nerves, and cardiovascular system. There are three major types of diabetes, based on etiology and clinical features. These are diabetes mellitus type 1 (T1DM), Type 2 (T2DM), and gestational diabetes mellitus (GDM). In Type 1 Diabetes, there is absolute insulin deficiency. In Type 2DM, there are insulin resistance and relative insulin deficiency. GDM is any degree of glucose intolerance that is recognized during pregnancy.
Diabetes is diagnosed when the fasting glucose is more than 126 mg/dl or the glucose after meals are more than 200 mg /dl. If the patient has weight loss, increased frequency of urination, his/her blood glucose level is more than 200 mg and if the average glucose level, which is also called the Glycosylated hemoglobin, is more than 6.5 %.
How can a person know if they are prone to getting diabetes?
The only way to figure out if you are a diabetic or not is by undergoing a health check-up. However, the following are the symptoms of diabetes that you must keep in mind:
(a) Excessive hunger
(b) Weight loss
(c) Increased frequency of urination
(d) Getting up in the night for passing urine
(e) Increased skin or genital infection
(f) Change in vision
If you experience these symptoms you should get your blood glucose checked.
Are people with relatives or parents having diabetes more prone to it?
Diabetes is a genetic disease and it runs in families. If the father or mother has type 2 diabetes, the risk of the child having Type 2 diabetes increases by four times. And if both parents have type 2 diabetes, there is more than 50% possibility of the child having Type 2 diabetes. There is also a 50% risk of having it if your sibling has it.
Can you tell us briefly about the dangers of diabetes for humans?
When the glucose levels in the body are high it can have an effect on any part of the body. Diabetes affects small and large vessels. It increases the risk of strokes. The eyes can get affected – the patient may develop cataract and the retina may get affected. Diabetes can also cause early heart attacks or heart failure and affect the liver. It is also the leading cause of kidney failure. Diabetes can also lead to pain, tingling sensations and numbness in the nerves of the limbs.
Is it a curable condition? If so then how?
Once diagnosed, diabetes can be controlled with medicines in the majority of the patients. Type 1 diabetes is characterised by an absolute deficiency of insulin and will require insulin for treatment lifelong. Type 2 diabetes is caused by insulin deficiency or resistance to the action of insulin. This type of diabetes can be controlled with oral drugs for a long period of time. If not controlled by oral drugs, the patient needs to be prescribed to take insulin.
Diet is a huge factor in diabetes. So, for people trying to prevent it, what kind of diet should they have? Any particular foods they should avoid?
Diet forms an important component and is the foremost step in diabetes management. We have to understand what are the components of the food
and how it is to be consumed. There are three main components – carbohydrate, fats, and proteins. The other components are fibre, vitamins, and minerals. For patients with diabetes, planning a diet is very important. A few principles to be followed are:
- Have three major meals
- Have 2 or 3 snacks in between
- Distribute calories evenly
- Follow a plate or a thali pattern
- The diet should also concentrate on the weight reduction
- Diet should also take into account whether the patient has a heart disease
Ideally how much sugar can a person consume in a single day so that it doesn’t affect their health?
Refined sugars are best avoided in diabetes. The carbohydrates are to be restricted to 200 to 300 grams per day. However, complex carbohydrates are better.
What role does exercising play in preventing and controlling diabetes?
Exercise plays a very important part in the management of diabetes. However, before advising the patient to exercise, the health status of the patient i.e. whether the patient has any heart or kidney diseases requires to be determined. Exercise helps in increasing glucose consumption improving blood supply to the muscles and heart. Exercise not only improves glycaemic control, but it can also improve insulin sensitivity and also improving cardiovascular risk factors.
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