Diabetes : the silent scourge

(World Diabetes Day – November 14) (by Shanika Sriyananda - Sunday Observer 11-11-2007) “Eat natural… stay active… be content…” would be the frequently murmured mantra among the youth very soon to escape the agony of being ‘Diabetic’ throughout their lives. Diabetes is 2,500 years-old and people around know enough about this illness. In most of the countries which knows as diabetes ‘hot spots’, the cases of diabetes have increased by manifold compared to the situation a decade ago. I can still remember uncle Bernie, my favourite neibour, who was still strong and active to his age, later became lean day by day’ Though he knew about his condition where the glucose tolerance rate has been abnormal due to impaired insulin activity, uncle Bernie never thought he would fall into that segment of patients. However, with the family doctor’s diagnosis that uncle Bernie was compelled to say ‘No’ to most his favourite dishes. Recovering from a diabetes coma, surveying a narrow escape, thanks to un...

What is insulin ? It is a hormone that is needed to convert sugar, starch and other food into energy needed, for daily life. Without insulin your body cannot get the energy it needs from your food. This hormone is made by a gland in the body called the pancreas. Most of our food intake is turned into glucose, a form of sugar which our body uses for energy. Insulin helps the glucose get into cells of the body to provide energy.

Type of Diabetes : There are two main types of diabetes. Type 1 - This is called insulin dependent diabetes (IDDM). Patients require insulin for survival and this occurs when very little or no insulin is produced. It develops most often in children and youn adults and is also found in adults. The onset is usually sudden and dramatic. This accounts for about 10 per cent of all diabetes in the country. Type 2 - This is called non-insulin dependent diabetes. Patients do not generally require insulin in administration for survival. This occurs whn the body is unable to produce sufficient insulin to meet its requirements or it cannot utilize the insulin that is produced effectively. Type 2 diabetes can be conreolled through diet, routine exercise and oral medication. This, which is recorded among adults is becoming common in young people, including children and teens. The onset is gradual and therefore hard to detect and accounts for about 90 per cents of the total diabetes population.

What is diabetes mellitus ? It is a chronic condition that arises when pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces which leads to raised blood glucose levels.

What are the types ? Type 1 - Insulin dependent : Childhood onset and they produce very little or no insulin – Insulin deficiency. Type 2 – Non insulin dependent : Adult onset and they cannot use insulin effectively that has been produced in body – Insulin resistance. Gestation diabetes mellitus (GDM) : pregnancy induced state of insulin resistance.

Who are at risk ? Family history of diabetes Physical inactivity Unhealthy diet Stress (occupation/financial/educational/nutritional or illness) Overweight or obese History of GDM

What are the symptoms ? Increased thirst and dry mouth Frequent urination Constant hunger Sudden weight loss Extreme tiredness or lack of energy Delayed wound healing Recurrent infections Blurred vision

Is there a cure ? NOT – only control and prevention.

What are the complications ? Heart disease / stroke Kidney disease Blindness Sensory impairment Amputations

Prevention diabetes mellitus ? 1. General population (General public health care professionals and policy makers) Education Awareness Advocacy

2. High Risk Family history Physical inactivity Increased waist Increased BMI

Secondary prevention Early detection Correct guidance and treatment Good compliance : responsibility with patient/family/doctor/policy makers. Regular monitoring/complication detection

Tertiary prevention. Correct management of life threatening complications: Heart/Kidney/Eye/Limb/Brain. Availability of medications/Complications assessment/Intensive care and follow up Availability of other specialized care / rehabilitation teams.