Essential Knowledge – A to Z of Diabetes

On a global scale, the number of diabetics in India is very high, and the number stands at 7.5 crores today. It is a bit alarming to note that this is much more than the total population of Tamil Nadu.

While Corona is infectious diabetes is not, and it is prevalent throughout the World. Researchers say that one in ten people are diabetic, and the number is increasing.

What are the primary causes of diabetes?

The possibility of a person aged 25 years becoming a diabetic is more now than earlier, when it was at 40 years. The cause could be genetic, if your seniors in the family like Grandparents, parents etc. were diabetic, or environmental factors could also be a cause.

Our lifestyle has changed in a big way, and the most important is the dietary changes. Consuming high-calorie foods is one cause of diabetes. We call this diabetogenic environment or obesity environment. Besides diet, sedentary lifestyle is also an important reason.

Stress also causes diabetes. For example, a person could experience stress due to issues at the workplace, in the family or community in general, and this causes diabetes. Stress increases the hormone “Cortisol” in our body, and this hormone puts us in a constant state of anxiety which increases the sugar levels in our body, and this ultimately leads to diabetes.

Types of Diabetes

There are two types of diabetes – Type 1 and Type 2. Earlier Type 1 diabetes was associated with childhood, however due to lifestyle changes there is an increased risk now of Type 2 diabetes even in children. And the above insulin resistance is the basis for Type 2 diabetes.

What is Insulin?

Pancreas produces insulin which regulates the sugar levels.

How does pancreas regulate insulin?

The food we eat is made up of carbohydrates, proteins and fat. Carbohydrate is glucose, for example…our car can function only when filled with petrol, similarly our body can function only if it receives energy, and glucose is necessary for our body to function properly. Glucose enters the body cells and provides us energy to function. Insulin transports glucose to the body cells and provides energy, and this regulates the sugar levels in the body. When insulin transports glucose to the cells, the insulin receptor mechanism opens and allows the glucose inside the cells. If glucose is not able to enter the cells, it then gets transported back to the blood stream, and the blood sugar level increases leading to diabetes.

Insulin resistance plays an important role in preventing glucose from entering the cells.

Who is susceptible to insulin resistance?

1. Those who consume excess calories, that is consumption of excess calories leading to malfunction
2. Those who do not perform physical activities
3. Those who are stressed out

These are triggers for diabetes, and result in increase in blood glucose levels. The kidneys in our body can store glucose up to 180 mg, and removes the excess glucose which leads to frequent urination.

Frequent urination not only removes excess glucose but also removes essential water from the body, which causes frequent thirst. At the same time the energy levels of the body reduce because glucose has not entered the cells. This causes great hunger pangs, and in such situations diabetics consume excess amounts of food.

Excessive urination, great hunger pangs, and excessive thirst are symptoms of diabetes. These three symptoms are called Polydipsia, Polyuria and Polyphagia respectively. And weight loss is also a symptom. But most people do not display these symptoms, hence diabetes is also known as a “silent disease”.

For some, increased sugar levels are discovered only at the time of regular tests being performed at the hospital before a surgery.

Can diabetes be prevented?

For a person with diabetes in the initial stages (pre-diabetes), there is a chance to reverse it. However if a proper diet is not followed, there is a risk of this leading to diabetes. So by following a proper diet, exercise and avoiding stress we can prevent the onset of diabetes.

Complications of Diabetes Mellitus

These days most people seem to develop diabetes during pregnancy, which is called Gestational Diabetes.

Generally our body undergoes a lot of hormonal changes during pregnancy. During this time pregnant women consume a lot of carbohydrates and consequently there is an increase in insulin levels. When we consume carbohydrate-rich foods and the insulin level in the body is low, chances of diabetes are more. Chances of onset of diabetes increases in people with excess body weight, or diabetic condition running in the family, or during pregnancy in women.

Gestational diabetes should be checked early on, otherwise there is an increased chance of it being passed on to the new born through the umbilical cord, and this increases the chance of it affecting the next generation.

In case of diabetes prior to pregnancy, proper diet should be followed. It is important to have the sugar levels under control during pregnancy so that both the mother and child are not affected.

In 90% of women who have gestational diabetes, the condition gets corrected and becomes normal after child birth. If women do not follow a proper diet, and their body weight increases, then there are chances that this could lead to Type 2 diabetes.

Type 1 Diabetes

The body’s immune system works against the beta cells in the pancreas, which destroys all the cells that produce insulin. This is called Auto-immune Disorder, which is a disorder that occurs when the child’s immunity does not function in their growing years. The insulin-producing cells are destroyed and the child can survive only if insulin is injected into their body.

There are a lot of advertisements that claim that diabetes can be completely cured without medication…is this scientifically possible?

There is a lot of research on this topic World-wide. Dr. Roy Taylor of New Castle University conducted a research in which a diabetic who was diagnosed with the condition 5 years earlier was given an activity schedule to expend a certain amount of calories and this resulted in reversal of his diabetes.

This research is now gaining momentum. If patients co-operate and follow instructions completely there is a high chance of reversing diabetes. However this treatment works only in patients within the first 5 years of diagnosis. Therefore it is a wrong approach to misunderstand news and information and stop medication.

By following a proper diet diabetics can prevent the side effects of this disease. Diabetics worry if their eyes, kidneys and heart will be affected. Do not worry…only uncontrolled diabetes leads to problems. Most of the time doctors treat diabetes with the aim of preventing the after effects. If you can get HbA1C test done once every three months and maintain the level at 7, you need not worry at all!

United Kingdom Prospective Diabetes Study (UKPDS) says…

Even if HbA1C level goes down by one point, chances of preventing heart problems goes up by 21%. For example, let us assume that a person’s HbA1C level is 9. Research says that if he is regular with his medication and brings down the level to 8, he can prevent heart problems in future.

HbA1C tests are necessary to keep diabetes in check. Some people take the medicines prescribed by the doctor for a certain period and then once they feel that their condition is better they stop taking medicines. Then when they suffer from wounds that do not heal, or infection in the urinary tract, and undergo tests, they realise that their sugar levels have gone up. At that point they have no option other than hospitalization. The money that they saved on medication and more, will be spent on hospitalization! This is the biggest problem in India now, especially Tamil Nadu, and we must take necessary steps to create awareness on this.

Are there any complications to taking medication and insulin in the long run?

Some diabetics worry that taking a lot of medication may result in problems later on, and stop taking medicines. All medications on the market since 2008 have undergone several research studies for possible effect on the heart, and have been made available in the market only after they have been certified that they are safe for use. All the diabetic medicines that are available now not only help reduce sugar levels in the blood, but also protect the heart and kidneys. Generally diabetic medicines do not affect the body in any way.

What are the benefits of insulin?

Before insulin was discovered, new-borns whose bodies did not secrete insulin died immediately after birth. However after the discovery of insulin, even such babies were known to have lived up to 60-75 years. Insulin was discovered in the year 1922 after several research studies.

Insulin is a hormone that is secreted by our body, and when its level decreases we inject insulin into the body. Therefore insulin is very beneficial and does not produce any after-effects.

Dr. K. Bharanidharan, MBBS, MD (General Medicine)
Senior Diabetologist
Kauvery Hospital, Chennai

 

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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