The Diabetes World And Its Management

Diabetes is a leading health concern. Genes are an important factor why an increasing number of people today have diabetes along with factors like lifestyle and diet. Healthy eating, regular exercise and maintaining an appropriate weight play a crucial role in avoiding this silent killer.

Coming 2030, India, China and the US will have the largest number of diabetics. Every fifth person with diabetes will be an Indian. It is also estimated that the health costs of diabetes, heart disease and stroke in India over the next ten years would be the highest in the world - a whopping US$333 billion!

Statistics for diabetic prevalence in India indicates that the epidemic is progressing rapidly with a total of 62.4 million Indians currently diagnosed with the disease. With India emerging as the diabetes capital of the world, it is time for a concerted campaign to keep diabetes at bay.

Causes of Diabetes

• Family history: The prevalence of diabetes increases with a family history of diabetes. The risk of a child developing diabetes with a parental history increases above 50 per cent. A high incidence of diabetes is seen among first-degree relatives. Regular check-ups after age 35 is the  best way to prevent the disease. When people from the vulnerable group undergo preventive testing, they should ensure that albumin is included in the test. The test for sugar should also be considered important where the fasting level should be below 110, random between 140 and 160, and the range for the 2-hour glucose test between 180-200.
• Obesity: Being overweight is one of the leading causes of type-2 diabetes. Even within an acceptable body weight range, weight gain could increase the risk of diabetes. Excess body fat especially concentrated around the abdomen leads to increased risk of diabetes.
• Physical inactivity and sedentary lifestyle: There  is enough evidence to demonstrate that physical inactivity leads to the development of type-2 diabetes. The availability of motorised transport combined with  a sedentary lifestyle has reduced physical activity in all populations leading to an increase in lifestyle disorders like diabetes.
• Insulin resistance: It has been estimated that Asian Indians are more insulin-resistant as compared to westerners. A cluster of factors consisting of abnormal fats (dyslipidaemia), high blood pressure, obesity, and abnormal glucose levels known as metabolic syndrome, is highly prevalent in Asian Indians.
• Urbanisation and stress:. Developing countries like India are undergoing rapid urbanisation. Urbanisation is associated with increasing obesity, decreased physical activity due to changes in lifestyle, diet and a switch from manual work to less physically-intense occupations. The impact of stress, both physical and emotional, along with an unhealthy lifestyle has a strong cascading effect on people with a vulnerable genetic background. This has led to a jump in type-2 diabetes.

What else does diabetes cause?

With diabetes, emerges other associated ailments including coronary artery disease (CAD). In fact, 80 per cent of deaths among diabetics could be attributed to CAD.

Heart disease: People with diabetes have a higher risk for heart attack and stroke

Eye complications: Diabetes has been associated with a higher risk of blindness and other vision problems

Kidney disease: Diabetes can damage the kidneys and may lead to kidney failure

Nerve damage (neuropathy): Diabetes can cause damage to the nerves

Foot problems: Nerve damage, infection of the feet, and problems with blood flow to the feet can be caused by diabetes

Skin complications: Diabetes can cause skin problems such as infections, sores, and itching. In fact, skin problems (fungal disorders) are sometimes a first sign that someone has diabetes

Dental disease: Diabetes can lead to problems with the teeth and gums (gingivitis and periodontitis).

Managing Diabetes

Having diabetes means one has to opt for medicines and blood-sugar level monitoring for a lifetime. However, healthy habits ensure that you will keep diabetes in check.

• Balanced diet: A healthy diet plays an important role in keeping diabetes under control. Eat a diet rich in all the essential nutrients, vitamins and minerals. Avoid eating junk, fried or sugary food which are harmful for your health as they clog your arteries. Include a fair quantity of fresh fruits, vegetables and whole grains in your diet. Reduce or cut out meat and dairy. Eat the fruit rather than drink its juice. Replace unhealthy desserts with fruit.
• Lose weight: People who are overweight have a higher chance of contracting diabetes. Losing weight helps reduce the risk. Studies show that even extremely overweight people are 70 per cent less at risk of contracting diabetes when they shed 5 per cent of their weight.
• Walk more: A recent study has found that a 15-20 minute walk after every meal is effective in keeping diabetes in check as it reduces one’s blood sugar level over the day. Instead of taking the elevator, take the stairs, or walk to places close by, or take your dog for a walk.
• Exercise: Studies have shown that people who exercise for at least 30 minutes a day, 4-5 times a week, reduced their risk of contracting diabetes by 80 per cent. It has been proven by studies that exercise helps increase the number of insulin receptors on your cells. This allows your body to utilise the hormone, insulin, with ease.
• Reduce stress: Certain hormones that trigger stress also play an important role in the management of sugar by  the body. This is why you feel like eating chocolates when distressed. Stress also increases your blood pressure, which can lead to heart disease.
• Avoid smoking: Smoking raises the danger of a wide range of diabetes problems including heart attack, stroke, nerve injury and kidney disease. It has been estimated that smokers who have diabetes are three times more prone to die of heart attack than non-smokers who have diabetes. So quit smoking or using any form of tobacco.
• Sleep: It is essential to catch the standard 7-8 hours, or at least a minimum of 6 hours of sleep every night. Studies have shown that people who get less than 6 hours of sleep double their risk of contracting diabetes. Sleeping for less than 5 hours also triples the odds of increased blood pressure. So catch a good night’s rest to avoid diabetes and heart disease.

Living with Diabetes

Living with diabetes can be difficult, if you don’t take precautions. Its side-effects can destroy your quality of life. Here is what you can do to reduce its effects on your body:

• Learn to cope: Coping with the fact that you have diabetes is the most difficult thing in the beginning. The associated stress can raise your blood sugar. Therefore, try to reduce stress through simple techniques like deep breathing, taking a walk, meditating, working on a hobby, or listening to your favourite music. Ask for help if you feel low. A health counsellor, friend, or family member who will listen to your concerns may help you feel better.
• Eat well: Make a diabetes meal plan with help from your doctor. Choose foods that are low in calories, saturated fat, transfats, sugar and salt. Eat foods with more fibre. Make fruits, vegetables, whole grains and cereals a part of your diet. Drink more water. When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein such as beans, and one quarter with a whole grain such as brown rice.
• Be active and alert: Set a goal to be active most days of the week. Start slow by taking 10-minute walks three times a day. Extend your walking time once you get accustomed to it. You can also consult your doctor for other forms of exercise.
• Take your medicines: for diabetes and any other health problems on time. Check your feet every day for cuts, blisters, red spots and swelling. Alert your doctor about any sores that do not go away. Brush your teeth and floss every day to keep your mouth, teeth and gums healthy.
• Keep track of your blood sugar: You may want to check your blood sugar levels one or more times a day. Keep a record of your blood sugar levels. Be sure to talk about them with your doctor. Check your blood pressure if your doctor advises and maintain a record.

Most important: undergo the following tests every year:

•Cholesterol test

•Triglyceride test

•Complete foot examination

•Dental exam to check teeth and gums

•Eye exam to check for vision problems

•Urine and blood tests, including Hb1AC.

People who are diabetic should complement their medical regimen with a healthy lifestyle which will control blood glucose levels, high blood pressure and cholesterol. Regular visits to the doctor is a must.