World Diabetes Day - 14 November

Diabetes, particularly type 2, has been on the increase worldwide over the last number of years. Lack of a healthy diet, regular exercise and obesity are the main reasons why people become more prone to it. We will be looking at what diabetes actually is, what different types there are, how a person can manage diabetes and lastly we'll explore some of the myths that surround this disease and how a person can be prevented from developing it.

As part of the Government Employees Medical Scheme's (GEMS) on-going effort to educate our members and future members on a range of healthcare topics, we would like to share and explore certain important healthcare issues. This article looks at the subject of diabetes this World Diabetes Day, 14 November 2012.

What exactly is diabetes?
Diabetes is a chronic disease which arises when a person's pancreas cannot produce enough insulin or when a person's body cannot use the insulin that is produced effectively. Insulin enables cells to take glucose from the blood and use it for energy. When a person's body fails to produce insulin or the body cannot use it effectively, it leads to raised sugar (glucose) levels in the blood. This can lead to long-term damage to the body and can cause various organs and tissues to fail.

Types of diabetes
There are three types of diabetes:

Type 1 diabetes
This is also called insulin-dependent diabetes. It is caused when the body's defence system attacks the insulin-producing cells. This mainly occurs in childhood or in young adults. No one really knows why this happens. People with this type of diabetes produce no or very little insulin. It is necessary to have injections of insulin every day and these control the levels of glucose in the person's blood.

Type 2 diabetes  
This is also known as adult-onset diabetes. This is the most common type and accounts for at least 90% of all cases. This occurs when a person's body becomes insulin resistant which leads to insulin deficiency. This type is more common with people over the age of 40 but can occur earlier in life. It is often associated with obesity, which itself can cause insulin resistance and elevated glucose levels.

Gestational diabetes (GDM)
This type of diabetes consists of high blood glucose levels during pregnancy. It appears in one in 25 pregnancies worldwide and is associated with complications in the period immediately before and after birth. It usually disappears after the child is born but these women and their children are at an increased risk of developing type 2 diabetes later in life.

Symptoms
The symptoms vary depending on your blood sugar levels. Some people, especially those with type 2 diabetes, may not experience symptoms initially. With type 1, the symptoms are noticeable much faster and are more severe.

Some of the symptoms to look out for include:

• Increased thirst
• Frequent urination
• Extreme hunger
• Unexplained weight loss
• Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough insulin)
• Fatigue
• Blurred vision
• Slow-healing sores
• Mild/high blood pressure
• Frequent infections - gum or skin and vaginal or bladder infections

Management of diabetes
At the center of managing your diabetes, is blood sugar control. In order to manage these levels, you need to know what makes your blood sugar levels rise and fall. Eating healthily by having balanced meals daily and regular exercise are extremely important. Sometimes this is sufficient to keep your diabetes under control. When this does not succeed, you may have to make use of insulin and other medication to keep your blood sugar levels under control.

A few myths debunked
A lot of people think that eating a lot of sugar rich foods or sweets cause diabetes. This is untrue. Almost everything that we eat is converted into sugar (glucose) by our bodies. Being overweight is a predisposing factor for developing diabetes. People with the disease often think that they are unable to eat carbohydrates as this raises their blood sugar levels. This happens to everyone, whether they are diabetic or not. Carbohydrates give the body energy and we need it.

Lastly, insulin has developed a bad reputation over the years. Some think that it causes complications. It is a natural hormone and is one of the safest medications available. It helps control your blood sugar levels and thus slows down or prevents complications associated with diabetes.

At the end of the day prevention is better than cure. Although no one knows what causes type 1 diabetes, by eating healthily and through regular exercise you can prevent type 2 diabetes in some cases.

References
1. International Diabetes Federation, www.idf.org
2. Mayo Clinic, www.mayoclinic.com