What is Diabetes?

Diabetes is an old illness. It has affected mankind for many hundreds of years and is referred in old Sanskrit writing. It is a chronic metabolic disorder with high levels of sugar in the blood. The word “Diabetes” means siphon and “Mellitus” stands for sweet. Diabetes and Diabetes Mellitus are used interchangeably in day-to-day practice.

How does it happen?

A gland in the tummy named pancreas secretes a hormone called Insulin, which controls blood sugar. When we eat, glucose is absorbed from the stomach and enters in the blood. The glucose must enter into the cells to make energy and insulin helps glucose to enter the cells. Diabetes is the result of inability of the pancreas to produce normal amount Insulin or Insulin becoming ineffective to do its’ job.

Diabetes: Why me?

Frequently this question is asked, despite no family history how did I get Diabetes. Family history certainly is an important factor, but the fact is being Asian, we all have high-risk gene for Diabetes. Remember it is not your fault that you have Diabetes. You are just happened to be the person who got it. In India 4% of villagers and up to 10% of city dwellers have Diabetes. Recent studies showed all over the world the incidence of Diabetes is increasing and it is more so in Asians. Also we are getting Diabetes at an earlier age than people in the west (around 10 yr).

Who are at risk of Diabetes?

Family history of Diabetes is the major risk factor. If you have a family history and your blood sugar is normal, it is advisable to check for Diabetes every year. Sedentary life-style, obesity, smoking, excessive alcohol intake, high blood pressure and in case of women previous Diabetes in pregnancy or delivering big baby (birth weight more than 4Kg) are risk factors for Diabetes.

What are the symptoms of Diabetes?

In adults, at least at the beginning you may not have any symptom. When your blood sugar is above 180 mg%, sugar starts appearing in the urine. Sugar in the urine drags water and you pass a lot of urine and feel dry and thirsty. You may also feel tired and loose weight. Your appetite increases and peculiarly you may notice that you are loosing weight in spite of eating more. Chance of infection is higher if you have high sugar and also your healing from infection, cut or wound may be unusually delayed. Some people complain of poor eyesight.

How do we diagnose Diabetes?

The normal blood glucose in the morning before taking any food (fasting) is less than 110 mg%. There are three ways we diagnose Diabetes. Urine glucose is not reliable for diagnosis.

• Fasting blood glucose 126 or more is diagnostic of Diabetes; value in-between 110 to 125 is called borderline Diabetes.

• A random blood glucose sample taken anytime of the day more than 200mg% is also diagnostic of Diabetes. If there are no symptoms a repeat test is needed.

• In doubtful cases sample is taken after a glucose drink, called glucose tolerance test.

What is the difference between Glucose and Sugar?

We use the words glucose and sugar interchangeably but they are not same. The main component in sugar is glucose, around 85%. The rest are fructose, galactose, etc, which are sugar but not glucose. Now a days, we measure glucose in blood, so even if we tell blood sugar is such and such, we actually mean blood glucose.

What are the types of Diabetes?

There are two main types: type 1 or young onset and type 2 or adult onset Diabetes. In type 1 Diabetes pancreas does not produce Insulin and you cannot survive without Insulin. In type 2 Diabetes, pancreas does produce Insulin but it is insufficient and/or less effective. Diabetes can manifest for the first time in pregnancy, called gestational Diabetes.

What should I do when I am told, “you have Diabetes”?

First step when you see your blood sugar result is high is to recheck to confirm the diagnosis. The next and most important, although most difficult, step is to accept the diagnosis. Do not try to run away from the diagnosis, try to know the facts about Diabetes. Several sources of information are available, like health magazines, Internet, various health related journals, education programmes, etc. To improve the awareness and knowledge about Diabetes, we will be publishing a series of articles on Diabetes in Deccan Herald over next few months.

Is there any good news about Diabetes?

The good news is that with proper care you can avoid or at least postpone the deadly complications of Diabetes. The bad news is that Diabetes is not going to go away. At present the word “cure” is not there for Diabetes. Also it is worth knowing that Diabetes worsens over time, this is not your fault, and this is the nature of Diabetes. So, initially you may be well controlled with diet, later you will require tablets and a time in future will come when only tablets are not going to do the job, you will need Insulin. The time to reach that stage depends and varies from one person to other. If not taken care properly, this time can be as less as few years. So, Control your Diabetes, do not allow Diabetes to control you.

Can we prevent Diabetes?

If you have genetic risk for developing diabetes because of family history, you cannot do anything about that. Things you can do are healthy eating (i.e., eating vegetables and fruits, avoiding fast food), healthy life-style (regular exercise, avoidance of smoking, moderation of alcohol, etc) and keeping your weight in accordance to your height. Certain medicines are being used recently for preventing Diabetes in people who have borderline Diabetes.