World Diabetes Day: Breaking The Silence And Taking Action

Diabetes is a chronic debilitating disease characterized by persistent high glucose levels. The pancreas does not produce enough insulin, or there is insulin resistance. Over time, uncontrolled diabetes can lead to damage in the body system, and the worst case, the organs may shut down. In 1990, the number of people estimated to have diabetes exceeded 200 million, and in 2022, the number had skyrocketed to 830 million.  Low-income and middle-income countries have a higher prevalence of diabetes than high-income countries. This is because diabetic people in the above-mentioned countries have low access to medication or treatment.   Diabetes is directly related to over 1.6 million deaths that occurred in 2021, and 47% of the deaths happened before the individuals turned 70. Cardiovascular and kidney disease deaths associated with diabetes were estimated to be between 11% and 530,000, respectively.   Among the 4 non-communicable diseases (cancer, cardiovascular disease, chronic respiratory disease, and diabetes),  diabetes has the highest mortality rate, and it has been on the increase since the early 2000s. Today, as we celebrate World Diabetes Day, it is important to educate women and children on the types, symptoms, prevention, and treatment of diabetes.

Types of Diabetes

1. Type 1 diabetes

Type 1 diabetes is also known as insulin-dependent or childhood diabetes. It is an autoimmune disease characterized by the pancreas’s inability to produce the hormone insulin due to the destruction of insulin beta cells. As a result, glucose builds up in the bloodstream. Type 1 diabetic patients require daily shots of insulin exogenously. The cause or prevention is unknown.   Symptoms

• Excess urination
• Excess thirst
• Fatigue
• Rapid heartbeat
• Blurred vision
• Rapid weight loss
• Hyperglycemia
• Recurring infections

 

2. Type 2 diabetes

Type 2 diabetes is also known as non-insulin dependent or adulthood diabetes. It is a metabolic disorder where the body cannot use the insulin produced. It is characterized by insulin resistance,  hyperglycemia, and impaired insulin secretion. In the past, it was believed that type 2 diabetes affected mostly adults, but in more recent times, it is increasingly seen in children.  When not treated, type 2 diabetes can cause severe damage to the nerves, blood vessels, and organs.  Statistics say that more than 95% of people with diabetes have type 2 diabetes.   Symptoms Symptoms of type 2 diabetes are mild and less marked in comparison to type 1  and may take years before they are detected. Sometimes, when they are diagnosed, it is most likely in the late phase. However, here are some of the most common symptoms:

• Excess urination
• Excess thirst
• Fatigue
• Blurred vision
• Slow healing of wounds
• Numbness of hand and feet
• Acanthosis nigricans

  3. Gestational diabetes (GD) Gestational diabetes is also known as pregnancy diabetes. The blood sugar levels are higher than normal but not in the diagnostic range of diabetes. It occurs between 24 to 28 weeks of pregnancy and is considered a high-risk pregnancy. Gestational diabetes is characterized by insulin resistance and hormonal changes.   Women with a family history of diabetes are genetically predisposed to gestational diabetes. Other factors include age (women older than 35), obesity, multiple delivery, and a previous history of gestational diabetes. The symptoms of gestational diabetes are similar to type 1 and type 2 diabetes.  

4. Impaired Glucose Tolerance (IGT) and Impaired Fasting Glycemia (IFG)

In Impaired Glucose Tolerance (IGT) and Impaired Fasting Glycemia (IFG), blood glucose levels are higher than normal, but they are not as high enough to be classified as diabetes. However, they can be precursors to type 2 diabetes. It is the transition between normal blood sugar levels and diabetes. The symptoms are similar to type 1 and type 2 diabetes, and people at risk are individuals with a family history of diabetes, gestational diabetes, obesity, and PCOS.

Diagnosis

A. Type 1 diabetes

1. Based on the presenting symptoms
2. Fasting Plasma Glucose (FPG)
3. Oral Glucose Tolerance Test (OGTT)
4. Random Blood Glucose
5. Autoantibody tests
6. Insulin/C-peptide levels

B. Type 2 Diabetes

1. Based on symptoms
2. Fasting Plasma Glucose (FPG)
3. Oral Glucose Tolerance Test (OGTT) after 2 hours.
4. Hemoglobin A1c (HbA1c)
5. Random Blood Glucose

Note: Insulin/C-peptide levels differentiate type 1 from type 2 diabetes.   C. Gestational diabetes Confirmation of gestational diabetes is better through prenatal screening than relying on presenting symptoms alone.

1. 50-gram glucose challenge
2. 100-gram oral glucose challenge (confirmatory test)

4. Impaired Glucose Tolerance (IGT) and Impaired Fasting Glycemia (IFG)

1. Fasting Plasma Glucose (FPG) test: Measures blood glucose levels after an 8-hour fast.
2. Oral Glucose Tolerance Test (OGTT): Measures blood glucose 2 hours after consuming sugar.

Prevention

Prevention of type 1 is quite challenging because it’s an autoimmune disease. A.Type 2 diabetes

1. Maintain a healthy weight and BMI
2. Regular but moderate exercise
3. Avoid smoking
4. Eat healthy, avoid sugar, fatty foods and refined carbohydrates

  B. Gestational diabetes

1. Maintain a healthy weight and BMI
2. Regular but moderate exercise
3. Eat healthy, avoid sugar, fatty foods and refined carbohydrates
4. Blood glucose monitoring
5. Regular prenatal care.

Treatment

One of the most important ways to treat diabetes is to avoid diabetes, and this can be done by living a healthy lifestyle. Treatment of type 1 diabetes requires daily shots of insulin injection. For individuals with type 2 diabetes, treatment regimens include drugs to help regulate blood sugar levels and insulin injections. Some of the drugs include:

• metformin
• sulfonylureas
• sodium-glucose co-transporters type 2 (SGLT-2) inhibitors.

In addition to drugs for regulating blood sugar levels, diabetic individuals also need drugs to lower blood pressure and reduce the risk of other complications.   READ ALSO:  Sunflower Seeds: Nutritional Value and Health Benefits 

Conclusion

Diabetes is not a death sentence as it can be managed, especially when diagnosed early. You can also prevent diabetes by living a healthy lifestyle, exercising, avoiding sugary foods, and smoking.   As we celebrate World Diabetes Day, we honour and recognize our women fighting with diabetes. This article aims to educate us and create more awareness of diabetes in the hope that we will take the proper steps to prevent it.