INTRODUCTION
According to the World Health Organization, a few decades ago diabetes was a rare disease, both in developed and developing countries. Today, the story is different. It is currently estimated that more than 143 million people worldwide are affected by the disease. This figure is increasing, by 2020 it is expected that more than 220 million people will be living with diabetes, if the current trend continues.
In the United States alone, there are 18.2 million people (6.3% of the population) living with diabetes. While another 13 million people have been diagnosed with diabetes. Unfortunately, 5.2 million (or almost a third) do not know they have the disease.
The figure for Nigeria is not readily available, but it is estimated that more than 1.5 million people have diabetes in Nigeria.
In developed countries, most diabetes patients are over the age of sixty, but in developing countries, diabetes strikes people in their prime.
WHAT IS THE DIABETES?
Diabetes Mellitus (or simply diabetes) is derived from the Greek word ‘Diabeinein’, meaning ‘Passing’ which describes copious urination, and Mellitus from the Latin word meaning ‘Sweetened with honey’. These two words mean sugary urine or sugar in the urine.
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed in the body to control the rate at which sugar, starch, and other foods are converted into the glucose needed for energy for daily life. The hormone is produced and released.
into the blood by an organ called the ‘pancreas’. This insulin helps keep your blood glucose level within a normal range. The World Health Organization (WHO) places this normal range between
60 – 100mg/dl (Before taking any food of the day, hence this value is called Fasting Blood Glucose). In health, despite various glucose demands in different situations, blood glucose rarely exceeds this value.
After a meal, the liver stores glucose from the meal as glycogen and releases it into the blood between meals. The role of insulin is to control this storage and release of glucose. It ensures that the amount of glucose in the blood at any particular time does not go above or below the normal range.
TYPES OF DIABETES.
According to the World Health Organization (WHO), five classes of diabetes are recognized, these are; Insulin Dependent Diabetes Mellitus (IDDM) or Type I Diabetes, Non-Insulin Dependent Diabetes Mellitus (NIDDM) or Type II Diabetes, Gestational Diabetes, Diabetes Insipidus and Bronze Diabetes.
TYPE I/INSULIN DEPENDENT DIABETES: This type of diabetes was initially called juvenile diabetes because it affects adolescents and young adults. It is caused by a sudden failure of the pancreas to produce insulin. It is, therefore, an acute disease, which presents with thirst, polyuria (emission of large amounts of urine), diuresis and weight loss. Type I diabetes is not common, accounting for less than 10% of all diabetes cases.
NON-INSULIN-DEPENDENT DIABETES/TYPE II: This is the most prevalent type of diabetes, accounting for more than 80% of all diabetes cases. It is found in adults and the elderly. This type of diabetes develops gradually over a long period of time (unnoticed) and is characterized by insufficient insulin, poor insulin in the blood, or the body’s inability to use the affected insulin (insulin resistance). Due to its slow and gradual onset, it is mostly undetected until one or more of its long-term complications appear.
Unlike type I diabetes, a type II diabetic’s blood insulin may be normal or even high, but it lacks the desired effect due to insulin resistance, and this is common among obese people.
GESTATIONAL DIABETES: This type of diabetes occurs during pregnancy and disappears after delivery, in 3 weeks. It is estimated that 3% of all pregnancies are accompanied by gestational diabetes and almost half of these patients are likely to develop permanent diabetes later in life.
WHAT CAUSES DIABETES.
As with hypertension and other noncommunicable diseases, no clear cause can be attributed to the most prevalent type of diabetes (type II diabetes, with type I diabetes secondary to pancreatic insufficiency). However, some factors are known to increase the chances of becoming diabetic and are called risk factors. For example, well-nourished, indolent populations are 2 to 20 times more likely to develop type II diabetes than lean, active populations of the same race. Some other factors that are known to increase the chances of getting diabetes include:
OBESITY: It is estimated that three quarters (¾) of all Type II diabetes patients are obese. Indolent and prosperous lifestyles tend to contribute to this. It is believed that a 10kg weight loss can reduce fasting blood sugar by almost 50md/dl. An active lifestyle with frequent exercise is also known to increase insulin sensitivity.
The international standard for measuring overweight and obesity is based on a value called the BODY MASS INDEX (BMI). This value is obtained by dividing the body weight (in kilograms) by the square of the height (in meters).
that is, BMI = Body Weight (Kg) / Height2 (Meters).
Note: 1 foot = 0.305 meters.
For adults, a BMI of less than 25 kg/m2 is preferred.
25 – 29 kg/m2 is considered overweight and above 30 kg/m2 is Obesity.
FAMILY HISTORY: A family history of diabetes increases the chances of getting the disease. In such a situation, it becomes very important to lead a healthy lifestyle and constant control of blood sugar level.
AGE AND RACE: The majority of patients with type II diabetes are over 40 years of age at the time of disease presentation. However, the rate of increase in the incidence of this disease with age is higher for those with a family history of diabetes, those who are obese, and probably those who lead sedentary lifestyles. Also, diabetes tends to be more common among Africans, African Americans, Latinos, Native Americans, and Asian Americans. Belonging to any of the races is a risk factor in itself.
HISTORY OF GESTATIONAL DIABETES: In a woman it also increases her odds/chance of developing permanent diabetes later in life.
YOU CAN PREVENT/DELAY DIABETES!
Diabetes has no permanent cure once it develops, it is controlled throughout life. But you can avoid falling into this pain for life. Before diabetes is present in people, it is almost always preceded by a condition called PRE DIABETES. A situation where blood glucose is higher than normal, but not yet high enough to diagnose diabetes. However, it’s sad that you can’t tell when you fall into this category if you haven’t been monitoring your blood glucose level regularly.
Prediabetes is itself a serious medical condition, although it can still be reversed by making changes to your diet pattern and increasing physical activity. To determine the level of sugar in the blood, a test called fasting blood glucose must be performed. This test measures the amount of glucose (sugar) in your blood before you eat any meal of the day. It is measured in milligrams per deciliter (mg/dl).
A value less than 100 mg/dl is generally accepted as normal, while a value greater than 100 mg/dl but less than 120 mg/dl is still not full diabetes and is considered prediabetes. A person with a pre-diabetes blood glucose level needs to take urgent action to lower their blood glucose level or risk diabetes for life.
However, it must be emphasized that the racial and genetic factors that predispose to diabetes are still beyond human understanding and control. It makes common sense, therefore, to minimize all human-controllable factors. Most of these factors have to do with social, occupational and dietary habits.
The following tips can help reduce your risk of diabetes:
* Reduce weight. Obesity appears to be the single most significant factor in diabetes. Reducing body weight and fat and maintaining an average body weight is very essential. For this, a body mass index (BMI) of less than 25 kg/m2 for men and 24 kg/m2 for women is recommended.
* Increase Physical Activity. It is an established fact that diabetes is more common among people who lead an affluent sedentary lifestyle. Simple dynamic exercises such as brisk walking for 30 to 50 minutes a day or 3 to 5 times a week have been shown to be very helpful. Exercise reduces body weight and fat, increases the functionality of the heart, reduces the chances of diabetes, and also increases emotions and healthy living.
* Reduce or eliminate alcohol. Alcohol intake of more than 2 units per day has been shown to negatively affect the body. Since alcohol is an addictive drug, it is very difficult to maintain a defined amount of intake for a long time. Therefore, it is best to strive to eliminate alcohol completely.
* Avoid smoking. Cigarette smoke has been shown to contain various poisonous substances. Smoking and alcohol have been linked to several diseases. Quitting smoking will definitely reduce the chances of several other ailments apart from diabetes.
* Lean on good eating habits, such as;
* Reduce consumption of fatty and junk foods
* Eat more fish and poultry (skinless is better).
* Garlic lowers blood pressure cholesterol; add it to your meal plan from time to time.
* Cut the number of eggs you eat to 3-4 a week (better boiled than fried).
* Reduce salt intake to less than 5.8 grams daily.
* Eat more vegetables and high-fiber foods, especially fruits.
* Finally, constantly monitor your fasting blood glucose level, as this is the only way to know when you’re getting into trouble.
CONCLUSION
Diabetes and Hypertension are so interrelated that they require a comprehensive plan of care, and this revolves around eating habits, social and environmental factors. Various lifestyle changes, such as regular exercise, maintaining a moderate body weight, reducing fat intake, and eating a high-fiber diet, help lead a normal, healthy life. These measures are known to increase insulin sensitivity and also lower blood pressure.
In conclusion, it is very important to create more health-conscious individuals in the population. A town that practically believes that it is better and cheaper to prevent a disease than to cure it, when it has become stronger. Furthermore, preventive health cannot be divorced from regular medical check-ups, since these two go hand in hand. There is no way to detect various non-communicable diseases without undergoing regular medical check-ups. The importance of these controls cannot be overemphasized.
Be alive to your health. Know your blood glucose values and live a healthier life free from the pain of diabetes.