What is Diabetes?

Diabetes is a group of diseases characterized by high blood glucose levels that result from defects in the body’s ability to produce and/or use insulin.

Type 1

Usually diagnosed in children and young adults, this form of diabetes means the body does not produce insulin. Type 1 diabetes also used to be known as juvenile diabetes.

Insulin is the hormone that converts sugar, starches and other food items into energy that the body needs to sustain life. Although this form of diabetes is rare, those who are affected need to obtain insulin therapy in order to lead a normal life. Once diagnosed with type 1 diabetes, patients must learn to manage the condition through insulin therapy, controlled diet and other treatments in order to live a happy and healthy life.

Type 2

Develops when blood sugar levels rise higher than normal. This is the most common form of diabetes.

In type 2 diabetes, the body does not use insulin properly and is called insulin resistance. At first the pancreas creates more than the required level of insulin to combat the resistance. But, over time it isn’t able to keep up with the requirement, which results in increased blood glucose levels. Type 2 diabetes generally develops in adults over the age of 40, although in recent times there have been patients from younger age groups. Type 2 diabetes can be controlled if detected early by living a healthy lifestyle; that includes exercise, healthy and wholesome diet and other treatments.

Gestational Diabetes

Develops when expecting mothers have a higher than normal level of blood sugar. This usually happens during the 24th week of pregnancy.

Gestational diabetes does not mean that you had diabetes before the pregnancy or that you will have diabetes after giving birth. However, it could lead to later complications in mother and baby if the blood sugar levels are not controlled. If diagnosed with gestational diabetes, doctors advice must be followed in order to ensure both mother and baby are healthy. There can be instances where gestational diabetes can continue after childbirth in the mother or baby, or both.

Can I get Diabetes?

Non-modifiable risks

Age:

The risk of diabetes (type 2) increases with age as the body struggles to create enough insulin to combat the levels of blood sugar. Although risk of developing diabetes has been stated to be around 40 years of age, it has been affecting younger adults and even children.

Family history:

Those who have a history of diabetes in the family are more likely to develop diabetes.

Race or ethnicity:

Research has shown that certain races are more prone to diabetes than others. However, it could be due to genetic or environmental factors or nutritional factors especially at a very young stage.

Modifiable risks

Abnormal nutrition

Nutrition plays a major role in the development of type 2 diabetes. It’s important to have a balanced and healthy diet to make sure that the body is able to produce the use insulin as intended. Both over and undernutrition can cause type 2 diabetes. Undernutrition during pregnancy can increase the risk of insulin resistance in the child, while overnutrition can lead to being overweight and obesity resulting in early development of type 2 diabetes.

Physical Inactivity

This is the most significant risk factor. Inability to engage in regular physical activity to maintain ideal body weight can result in the development of type 2 diabetes.

Pre-diabetes

Impaired Fasting Glycaemia (IFG) or Impaired Glucose Tolerance (IGT) puts you at an increased risk and should be actively corrected through proper nutrition, exercise, and stress control.

Diabetes during pregnancy (gestational diabetes)

Gestational diabetes poses a risk to both mother and child unless it is properly monitored and correct treatment is administered to control the onset of diabetes.

Stress

Stress related hormonal and metabolic changes are associated with nutrition, psychosocial problems may cause imbalances in the body that may put individuals at a higher risk for the development of diabetes. Infections along with the above pose an additional risk factor for the development of type 2 diabetes.

Symptoms of diabetes

Early detection and treatment of diabetes greatly reduces the risks of diabetes related complications that can develop over time. Here are a few typical symptoms of diabetes. If you think you have any of these symptoms, however mild they may seem please contact [contact information]

• Urinating often
• Ants around urinal or toilet
• Feeling very thirsty
• Feeling very hungry, even though you have regular meals
• Extreme fatigue
• Blurry vision
• Cuts or bruises that take long to heal
• Experiencing cramps in your limbs
• Weight loss even though you are eating more
• Tingling pain or numbness in hands or feet

Interesting facts about Diabetes

Here are a few interesting facts about diabetes and it’s penetration throughout the world.

1. There is NO CURE for diabetes
2. Diabetes increasing in pandemic proportions
3. In 2011, 366 million people (8.3%) worldwide were affected by diabetes and 280 million people (6.4%) were affected by Impaired Glucose Tolerance (IGT). Numbers are expected to rise to 552 million (9.9%) for diabetes and 398 million (7.1%) for IGT by 2030.
4. In 2011, 71.4 million people (8.3%) in South East Asia were affected by diabetes and 23.8 million people (2.8%) were affected by Impaired Glucose Tolerance (IGT). Numbers are expected to rise to 120.9 million (10.2%) for diabetes and 38.6 million (3.2%) for IGT by2030.
5. 183 million people (50%) with diabetes are undiagnosed.
6. 80% of people with diabetes live in low-and middle-income countries.
7. Diabetes is the 4th or 5th leading cause of death in most high-income countries.
8. Almost one-fifth of the world’s people with diabetes live in South-East Asia Region.
9. Diabetes caused 4.6 million deaths in 2011 (8.2% of global all-cause mortality).
10. Diabetes will cause 10 million deaths by 2030.
11. Approximately 8 people die every minute from diabetes related causes
12. Half of the deaths below the age of 60 are caused by diabetes related causes
13. 18 people develop diabetes every minute
14. Adopting a healthy diet and increasing physical activity can reduce the development of Type 2 Diabetes up to 80%
15. 50% or more of people with diabetes die of cardio vascular disease, heart and strokes.
16. Diabetes is responsible for over 1 million amputations each year.
17. 2.5 million people develop blindness each year due to diabetes
18. 20% of people with diabetes die of renal failure.
19. More than 2.5 million people worldwide are affected by diabetic retinopathy.
20. On average, people with diabetes will die 5-10 years younger than people without diabetes and mostly due to cardiovascular disease.
21. It has been estimated that between 5-10% of the total healthcare spending of the world is spent on diabetes related conditions.

Eating a well-balanced diet is essential in taking care of yourself. Regular physical activity is equally important for maintaining a healthy and balanced life. Combining a well-balanced diet with physical activity is extremely important for those who have diabetes and are at the risk of diabetes.

Food

People with diabetes have the same nutritional needs as anyone else. The key is to plan your meals to help manage diabetes. After all diabetes shouldn’t keep you from eating a wide variety of foods including some of your favorites.

So what can I eat?

Living with diabetes does not mean giving up all your favorite types of foods. It’s all about planning and making healthy food choices. Replace some of the key ingredients in your meals to make your favorite dish a healthy one.

Basics

Here are some of the basic healthy meal choices that we can make.

Rice – Replace white rice with high-fiber red rice. If you use rice flour try using rice flour that is made out of red rice.

Non-starchy vegetables – Vegetables classified as non-starchy are full of minerals and vitamins, and they contain very few calories and carbohydrates. Here are some of the most popular non-starchy vegetables:

• Asparagus
• Beans
• Beetroot
• Broccoli
• Cabbage
• Carrot
• Cauliflower
• Celery
• Cucumber
• Eggplant (Brinjals)
• Greens (gotukola, mukunuwenna, spinach, kankung, kathurumurunga)
• Leeks
• Mushrooms
• Ladies fingers (Okra)
• Onions
• Tomato
• Turnips
• Yams
• Yard-long beans (maa karal)
• Raddish
• Drumsticks (Murunga)
• Bittergourd

Fruits: Fruits are a great source of vitamins and minerals just like vegetables. But they do contain carbohydrates, so you must count them as part of your diet. Having a slice of fruit as a dessert can be a great way to satisfy your sweet tooth.

Meats: Switch to fish or chicken. Fish is high in proteins and low in fat. Prepare chicken without the skin for less saturated fat.

Grains: Green gram, cowpea, gram, red rice, mineri, olu rice, whole wheat flour, soya, uludu, kurakkan.

Dairy: Dairy products are high in calcium and vitamin D and protein. Best choices are non-fat milk, non-fat yoghurt, unflavoured soy milk.

Drinks: Water, unsweetened teas, coffee, unsweetened fruit juice

Fitness

Physical exercise does not mean dragging yourself to a gym and forcing yourself to workout. Physical activity is essential and anything that gets you moving and burning calories can be considered as such. Dancing, walking, jogging, working in the garden, bicycling can be fun ways of incorporating physical activity into your daily routine. Here are some of the benefits of regular physical activity:

• Lowers blood sugar
• Lowers blood pressure and cholesterol
• Lowers risk of heart disease and stroke
• Burns calories and helps you to lose and maintain weight
• Increases your energy for daily activity
• Relieves stress
• Improves blood circulation

The National Diabetes Center provides a host of services that will help you identify, manage and control diabetes.

What are the services available at NDC?

Single Visit Screening

Single Visit Screening is designed to detect complications of diabetes that includes a complete physical and biochemical assessment. NDC has two screening packages available:

1. Standard Screening Package –  Rs. 3,500.00

   Standard screening package includes:

   1. FBS
   2. Lipid Profile
   3. HbA1c
   4. Serum creatinine
   5. ECG
   6. Urine Albumin/Sugar
   7. Microalbumin
   8. Eye check including fundal
   9. photography
   10. Neuropathy Assessment
   11. Full physical assessment
   12. Doctor’s Consultation
2. Executive Screening Package – Rs. 5,500.00

   Executive screening package includes:

   1. FBS
   2. Lipid Profile
   3. HbA1c
   4. Liver Profile
   5. Renal Profile
   6. ECG
   7. Eye check including fundal
   8. photography
   9. Neuropathy Assessment
   10. Full physical assessment
   11. Doctor’s Consultation

Wellness Program

Wellness is a holistic approach to healthy living, focusing on the complete physical, mental and social aspect of healthy living. It’s an active process of becoming aware of elements of a healthy lifestyle and being able to make healthy choices to improve your overall lifestyle.

Our wellness program isn’t just for those with diabetes or those at risk of diabetes; it is for everyone. Biochemical and clinical assessments together with scientific study and measurement of the individual’s body is used to determine areas that need to be improved. Individuals who are at risk of diabetes will be automatically referred to a medical office who will provide lifestyle modification advice on a regular basis.

Skin Complications

Diabetes can affect any part of your body including your skin. Here are some of the general skin conditions that can occur due to diabetes:

1. Infections (Fungal/Bacteria)
2. Itching

Eye Complications

Diabetes can lead to several different eye complications from minor eye disorders to complete blindness. Some of the common complications include glaucoma, cataracts and diabetic retinopathy.

1. Cataracts

   People with diabetes are about 60% more likely to suffer from cataracts. Cataract is the clouding of the clear lens in the eye. People with diabetes tend to develop cataracts at a younger age and progress faster than those without diabetes. Clouding of the eye can develop to a point where it is impossible for a person to see.

2. Diabetic retinopathy

   Refers to all disorders related to the retina, caused by diabetes. Two main categories of retinal disorders are; proliferative and non-proliferative. Proliferative Retinopathy is when blood vessels in the retina are damaged to the point where they close up. To combat this, new blood vessels start growing in the retina. These new blood vessels are weak and can start leaking blood. This can progress to a point where the retina is pulled out of place. This advanced stage is called retinal detachment.

   Non-proliferative retinopathy is when capillaries in the back of the eye balloon and form pouches. This can become severe as more and more blood vessels are blocked.

3. Glaucoma

   People with diabetes are at a higher risk of glaucoma. In fact approximately 40% of diabetes patients are likely to suffer from glaucoma. Glaucoma occurs when pressure builds up in the eye. The pressure ultimately pinches blood vessels that carry blood to the retina and optic nerve. Loss of vision is gradual and caused by damage to the retina and optic nerve.

Neuropathy (Nerve Damage)

Neuropathy refers to nerve damage caused by diabetes. This is most prevalent in feet and hands. Many diabetic patients suffer from some form of neuropathy. However, this is most common in feet. Neuropathy can cause impairment of sensation (feeling) or motor skills (movement).

Foot Complications

Diabetes can be the cause of multiple foot complications. Loss of sensation or feeling in the limbs is the most common due to nerve damage where you lose the ability to feel pain heat or cold. This means that you may not feel injury, which means you may not notice it until the skin breaks down and results in an infection and ulceration.

People with diabetes must examine their feet regularly

Not recognizing and treating these ulcerations correctly may increase the risk of amputation. People with diabetes are 25 times more likely to face amputation than people who don’t have diabetes.

Over 1 million diabetes related amputations have been carried out in the world.

Stroke

A stroke usually happens when blood supply to part of the brain is interrupted. Any part of the brain can be affected and it can cause unilateral weakness. In severe cases it can cause partial or complete paralysis. It’s important to know that if you have diabetes, your risk of a stroke is 2 – 4 times higher than that of a person who does not have diabetes.

Heart Disease

Research shows that people with diabetes are at a much higher risk of heart disease than people who don’t have diabetes. Diabetes, heart disease and stroke are all linked to each other. If proper medical care is not provided these can quickly escalate and result in death. In fact, 2 out of 3 people with diabetes die of heart disease or stroke. What are common symptoms?

1. Angina – feeling a chest pain when exercising or exerting yourself.
2. Heart Attack – A heart attack occurs when blood flow to a part of your heart is blocked for a long enough time that part of the heart muscle is damaged or dies. Chest pain, pain in arms, back, jaw or stomach, shortness of breath, tiredness or fatigue can all be symptoms.

It’s important to remember that diabetes can cause nerve damage which means you may not feel any pain during the heart attack. If you have any of these symptoms seek immediate medical attention.

Kidney Disease

Nephropathy is the study of kidney and disease. Infection can damage kidney. and increase the blood sugar.

Pregnancy

Being overweight and stressed can cause diabetes in the middle of the pregnancy. This condition is reversible after pregnancy. Diabetes during pregnancy increases the risks with each pregnancy and can lead to complications in the mother and child. Diabetes during pregnancy will be a risk factor as the child is more prone to get diabetes later on in life.