Demystifying Diabetes Mellitus

Diabetes mellitus (commonly referred to as diabetes) is a health condition in which the body does not produce enough insulin, or does not properly respond to it. Insulin is a hormone, produced in the pancreas, which is needed to turn sugary and starchy foods into energy.

Like many diseases, diabetes has been found to be more prevalent among certain ethnic groups.  In the United States, for example, the ratio of black to white diabetes patients is 10:6 (www.BlackDiabetic.org), and the First Nations Centre at the National Aboriginal Health Organization has determined that “The rate of diabetes for the First Nation population is about three times higher than the average Canadian rate.” In this issue, Black Ink Magazine takes a closer look at diabetes itself, how to avoid becoming diabetic, and ways of coping with the disease after diagnosis.

First, it is important to note that there are three principal types of diabetes: type1, type 2 and gestational diabetes.

Type 1 diabetes

This type of diabetes develops when the body is unable to produce any insulin. It is usually found in children and in adults under 40 years of age. It is treated by insulin injections, diet and regular physical activities.

Type 2 diabetes

This type of diabetes develops when the body fails to use insulin properly. This type of diabetes usually appears in whites over the age of 40, and in member of South Asian, African-Caribbean, and minority ethnic groups who are over the age of 25. It is now found in obese children. It is treated in one of the following ways:

• By diet and physical activity.
• By diet, tablets and physical activity.
• By diet, insulin injection and physical activity.

Gestational Diabetes:

This type of diabetes develops in pregnant women who have never had diabetes before, but whose blood sugar levels are high during their pregnancy. About 4% of all pregnant women suffer from this condition. It may develop into type 2, or more rarely, type 1 diabetes.

There are other forms of diabetes which are categorized separately, including the following:

• Congenital diabetes, which develops due to genetic defects of insulin secretions
• Cystic Fibrosis-related diabetes
• Steroid diabetes induced by high doses of glucocorticoids (steroid hormones)

All forms of diabetes have been treatable since insulin became medically available in 1921, but there is not yet any cure for the common type of diabetes, except a pancreas transplant. Gestational diabetes usually resolves after delivery of the baby.

According to Canada’s current national survey data, between 1.2 and 1.4 million individuals aged 12 and over have diabetes, but only 800,000 are diagnosed cases.

Prevalence of Diabetes: 3% of people age 33–64 and 10% of those aged 65 and over have diagnoses of diabetes.

Incidence: Diabetes is diagnosed in an estimated 60,000 Canadians every year.

According to Diabetes UK, over two million people in the UK are diabetic, and another 750,000 have diabetes but are completely unaware that they have it.

According to research by the American Diabetes Association in 2009, there are now 23.6 million children and adults in the United States who have diabetes (7.8% of the population).

International Diabetes Federation survey data shows that worldwide, diabetes has surged in the last two decades from 30 million to 230 million diagnosed cases.

These are signs and symptoms of diabetes you must look for:

• Increased thirst
• Extreme tiredness
• Unexplained weight loss
• Frequent urination – especially at night
• Genital itchiness
• Blurred vision
• Slow healing of cuts and wounds

You can have diabetes for some time without knowing; in fact, if you have type 2 diabetes, you may not notice any of the above symptoms at all. If left untreated and uncontrolled, diabetes can lead to serious complications such as strokes, heart disease, blindness, problems with blood circulation, kidney damage, and many other harmful and potentially fatal health problems.

Are you at risk?

• Do you have a relative with type 2 diabetes?
• Are you overweight or obese?
• Are you over the age of 40?
• Are you physically inactive?
• Is your blood glucose high?
• Are you of South Asian, African-Caribbean or Middle Eastern descent?

A yearly health check, especially of your urine and blood glucose levels, will detect diabetes. It is very important to visit your general physician for this check.

Living with Diabetes

A diagnosis of diabetes can be overwhelming for some individuals.  It requires a major lifestyle change, but you can still lead a healthy, active life. You just need regular checkups and to have good

control of your diabetes. Taking the following steps will reduce your chances of developing serious complications linked to diabetes.

• Monitor your blood glucose regularly.
• Consult a dietitian to create a balanced meal.
• Eat regular, small and balanced meals.
• Maintain normal blood pressure.
• Limit your intake of fat and sugar.
• Eat more fruits and vegetables; aim for at least five servings daily to provide you with vitamins and fibre.
• Use less salt.
• Drink alcohol in moderation.
• Exercise regularly.
• Take medication as prescribed.
• Take insulin injections as prescribed.
• Stop smoking.
• Lose weight.
• Visit your optician yearly.
• Attend regular diabetic clinic.
• Join a local diabetic support group.
• Join a diabetes association.
• Continue to take your medication when ill.
• Take medication when fasting.
• Visit your doctor and dentist regularly.
• Read diabetes pamphlets.
• Inform the Driver and Vehicle Licensing Agency (DVLA).
• Attend diabetes courses: the DAFNE (Doses Adjustment For Normal Eating) Course teaches type 1 diabetics how to adjust their insulin doses to suit what they eat, helping them to minimize hypoglycemic attacks, while the DESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed) Course helps type 2 diabetics to identify their own health risks and set specific goals.

Clearly, diabetes is a very serious condition, one which affects many thousands in our community and which can make individual susceptible to a wide variety of debilitating or even life-threatening conditions. The good news is, if you detect your diabetes early and act accordingly, you reduce the risk of most serious complications, and you will be able to enjoy a normal lifestyle.

Hope Roberts August 2010 ©

References:

• “Diabetes Mellitus” – Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Diabetes_Melittus) (2009)

• Diabetes is surging worldwide- Health& Science- International

• Herald Tribune –  (http://www.nytimes.com/2006/06/11/health/11iht-health.1947808.html?_r=1&_=1) (2006)

• NHS Choices / Your health your choices/ Knowing the symptoms of Diabetes. (http://www.nhs.uk/Pathways/diabetes/Pages/Symptoms.aspx) (2009)

• NHS choices /Your health, your choices/ Living with diabetes. (http://www.nhs.uk./Pathways /Diabetes/Pages Living .aspx) (2008)

• Diabetes in Canada- Public Health Agency of Canada. (http://www.phac-aspc.gc.ca/publicat/dic-dac99/d02-eng.php) (1999)

• Diabetes UK/ A guide  for African-Caribbean people/Your key to better health leaflet. (Http://www.diabetes.org.uk)  (July 2004)
• Diabetes UK/ What diabetes care to expect leaflet. (http://www.diabetes.org.uk)  (January 2003)