A silent killer stalks the world.
For a disease that currently afflicts 8.5% of the total world population and is the cause of death of 1.6 million annually, there is still much to learn about diabetes and there are still a lot of outrageous myths surrounding this condition. With so much information online, both true and false, one might be wondering what this disease is really like.
Diabetes is a serious condition that can affect the whole body. People with diabetics simply cannot maintain healthy levels of glucose in the blood. The food that the body intakes is not properly processed (turned into glucose or sugar) for use as energy. The sugar from the food then builds up in the bloodstream.
One of the organs of the endocrine system, a collection of glands that produce the hormones needed for regulating metabolism, growth, etc., the Pancreas is the one that makes a hormone called insulin. This hormone helps glucose get into the cells of the body. When people have diabetes, their bodies don’t make enough insulin or cannot use it properly.
DIABETES BY THE NUMBERS
November is Diabetes Awareness Month.
At first glance, dedicating an entire month for a single disease’s awareness seems a tad excessive, however, when faced with the stats below, a whole month seems to be not enough.
- From 108 million, the number of people with diabetes worldwide has risen to 422 million in 2014.
- In 2015, 1.6 million deaths were directly caused by diabetes.
- In 2012, 2.2 million deaths were attributed to high blood glucose.
- It was reported in 2015 that 30.3 million Americans, around 9.4 of the total population, had diabetes. Of which 1.25 million are children and adults with type 1 diabetes.
- Out of the estimated 30.3 million Americans with diabetes, 23.1 million of these were diagnosed and 7.2 million were not.
- 2% of American seniors (age 65 and older), both diagnosed and undiagnosed, had diabetes.
- Every year, 1.5 million Americans are diagnosed with diabetes
- It was estimated in 2015 that approximately 84.1 million Americans age 18 and older had prediabetes. That’s around 26% of the total population.
- In 2015, it is the 7th leading cause of death in the United states.
THE LOCAL SITUATION
In the Philippines, approximately 6 million Filipinos or approximately 6% of the total population have been diagnosed to have diabetes. According to Dr. Augusto Litonjua, president of the Philippine Center of Diabetes Education Foundation, for every person diagnosed to have diabetes, there is one person that is diabetic but remains undiagnosed.
The primary reason for the upswing in the number of the diabetics in the Philippines is the changing lifestyle among Filipinos. More and more Filipinos are preferring processed food over healthy, natural food. The rise of business process outsourcing (BPO) companies also contribute to this disturbing trend as they often require their employers to work the night shift. The body suffers a lot of stress due to this reverse habit that breaks the body’s diurnal rhythm or the sleep-wake cycles.
Add to that the lack of any physical activity, vices such as smoking and drinking, and the eating out, especially of those who man the night-shift, and you’ll get the reason why the Philippines is now considered a diabetes hotspot.
WHAT’S IN A NAME?
Diabetes Mellitus originated from the Greek word diabetes – meaning siphon (pass through) and the Latin word mellitus – meaning honeyed or sweet. It is believed that the term diabetes was first used by Apollonius of Memphis around 250 BCE. The first recorded usage of this term in English was in a medical text written in 1425, the term used was “diabete.”
It was only in 1675 that the word “mellitus” was added to the term diabetes by Thomas Willis, an English doctor. Mellitus was added because of the sweet taste of the urine. Literature from ancient Greeks, Chinese, Egyptians, Indians, and Persians show that they had already noticed the sweet taste in urine during their time.
TWO TYPES OF DIABETES
There are two types of diabetes: Type 1 and Type 2. The common perception is that people with Type 1 diabetes tend to be underweight whereas all those who have Type 2 are overweight or obese. While for the majority, this is true, there are still some cases that shows the reverse. Around 20% of those who have Type 2 diabetes have healthy BMIs and are dependent on insulin. There are also cases of Type 1 diabetics who are obese.
The pancreas is at the center of things for type 1 diabetics. Also known as juvenile diabetes or insulin-dependent diabetes, type 1 diabetes is a chronic condition wherein the pancreas makes very little insulin or nothing at all. Insulin is an important hormone that the body needs to allow glucose to enter cells and then produce energy.
As of today, there is still no known cure for type 1 diabetes, although studies are yielding more and more positive news. Treatment for this condition is confined to managing blood sugar levels with insulin, healthy diet, and active lifestyle to prevent complications.
For type 2 diabetes, insulin is not the problem. Rather, it is the way the body reacts to it. Your body might not be producing the right amount of insulin or it is resisting its effects. The type of diabetes that is more common in adults, it can also affect children. Same as type 1 diabetes, there is no known cure for type 2 diabetes. It can also be managed by having a healthy and active lifestyle. Plus, insulin therapy or medications can also be prescribed by doctors.
IDENTIFY THE CAUSES
For type 1 diabetes, the exact cause is still unknown. Some scientists postulate that it is caused by a combination of genetic and environmental factors.
Even if the cause of this type is still largely unidentified, experts state that the immune system of people who have type 1 diabetes attacks and then destroys the insulin-producing cells in their pancreas, thereby leaving them with little to no insulin. The sugar then builds up in the bloodstream instead of being transported by the cells.
Gestational diabetes, on the other hand, is caused by the hormones produced by the placenta to sustain pregnancy. These hormones fortify your cells to be more resistant to insulin, making your pancreas work overtime to keep up with the demand. Sometimes, though, the pancreas can’t keep up, thereby only a small portion of the glucose gets into the cells. The rest stays in the bloodstream.
Meanwhile, type 2 diabetes happens when the body cannot use the insulin that is produced (insulin-resistance) or the pancreas couldn’t produce enough insulin to sustain a normal blood glucose level. The main reasons for this appear to be genetics (having close relatives with this condition), lifestyle (being overweight and obese), and age (those who are over the age of 40 are more at risk).
Some of the symptoms of diabetes are very mild that some people never even suspected that they have it in the first place. However, for most, the symptoms are typical. Some of the more common symptoms are the following:
- Frequent urination
- Feeling very thirsty
- Extreme fatigue
- Extreme feeling of hunger (even while eating)
- Weight loss (Type 1)
- Tingling, pain, or numbness in the hands or feet (Type 2)
- Blurry vision
- Cuts and bruises are slow to heal
DIAGNOSING DIABETES
Anyone who exhibited the symptoms above should immediately see their doctor and get tested. Other than the signs, there are also several risk factors that need to be considered when thinking of getting tested. If you have the risk factors below, it would be prudent to get tested right away:
- Overweight or obese
- Have a family history of diabetes
- Age 45 or older
- Have high blood pressure
- Not physically active
- Have a history of gestational diabetes (or gave birth to a baby weighing 9 pounds or more)
- Have a history of heart diseases or stroke
- Have depression
- Have polycystic ovary syndrome (PCOS)
- Have acanthosis nigricans – dark, thick, and velvety skin around the neck or armpits
- Have a low level of HDL or good cholesterol or a high level of triglycerides
| DIAGNOSING DIABETES | |||
| TEST | NORMAL | PREDIABETES | DIABETES |
| A1C TEST | Less than 5.7% | 5.7% to 6.4% | 6.5% or higher |
| FBS TEST | Less than 100 mg/dl | 100 mg/dl to 125 mg/dl | 126 mg/dl or higher |
| OGTT TEST | Less than 140 mg/dl | 140 mg/dl to 199 mg/dl | 200 mg/dl or higher |
| RPG TEST | Less than 140 mg/dl | 140 mg/dl to 199 mg/dl | 200 mg/dl or higher |
Table 1. Laboratory examinations and corresponding results to determine prediabetes and diabetes
These four laboratory examinations can accurately determine your blood sugar level. Depending on your symptoms, your doctor might ask you to take one or two of these tests:
This blood test is known by a variety of names such as: Hemoglobin A1C, HbA1C, Hb1C, A1C, glycohemoglobin, and estimated glucose average. Glycated Hemoglobin is a blood test that gives an estimated average of the state of your body’s blood sugar level during the past 2-3 months. Usually, a doctor would want to see your A1C results at 2-4 times a year.
As the name suggests, this blood test involves fasting or refraining from eating or drinking all kinds of liquids for eight hours. A carbohydrate metabolism test is conducted after fasting to measure the body’s blood glucose level. Other than determining is someone has diabetes; the test also measures the effectiveness of the medication for diabetes that the doctor prescribed.
Oral Glucose Tolerance Test (OGTT)
This used to be the standard when testing people for diabetes. Nowadays, the Oral Glucose Tolerance Test is mainly used on pregnant women for diagnosing gestational diabetes. Like FBS, the person who will take the OGTT needs to fast overnight (at least 8 hours but not over 16 hours). The fasting plasma glucose is tested the next morning. After that, the person is given a dose of oral glucose, with the dosage depending on the length of the test.
Unlike the other blood tests, the Random Plasma Glucose test doesn’t require fasting. Anyone can take this test even after eating or drinking something. This is usually done in the emergency room or when a doctor or patient doesn’t have the luxury of waiting for a fasting blood sugar test.
DIABETES COMPLICATIONS TO EXPECT
If managed effectively, diabetes is not fatal. Moreover, the condition itself is not actually dangerous, the danger lies in the complications that come attached to it. These complications develop gradually, becoming riskier the longer diabetes is left untreated and the less controlled one’s blood sugar is.
Cardiovascular Diseases
- The risk of having cardiovascular diseases automatically increases once one is diagnosed with diabetes. These diseases include heart attack, stroke and atherosclerosis (narrowing of arteries), and coronary heart disease with angina (chest pain).
Kidney Damage (Nephropathy)
- Diabetes is not only responsible for increasing the amount of blood sugar in the body, it also attacks the filtering capabilities of the kidneys. This can lead to kidney failure.
Nerve Damage (Neuropathy)
- Nerves are also affected by diabetes. The excess sugar in the blood can irrevocably damage the capillary walls. These tiny blood vessels are responsible for bringing nutrients and other nourishment to nerves, especially those in the legs.
Eye Damage (Retinopathy)
- Since there are also blood vessels in the retina, they are also targeted by the excess blood sugar. This can lead to blindness and other eye conditions like glaucoma or cataracts.
Foot Damage
- Poor blood flow to the feet, because of the excess blood sugar in the body, increases the risk of getting various foot diseases. The cuts and bruises will also heal slowly and might turn gangrenous. This might lead to toe, foot, or even leg amputation.
Alzheimer’s Disease
- The high blood sugar can also lead to Alzheimer’s Disease once the type 2 diabetic gets older.
Hearing Impairment
- Diabetics are twice more likely to develop hearing impairment than those who aren’t diagnosed with diabetes.
Skin Diseases
- The high blood sugar in the body also makes diabetics more at risk to fungal and bacterial skin infections such as boils, carbuncles, styes (infections of the eyelid glands), folliculitis (hair follicle infections), and infections around the nails.
WHAT TO DO NEXT
Being diagnosed with diabetes might seem to be the end of the world but it’s not. This disease might not have any form of “cure,” but then there are plenty of ways to manage it and make living as normal as possible. Also, managing diabetes is important for staving off the complications that come with this condition.
Food
First is where you get your sugar: food. Other than knowing which types of food have the most sugar, you also need to know the combinations of food to eat for a balanced diet.
- You and your doctor need to work as a team. Coordinate with your doctor with regards your meal plan to ensure that you have just the right amount of insulin (neither too low nor too high), there is a little of everything that you need to function properly (starches, proteins, fruits, vegetables, and even fats), which kinds are good for you, and of course, your medication schedule.
- Know the food and drinks you should avoid. The tastiest ones are probably not the best for you. You should steer clear from sugar-sweetened beverages, starches with high carbohydrates count, and overly fatty food.
Aside from eating healthy, you should also be physically active. Exercising will force your muscles to use glucose 9sugar) for energy and will also help your body efficiently use insulin.
- Religiously follow the exercise schedule/regimen your doctor prescribed. First, you should set an appointment with your doctor and inquire as to what your target weight/blood sugar level is and what kind of exercises you can do to achieve that. Once that is done, stick to it like white on rice. Stay hydrated while exercising, dehydration can affect your blood sugar level so it’s better to err on the side of caution.
- Check your blood sugar level before, during, and after your exercise. Not that you shouldn’t regularly check your blood sugar level while not exercising, but when doing your daily regimen, it is essential for you to do this. Your blood sugar level might plunge dangerously low while you’re exercising. More so if exercising is a new activity for you and your body is not yet used to it.
If your blood sugar level is below 100 milligrams per deciliter (mg/dL), or 5.6 millimoles per liter (mmol/L), eat a snack before you start exercising to prevent a precariously low blood sugar.
Medication
Finally, the last piece of the diabetic puzzle: medication. Eating healthy and being physically active can only take you so far without the aid of doctor-prescribed medication.
- Regularly report problems to your doctor. After being prescribed medication, go back to your doctor if your blood sugar level is dropping too low or if it’s not achieving the desired effect. Your doctor might either adjust the dosage or timing, or prescribe different medication.
ADDITIONAL STEP TO TAKE
As stated earlier, diabetes is most certainly not deadly per se, it is the complications that make this disease fatally dangerous. If managed effectively, even the threat of complications considerably lessens. To complement the above-mentioned steps in coping with diabetes, one can always take herbal food supplements that help normalized the body’s blood sugar level.
Herbal food supplements for diabetes are mostly available online, although a large number can also be purchased over-the-counter in large supermarkets and drugstores. One needs to be discerning when deciding what to buy since there are a lot of these supplements that promise the moon and the stars to their unsuspecting consumers. Be sure to pick the herbal food supplement that is clinically tested and one that has health and quality certifications.
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