Doris Obinna
Diabetes is the disorder of the insulin and leptin, signalling that it occurs over a long period of time. First into the pre-diabetic state and then into full-blown diabetes, if left unchecked, the insulin is a sensitive key in this matter.
Experts say normal blood sugar levels are less than 100 mg/dL after not eating (i.e fasting) for at least eight hours, and less than 140 mg/dL two hours after eating. For most people without diabetes, blood sugar levels before meals hover around 70 to 80.
According to the World Health Organisation (WHO), the number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. Between 2000 and 2016, there was a five per cent increase in premature mortality from diabetes.
WHO added: “Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves.”
World Diabetes Day is celebrated every November 14. It became an official United Nations Day in 2006 with the passage of United Nation Resolution 61/225.
A general practitioner, Dr Sunday Olalekan, said the disease is usually characterized by the loss of insulin producing beta cells of the islets of langerhans in the pancreas, leading to insulin deficiency: “Type 1 diabetes does affect children and adult, and sometimes these diseases are hereditary.
“While insulin resistance, which may be combined with the relatively reduced insulin secretion, usually characterizes the type 2 the defective responsiveness of the body tissues to insulin is believed to have been the cause of this. Also all forms of diabetes increase the risk of long-term complication.
“Patients who are usually diagnosis with this disease usually have complication damages of the blood vessels including the damage of the eyes, kidney and nerves. The damaged eyes, which is usually known as the ‘retinopathy’ is caused by the damage to the blood vessels in the retina of the eyes and can result in gradual vision loss and blindness.
“Damage to the kidneys, known as ‘nephropathy’ can lead to tissues scarring, urine protein loss and eventually a chronic kidney disease. Also the damage to nerves of the body known as the ‘diabetic neuropathy,’ is usually the most common complication of diabetes, the symptoms can include numbness, tingling, and altered pain sensation. Diabetes related foot problems may occur and sometime can be very difficult to treat, occasionally requiring amputation.”
Signs and symptoms
Olalekan said: “Hyperglycemia does not cause symptoms until glucose values are significantly elevated, usually above 180 to 200 milligrams per deciliter (mg/dL), or 10 to 11 millimoles per liter (mmol/L). Symptoms of hyperglycemia develop slowly over several days or weeks.
“The longer blood sugar levels stay high, the more serious the symptoms become. However, some people who have had Type 2 diabetes for a long time may not show any symptoms despite elevated blood sugar levels.
“Recognising early signs and symptoms of hyperglycemia can help you treat the condition promptly. Watch out for signs like; frequent urination, increased thirst, blurred vision, fatigue and headache.
“If hyperglycemia goes untreated, it can cause toxic acids (ketones) to build up in your blood and urine (ketoacidosis). Signs and symptoms include: fruity-smelling breath, nausea and vomiting, shortness of breath, dry mouth, weakness and abdominal pain.”
Causes
He said: “During digestion, your body breaks down carbohydrates from foods such as bread, rice and pasta into various sugar molecules. One of these sugar molecules is glucose, a main energy source for your body. Glucose is absorbed directly into your bloodstream after you eat, but it can’t enter the cells of most of your tissues without the help of insulin a hormone secreted by your pancreas.
“When the level of glucose in your blood rises, it signals your pancreas to release insulin. The insulin, in turn, unlocks your cells so that glucose can enter and provide the fuel your cells need to function properly. Any extra glucose is stored in your liver and muscles in the form of glycogen.
“This process lowers the amount of glucose in your bloodstream and prevents it from reaching dangerously high levels. As your blood sugar level returns to normal, so does the secretion of insulin from your pancreas.
“Diabetes drastically diminishes the effects of insulin on your body, either because your pancreas is unable to produce enough insulin (type 1 diabetes) or because your body is resistant to the effects of insulin or doesn’t produce enough insulin to maintain a normal glucose level (type 2 diabetes). As a result, glucose tends to build up in your bloodstream (hyperglycemia) and may reach dangerously high levels if not treated properly. Insulin or other drugs are used to lower blood sugar levels.”
Prevention
Olalekan advised: “Follow your diabetes meal plan. If you take insulin or oral diabetes medication, it’s important that you be consistent about the amount and timing of your meals and snacks. The food you eat must be in balance with the insulin working in your body.
“Monitor your blood sugar. Depending on your treatment plan, you may check and record your blood sugar level several times a week or several times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
“Note when your glucose readings are above or below your goal range. Take your medication as prescribed by your health care provider. Adjust your medication if you change your physical activity. The adjustment depends on the blood sugar test results and on the type and length of the activity.”
Risk factors
The risk factors include, not using enough insulin or oral diabetes medication, not injecting insulin properly or using expired insulin and not following your diabetes eating plan: “Being inactive with illness or infection, using certain medications, such as steroids.
“Again, experiencing emotional stress, such as family conflict or workplace challenges, illness or stress can trigger hyperglycemia because hormones produced to combat illness or stress can also cause your blood sugar to rise.
“Even people who don’t have diabetes may develop hyperglycemia during severe illness. But people with diabetes may need to take extra diabetes medication to keep blood glucose near normal during illness or stress.
Foods that can help
“A healthy diet is an important part of managing diabetes well. But when you are living with type 2 diabetes, eating smart is essential to managing your condition. A healthy diet helps you lose weight and maintain a healthy weight. It can help keep your blood sugar levels stable. Following your diet plan helps prevent complications such as heart disease and high blood pressure and keep your diabetes under control.
“Eating a high-fiber diet rich in natural whole foods (unrefined and unprocessed fruits, vegetables, nuts, seeds, beans, legumes, and peas) while restricting or eliminating foods containing refined carbohydrates such as white rice, white bread, potatoes, packaged snacks, cakes, and pastries.
“Consult a dietician, if you are unclear about which foods you should eat and which you should avoid. At least 30 minutes of moderate intensity physical activity at least 5 days per week (Remember: any activity is better than none). Activity that makes you breathes harder and raises your pulse rate.
“Results in mild sweating, allows you to carry on a conversation with your partner while exercising. Get six or more hours of uninterrupted sleep each night. In some cases, medicine may play a role in reducing the chances of developing diabetes. This should be discussed with your doctor.”
Emergency
complications
Olalekan also disclosed that in emergency complications, if blood sugar rises high enough or for a prolonged period of time, it could lead to two serious conditions: “Diabetic ketoacidosis develops when you don’t have enough insulin in your body. When this happens, sugar (glucose) can’t enter your cells for energy.
“Your blood sugar level rises, and your body begins to break down fat for energy. This process produces toxic acids known as ketones. Excess ketones accumulate in the blood and eventually ‘spill over’into the urine. Left untreated, diabetic ketoacidosis can lead to a diabetic coma and be life threatening.
“Hyperglycemic hyperosmolar condition occurs when people produce insulin, but it doesn’t work properly. Blood glucose levels may become very high greater than 600 mg/dL (33 mmol/L). Because insulin is present but not working properly, the body can’t use either glucose or fat for energy. Glucose is then spilled into the urine, causing increased urination. Left untreated, diabetic hyperglycemic hyperosmolar state can lead to life-threatening dehydration and coma. Prompt medical care is essential.”