How to Combat Diabetes

Diabetes is a persistent disease caused by either the inability of the pancreas to secrete adequate insulin or owing to lack of total utilization of secreted insulin through different systems of the body. Diabetes, if remained uncontrolled for a prolonged period can lead to severe health damages, particularly to the nerves and the blood vessels. There are mainly two types of serious complications of diabetes: -

1. Chronic complications: These types of complications are diseases linked to both large and small blood vessels which lead to severe damages to the feet, kidneys, eyes, nerves and heart.

2. Acute complications: Acute complications are associated with either extreme elevation or considerable reduction of blood sugar level (due to diabetes drugs) i.e. hyperglycemia or hypoglycemia.

Different forms of diabetes

Two major forms of diabetes are there, namely type 1 and type 2 diabetes.

Type 1 Diabetes

Previously the Type 1 diabetes was known as juvenile onset diabetes mellitus or insulin dependent diabetes mellitus (IDDM). Here, the ability of the pancreas to secrete insulin is lost due to some autoimmune attack made by the body’s own immune system (the body’s immune system incorrectly generates inflammatory cells and antibodies against the body’s own cells). The attack is on the β cells of the pancreas, from which insulin is secreted. For most of the patients suffering from type 1 diabetes, there is an abundance of abnormal antibodies. Antibodies are basically proteins present in the blood that constitute the immune system of the body. This tendency towards the production of misdirected antibodies is thought to be in part inherited genetically, though detailed research is still going on. The survival of Type 1 diabetes patients depends solely on insulin medication. 

The activation of abnormal responses of antibodies against the β cells of the pancreas (insulin producers) may also happen upon exposure to several environmental toxins and due to the viral infections induced by Coxsackie and mumps viruses. Anti-insulin antibodies, anti-glutamic decarboxylase antibodies and anti-islet cell antibodies are a few of the antibodies associated with type 1 diabetes. These antibodies are usually recognized in most of the patients suffering from type 1 diabetes and thus can be used as a diagnostic indicator to determine whether a patient has a risk of developing type 1 diabetes in the near future.

Type 2 diabetes

Formerly, the Type 2 diabetes was known as adult onset diabetes mellitus (AODM) or non-insulin dependent diabetes mellitus (NIDDM). Here, unlike type 1 diabetes, patients do not lose the ability of producing insulin, but it cannot suffice their body’s requirement, especially in case of insulin resistance. Often the production of insulin in these patients is more than the normal, yet it cannot suffice the need of the body as most of the body’s cells (muscle and fat cells in particular) lost the sensitivity towards insulin.

In other circumstances type 2 diabetes patients suffer from increased insulin resistance and suboptimal or defective insulin secretion from the pancreas. Moreover, the control over glucose gets worse in type 2 diabetic patients with the stable reduction in the production of insulin through β cells of the pancreas leading to insulin therapy. The condition turns critical when liver in patients with type 2 diabetes starts producing glucose by gluconeogenesis in spite of elevated levels of glucose in blood. The total management of gluconeogenesis gets compromised.

Along with genetic connection, obesity is the most significant contributor in the development of diabetes. The risks of diabetes development possess direct correlation with the degree of obesity in both adults and children. The current studies suggest that with each 20% increase over normal body weight, the chance of developing diabetes doubles.

Gestational Diabetes

Gestational Diabetes attacks adult women at the time of pregnancy. This situation arises as many women during their pregnancy got elevated blood glucose levels. At the same time the production rate of insulin in their body is not sufficient to transfer the blood glucose to different cells of the body, resulting in a gradual increase in the blood glucose level.

At the time of pregnancy the diagnosis of gestational diabetes can be carried out and in most of the cases adequate exercise with proper diet is enough to control the gestational diabetes. But still 10-20% of the patients suffering from gestational diabetes require some sort of medications to control the blood glucose level. If remained undiagnosed and thus uncontrolled gestational diabetes can increase the risk of complications in childbirth considerably. It usually results in larger than normal babies.

In a striking finding, the scientists of Harvard University and the National Institutes of Health established the fact that women who received diets comprised of high amount of cholesterol along with the animal fat prior to pregnancy poses higher risk of attaining gestational diabetes, in comparison to those who lived on diets containing less animal fat and cholesterol.

The main symptoms of diabetes

• An elevated rate of urination and excessive thirst
• Increased hunger
• Blurry vision
• Loss of weight and increased fatigue
• Gums becoming tender, swollen and red
• Increase in the frequency of infection with a decrease in the rate of healing
• Itchy feelings in both hands and feet
• Decrease in concentration and interest

A few essential facts on diabetes:

• As per WHO, diabetes is a silent epidemic as more than 246 million world population is suffering from this disease which makes 6% of the adult population of the world.
• The diabetes capital of the world is India. At present approximately 40 million people in India are diabetic. By 2025 the estimated number of diabetic patients in India will be touching 70 million, which signifies that every 5th diabetes patient in this world will be from India.
• One in every 20 deaths across the globe is because of diabetes. Currently diabetes is responsible for 6 deaths per minute. Diabetes and its related diseases can be accountable for nearly 3.2 million deaths every year around the world.
• As there is minimum to no early symptoms of diabetes, it can be regarded as a significant “silent killer disease”. Feeling thirsty is the most common early symptom.
• The type 1 diabetes, which mainly affects the children, constitutes 5% of the total number of diabetes cases with the rest of the 90-95% cases being of type 2 diabetes. Type 2 diabetes generally affects middle aged people. Every year, nearly 70,000 children below the age of 15 get affected by type 1 diabetes.
• Diabetes is associated with a number of other serious diseases. It is the primary reason behind renal disorder across the world. Besides, it is also responsible for one million limb amputation, 5 million blindness, cataract formation and heart diseases in the adult population.
• Destruction of the blood vessels, including the capillaries in the eyes is another dreadful symptom indicating diabetes. This leads to blurred vision and eventual blindness. Other diseases related to eye like glaucoma and cataracts can get aggravated in the presence of diabetes. Diabetic retinopathy is another common eye illness associated with diabetes.
• Moreover, diabetes makes people twice as susceptible to cardiac disorders when compared to non diabetic population.
• The modern trend of sedentary lifestyle is the main contributor to this drastic increase of frequency of diabetes. A regular habit of exercise and controlled diet can lessen the chance of diabetes by more than 50%.
• Even after getting diabetic, proper control over diabetes can significantly lessen the chance of getting into other complications or aggravation of complications.
• Prevention of diabetes is possible through daily exercise for half an hour.
• Low-glycemic diet, i.e. carbohydrate-containing foods that are less likely to cause large increases in blood sugar levels reduces diabetes risk factors and makes it less likely to get the disease. 
• Deaths from diabetes are estimated to rise by 50% or even more in the next 10 years. They are predicted to increase remarkably by more than 80% in upper-middle income countries.
• Worldwide occurrence of Type 2 diabetes, previously rare in children has notably in recent years. In certain countries, almost half of diabetes diagnosed cases are found in children.

Individuals at high risk of getting diabetes include those who:

• Are more than 45 years of age
• Are obese
• Have diabetes in their family most likely parents, but also brothers or sisters
• Developed diabetes during pregnancy
• Had a child with more than 9 pound weight
• Have an elevated blood pressure
• Have an increased cholesterol level or other abnormally developed blood fats

Treatment

Type 1 diabetes

Treatment for Type 1 diabetes treatment is a daily job. It is difficult to control Type 1 diabetes in particular due to lack of insulin production by the pancreas.

Type 1 diabetes treatment needs a strict regimen that typically involves a well calculated diet plan, planned physical activity, multiple daily injections of insulin and regular blood glucose testing.

Proper management of Type 2 diabetes includes:

• Planned diet
• Proper physical exercise
• Diabetes medication if needed or insulin therapy
• Monitoring of Blood sugar 

Nutrition

In Type 1 or Type 2 diabetes, it is needed to be quite aware of not only the diet, but also the management of time and quantity of food to be consumed. Following a planned meal helps reduce weight, thereby lowering the risk of developing complications.

Physical Activity

Regular physical activity is important for diabetes control and prevention of related complications such as high blood pressure and heart disease. Moderate exercise for 30 minutes like regular brisk walking is quite effective in managing diabetes.

Medications

Sometimes planned diet and physical activity is not enough for controlling Type 2 diabetes. One might need oral medication to help manage the blood glucose levels. Some of the key medications are as follows:

Ø Metformin (Glucophage, Glumetza, others)

Metformin is the first medication referred for Type 2 diabetes. It improves the sensitivity of the body tissues to insulin, thereby helping effective utilization of insulin by the system.

Metformin also reduces production of glucose in the liver.

Ø DPP-4 inhibitors

These medications besides reducing blood glucose levels tend to have a modest effect. They also help control weight gain. Some of the examples of these medications are linagliptin (Tradjenta), saxagliptin (Onglyza) and sitagliptin (Januvia).

Ø SGLT2 inhibitors. 

These are the newest medicines for diabetes in the market. They help prevent reabsorbing sugar in the blood by the kidneys; instead, the sugar is discharged in the urine.

Examples are dapagliflozin (Farxiga) and canagliflozin (Invokana). Some side effects may include urinary tract and yeast infections.

Ø Insulin therapy.

Some Type 2 diabetic patients might need insulin therapy as well.

Since insulin taken orally is interrupted by normal, it must be injected. Depending on requirement, doctors may prescribe an insulin mixture throughout the day and night. Often, Type 2 diabetic patients start use of insulin with a single long-acting shot at night.

Injections of insulin involve either a syringe and fine needle, or an insulin pen injector — a device with a get up similar to an ink pen, only the cartridge is packed with insulin.

Some of the types of insulin include:

• Insulin aspart (Novolog)
• Insulin glulisine (Apidra)
• Insulin glargine (Lantus)
• Insulin lispro (Humalog)
• Insulin isophane (Humulin N, Novolin N)
• Insulin detemir (Levemir)

Bariatric surgery

A person with 2 diabetes and body mass index (BMI) greater than 35 may possibly be a candidate for Bariatric surgery (weight-loss surgery). Blood glucose levels normalize in 55 to 95 % of patients with diabetes if surgery by passing a portion of the small intestine is performed.

Disadvantages of surgical procedures include cost, and risk of death. Additionally, drastic change in lifestyle is needed and long-term complications like osteoporosis and nutritional deficiencies may occur.

Food habits

Here comes a list of food items suitable for diabetic patients:

Diabetes and Carbohydrates

• Whole-grain bread
• Wheat flour
• Brown rice
• Baked sweet or white potato or baked steak fries
• Popcorn or corn made products

Vegetables

• Fresh vegetables, raw, roasted or lightly steamed or grilled
• Lightly steamed frozen vegetables 
• Unsalted or low sodium canned vegetables
• Spinach, Lettuces, greens, arugula, kale

Fruits and Diabetes

• Fresh fruit or 100 %fruit juice
• Sugar-free jams or fruit preserves
• Sugar-free apple sauce

Protein products

• Baked, boiled, stewed or grilled meats
• Turkey bacon
• Low-fat containing cheeses
• Skinless chicken breast 
• Baked, steamed, boiled or grilled fish
• Lightly sautéed Tofu, cooked in soup
• Beans
• Eggs
• Nuts

Hope this will help people understand diabetes better and they will be able to fight this disease with more vigour. Diabetes can be checked and kept under control if not totally cured. Do not underestimate diabetes as it is a silent killer. Help people fight against diabetes.