Diabetes Mellitus, commonly known as diabetes, refers to a group of illnesses called metabolic disorders which leads to the presence of high levels of sugar (blood glucose) in the bloodstream, a condition called hyperglycemia.
With diabetes, there is either a deficiency in the secretion of insulin meaning that your body is not making enough of it or an inadequacy of insulin action meaning a decline in your body’s response to it.
Glucose has a very important role in providing your body with adequate energy so that you can function continuously daily. Your brain in particular is glucose-dependent and is unable to store it. Your brain demands glucose for fuel so that you can capably think, learn and remember. Red blood cells, the lens of the eyes, the renal medulla (the inner region of the kidney) and your muscles wholly rely on glucose for energy.
Insulin is a hormone produced by your pancreas and plays a vital role in regulating blood sugar levels by allowing glucose into the cells so that it can be used for energy, and by instructing the liver, muscle and fat cells to store the excess glucose, which can be used later when there is a higher demand for energy.
The World Health Organisation (WHO) says, “Diabetes prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries and … diabetes was the seventh leading cause of death in 2016”. In an older analysis (2014), they found worldwide there were 422 million adults diagnosed with diabetes.
There are multiple types of diabetes. However, the forms which are most known are: Type I and Type II of which the latter is most common. The destruction of pancreatic beta-cells appears to be consistent with all forms. The WHO says these cells are incapable of renewing after the age of 30 years.
Type I Diabetes occurs when the body fails to produce insulin owing to the destruction of the beta-cells by the immune system and onset is common in childhood and early adulthood. Risk factors include certain genetic haplotypes and unknown environmental factors (exposure to viral illnesses).
Type II Diabetes is caused by insulin resistance and mostly associated with but not limited to being overweight or obese. Risk factors include history of first-degree relatives such as a parent; ethnicity (Afro-Caribbean, South Asian and Hispanic); history of diabetes during pregnancy (Gestational Diabetes); having given birth to a baby weighing more than 9 lbs or 4 kg; Polycystic Ovarian Syndrome (PCOS) and age. Your risk increases as you get older probably owing to a sedentary lifestyle, physical inactivity, being overweight, or obesity.
The progression of Type II Diabetes is slow and symptoms may be absent during the initial period simply because your body is able to compensate. However, as the disease progresses, you will become symptomatic. Significant signs and symptoms include excessive thirst and hunger; frequent urination; blurred vision; marked weight loss; notable tiredness and fatigue; slow healing of sores, cuts and wounds; frequent urinary tract and yeast infections and erectile dysfunction in men.
Screening and early diagnosis are vital in the efficient management of diabetes, thereby preventing complications and ensuring longevity. There are numerous walking diabetics among us who are not presented with symptoms due to the slow pace of progression of this disease. Persons who are unable to recognise common signs and symptoms and persons who are reluctant to seek help owing to fear of the ‘white coat’ or needles are prevalent. Nevertheless, everyone who has risk factors and those who are presented with symptoms should visit a doctor to screen for diabetes. Blood sugar testing is imperative in diagnosis.
While you cannot prevent Type I Diabetes nor can you control certain risk factors such as age and family history in Type II, making changes to one’s way of life by maintaining a healthy weight, getting active, eating healthy, and avoiding excessive alcohol consumption and smoking can help to prevent or delay the onset of diabetes.
Management for diabetes encompasses a multidisciplinary approach which involves (I) lifestyle modification such as: consuming a healthy balanced diet. Diabetics are advised to embrace a diet which includes lots of vegetables, whole grains, nuts, fish, lean meats such as chicken and turkey, and small portions of fruits. It is wise to avoid high-carb foods such as white rice or bread, sugar-filled baked goods and beverages, and sweet treats such as chocolate and ice cream as well as red meat, and processed and canned foods. It is also recommended to have smaller portions of food and to eat six times per day in order to maintain stable blood sugar levels.
Participating in daily physical activity is critical; as are maintaining a healthy weight according to your Body Mass Index (BMI) and avoiding use of tobacco, excessive alcohol consumption and use of illegal drugs. Additionally, it is of great importance to protect your feet by wearing soft, comfortable footwear both in your home and outside, never walking bare feet and constantly inspecting your feet for cuts, pricks or bruises, which lead to a high incidence of leg amputations among diabetics.
Pharmacological management comprises use of medication to help control blood glucose levels as well as control other chronic illnesses such as hypertension, heart disease or kidney disease if present; annual or semi-annual check-ups to assess glycemic control, and prevent or prolong end-organ damage to organs such as the eyes, kidneys, and heart as well as diabetic foot problems. These complications are usually silent until far advanced.
During these visits, your doctor will request a series of tests checking how well your blood sugars have been controlled, how well your heart and kidneys are working; cholesterol levels are important too.
Your health-care provider will also indicate fundoscopy and retinal imaging to check the status of your eyes. Often enough as this disease progresses, one might have to change medications or switch to insulin all of which cannot be done without regular check-ups.
World Diabetes Day is celebrated universally and is devoted to spreading awareness of risks and management of Diabetes Mellitus as well as supporting people who live with this disease worldwide. It is celebrated on November 14 every year in commemoration of Sir Frederick Grant Banting, a Canadian physician, Nobel Prize winner and co-discoverer of insulin, who was born on November 14, 1981.
This year’s theme: “The Nurse and Diabetes” is dedicated to raising awareness of the significant role of nurses in helping diabetic patients.
All things considered, I would like to urge the general public to seek medical services as it relates to screening for Diabetes Mellitus by making a doctor’s appointment and discussing blood glucose testing.
Early diagnosis is of the utmost importance since it leads to healthier outcomes and prevents serious complications. To our diagnosed population with diabetes, I would like to encourage you to continue taking optimum measures in controlling this illness and to keep in mind that the health-care system, including health-care providers, supports you and will continue to do so.
To our nurses,
I say thank you.