Yasmin Williams - HEALTH-WISE

DIABETES, LIKE hypertension, is one of the chronic lifestyle-related diseases. A person diagnosed with this condition will have to manage the problem throughout his or her lifetime.

About 18 out of every 100 Jamaicans have diabetes. In diabetes, the body is not able to use the glucose that it gets from the food that is eaten. Glucose provides needed energy for the body. Insulin, a substance produced in an organ in the body called the pancreas, enables the body to use glucose.

In diabetes, there is either little or no insulin, or the body cannot use the insulin it makes. This causes high levels of glucose in the blood.

There are two main types of diabetes:

Type 1 ­ occurring usually in young persons. In this type, administration of insulin is the norm.

Type 2 ­ diabetes occurring in the older age group. In this type there is marked response to lifestyle changes. Insulin and/or oral medication are used in these patients to normalise the elevated blood glucose.

As many as 30-50 per cent of diabetics may not know they have diabetes because they have no signs or symptoms. Such persons would only know they had diabetes if they did a blood glucose test. If you are at risk for developing diabetes, you should have periodic blood glucose screening tests. The risk factors for diabetes can be classified as modifiable risk factors and nonmodifiable risk factors.

NON-MODIFIABLE RISK FACTORS

Age

Family

Race

MODIFIABLE RISK FACTORS

Sedentary lifestyle

Overweight

If one has a history of non-modifiable risk factors, there is nothing one can do to eliminate them. However, one can eliminate or prevent the presence of the modifiable risk factors and be proactive by doing regular blood glucose monitoring. Women who have given birth to large babies or who had high blood sugar levels in pregnancy (gestational diabetes) are at risk for developing diabetes.

Some signs and symptoms of diabetes are:

1. Passing a lot of urine (polyuria)

2. Drinking a lot of water (polydipsia)

3. Tiredness

4. Weight loss

5. Tingling or numbness of hands and/or feet

6. Recurrent yeast infections

Like high blood pressure, high blood glucose levels cause damage to the blood vessels of the heart, eyes, kidney, and brain and additionally, affect the nerves and blood vessels of the extremities especially the lower limbs.

Amputation of a lower limb may be necessary if the extremity becomes badly damaged. A high blood glucose or a very low blood glucose level may cause unconsciousness/coma in the diabetic.

Diabetes by itself or in association with hypertension and/or high blood cholesterol is responsible for many of the heart attacks and 'strokes' which occur. Diabetes is part of what is referred to as 'the Metabolic Syndrome' ­ a recently - defined area for research and clinical care. The characteristics of patients with this syndrome are, diabetic or with impaired glucose tolerance, hypertensive, dyslipidemic (abnormal levels of blood fats) and obesity.

The diagnosis is made if at least three of the characteristics are present. The underlying metabolic abnormality appears to be resistance to the action of insulin and significantly, persons with the metabolic syndrome are at increased risk for stroke and heart attack ­ cardiovascular events. A person who is diabetic with no known cardiovascular disease is said to be at the same risk for stroke or heart attack as a person who has already had an attack.

TO PREVENT, DELAY OR CONTROL DIABETES

1. Exercise regularly

2. Eat a healthy diet (foods from all six food groups in appropriate quantities)

If you are diabetic, in addition to the lifestyle changes discussed:

3. See your doctor on a regular basis

4. Take your tablets/insulin daily as prescribed. You may be lucky and find that lifestyle modification is enough to maintain your blood sugar level within the normal range. If not, it will certainly facilitate reduction in the amount of medication needed with reduced side effects and cost.

5. Have regular checks to document your blood glucose levels

6. Control your blood pressure

7. Do not smoke

8. Control your blood cholesterol level.

Dr. Yasmin Williams is a Family Doctor and Public Health Specialist.