Are you diabetic?

2010-05-20 00:00

DIABETES is a condition in which the body does not produce enough insulin, or does not use the insulin which the pancreas is producing in an efficient manner. A little bit of biology may help to put this in perspective. The pancreas is responsible for producing the hormone insulin. But due to various system failures, sometimes this does not happen as effectively as it should. In a nondiabetic person who has had a meal, the meal is digested and the starch in the meal is converted to glucose and sent into the bloodstream. From there the insulin assists the cells to take up the glucose into the body cells where it is used for energy. If there is no insulin, or poor use of insulin, the glucose circulates in the bloodstream, doing damage to nerve endings in the body, while the cells of the body have little or no energy to function, hence the feeling of tiredness experienced by a person with insulin resistance or diabetes.

So, let’s start at the beginning. Your diagnosis of diabetes. You are feeling tired, you lack energy, you may be continuously thirsty and you go to the toilet often. These are signs of diabetes that you need to be aware of, particularly if there is a history of diabetes or insulin resistance in your family. You know it’s time to see your doctor, who will do a full physical and run the initial tests. This is when your doctor may say to you that your blood sugar levels are running too high and you need to have further blood tests to confirm a provisionary diagnosis of diabetes. You head off to the lab, where an oral glucose tolerance test is done. This test involves an initial blood test to determine baseline blood sugar levels. You are then asked to drink a glucose solution, and further blood tests are done to establish the effect of the glucose on your body. The results of this are sent to your doctors, and your diagnosis of diabetes is confirmed. So what are considered normal blood sugar levels? Blood sugars are measured in millimols per litre, and the normal range is from 4 to 8 mmol/l. Anything higher or lower than this is damaging to your body.

Your doctor will confirm the diabetes in another appointment and explain what this diagnosis means for the future. He will probably also start you on some form of medication. The decision as to what medication is used, depends on how high your blood sugar levels are when you are diagnosed. Some tablets help the body use the insulin that is produced, whereas others assist the pancreas to produce further quantities of insulin. Another option, and by no means the last resort is the supplementation of insulin in the form of insulin injections, which are often the means of achieving better control of blood sugars overall. Your doctor will also ask you to see other members of the diabetes care team. These include the diabetes educator, the dietician, a biokineticist, an ophthalmologist and a podiatrist. This is essential in order for you to learn as much as you can about your condition and how to manage it to the best of your ability. 



Some interesting facts and figures:

• In 1985 the number of people with diabetes worldwide was 30 million.

• Today there are more than 345 million people with diabetes, over a seven-fold increase in just 20 years.

• The African region is expected to experience the highest increase.

• If nothing is done to slow down the epidemic, the numbers will reach 380 million within 20 years.

• The largest age group currently affected by diabetes lies between 40 and 59 years.

• Diabetes is one of the major causes of premature illness and death worldwide.

• In developing countries less than half of people with diabetes are diagnosed.

• Undiagnosed diabetes accounted for 85% of those with diabetes in studies done in South Africa.

• 80% of Type 2 diabetes is preventable by changing diet, increasing physical activity and improving the living environment.

• Without effective programmes for control, the incidence of diabetes is likely to continue to rise globally. It is fast becoming a pandemic.

• Diabetes is the main cause of partial loss of sight and blindness in adults in developed countries.

• Diabetes accounts for the vast majority of limb amputations that are not the result of an accident.

• People with diabetes are much more likely to have a heart attack, a stroke or to develop kidney disease.

• It is estimated that the cost of diabetes complications accounts for between five percent and 10% of healthcare spending worldwide, and this does not take into account the day-to-day financial burden of ongoing diabetes care.

— Statistics courtesy of the International Diabetes Federation (IDF).



• Kate Bristow is a professional nursing sister who has specialised in the field of diabetes and diabetic education. She will be writing a monthly column in The Witness.

Bristow practises from the St Anne’s medical centre in Pietermaritzburg, and can be contacted at 082 406 8707 for further information.

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