November is Diabetes Awareness Month
NOVEMBER IS Diabetes Awareness Month. World Diabetes Day was on November 14. The day was chosen to pay tribute to Dr Frederick Banting, the co-discoverer of insulin (in 1921), who was born on November 14, 1891.
Diabetes mellitus is potentially an extremely dangerous, debilitating and deadly disease. The most common kind is type 2 diabetes. It was formerly a disease of adulthood but is now being diagnosed in children. It is often facilitated by excess body weight and physical inactivity.
In this form of diabetes, the body is unable to make good use of its own insulin, the hormone that helps to regulate blood glucose levels. That is called insulin resistance. In response, the pancreas increases its insulin production but, over time, the production wanes. When oral medications prescribed to reduce insulin resistance and others prescribed to ‘encourage’ the pancreas to produce more insulin fail, insulin must be given by way of a tiny needle.
Type 1 diabetes is far less common. It starts from an early age and occurs in persons whose pancreas fails to produce adequate amounts of insulin. These people must be given insulin several times each day to survive. The genesis of type 1 diabetes has no relationship to body habitus or physical activity.
The World Health Organization states that diabetes is rising quickly in countries like Jamaica. The increasing global prevalence of type 2 diabetes has been blamed on our ‘modern’ lifestyle. The disease leads to multi-organ damage (stroke, heart attack, blindness, kidney failure), loss of limbs, poor immune function, susceptibility to numerous infections and even bowel dysfunction.
I try to explain diabetes to my patients in this way: if Mary and Jane are roughly the same size and age and if Mary has diabetes in a very bad way but Jane does not, who has more sugar in their body? Although the simplicity of the question makes people wonder if it’s a trick, just about everyone thinks that, since Mary is badly diabetic, she has more sugar on board. In fact, both Mary and Jane will have the same amount of sugar in their bodies, but Mary has her sugar in the wrong place. A lot of her sugar (glucose) is stuck in the blood stream and is unable to get from the blood stream to the individual cells to provide nourishment. Sugar (glucose) is the main energy source for living cells.
All starch (carbohydrates) must be broken down to glucose in order to be used by the body. Everyone identifies items like ground provisions, wheat products, rice and fruits of all kinds as starch. However, many people do not realise that vegetables are starches too. Our bodies find it easy to break down most starches to glucose and absorb them, but vegetables provide a challenge since they are difficult to work on and we can’t totally digest them.
Interestingly, there is even a negative calorie concept. If someone only eats celery (a very fibrous and watery vegetable), when digested it provides less energy than the amount of energy our bodies use up processing it and absorbing the sugar from it. Other vegetables are not as unyielding but eating them works in our favour since they all provide a lot of roughage, vitamins (if not overcooked), minerals and not that much glucose.
The body needs insulin to allow the glucose from the blood stream to pass into the cells. As stated before, in diabetes, the entire system fails and this leads to very serious consequences.
A lot of people are walking around with no symptoms and no idea that they already have diabetes. It is therefore wise to check for it intermittently. Preventative action includes high-fibre diet with reduced simple sugars, weight control and increased physical activity. If diagnosed, in addition to proper diet and regular exercise, medications play an essential role in controlling this incurable disease.
Diabetics must adhere to lifestyle modifications and take whatever treatment is prescribed to fully control their blood glucose. Many patients hate taking tablets and are terrified of using insulin injections (if needed). The very sad fact is that, if not properly treated, diabetes will cause major suffering and an early death.