TAMING THE SILENT KILLER- EVERY 6 SECONDS DIABETES CLAIMS THE LIFE OF A VICTIM
Diabetes is an incognito terrorist, which leaves destruction amongst the masses; taking pity to neither child, adult nor elderly. Unlike some diseases which kills victims with clear signs of infection, this is an undercover terror, which silently claims lives. At times, even the patient is unaware of its existence within their system. On the World Diabetes Day, Head of wellness center and Health Educator of Hemas Hospitals (Pvt) Ltd Dr. Kaushalya Perera delivered an insightful exposition regarding the importance of taming this silent killer.
What are the early symptoms which can help diagnose diabetes?
Patients feel an unquenchable thirst. Excessive sudden weightloss over a very short period of time, is another symptom. Regardless of the amounts of food consumed patients feel significant hunger. Blurred vision, slow wound recovery, genital irritation due to recurring fungal infection can also be observed. Sexual dysfunctions for both men and women can be a symptom which most parties refuse to accept and voice out.
How do you classify diabetes?
Diabetes classification transcends even beyond the most infamous type 1 and type 2 interpretations. Apart from these, there are the Maturity Onset Diabetes of the Young (MODY), Latent Autoimmune Diabetes in Adults (LADA), Gestational diabetes (developed during pregnancy and usually disappears after giving birth) and Secondary diabetes (as a secondary effect due to Cushing syndrome and other conditions).
What are the expected results which need to be maintained through these investigations?
According to the 2019 guidelines, the HBA1C should be maintained at 6.5- 7%. Patients who are above 60 have the flexibility to maintain the level at around 7%.
Why is Diabetes labelled as a ‘silent killer’?
Every 6 seconds a person dies from diabetes. Due to neuropathy (nerve damage) diabetic patients are unaware of the presence of a heart attacks and chose to go to sleep without seeking medical attention. The chances of survival decrease with every moment which is delayed.
Why do experts claim that diabetes affect the entire human body? An average human body comprise of an abundance of blood vessels from the brain to the toe tips. These vessels are considered as the transportation channel which circulate oxygen, glucose and nutrients to each organ of the body. When the blood vessels contain higher glucose levels , it runs the risk of damaging the inner layer of the blood vessel.
High concentrations of sugar particles are considered as toxic for the blood vessels. The damaged layer then invites LDLS and Triglycerides. These get accumulated on the damaged surface. Platelets and Red
Blood Cells get attracted to this location, and ultimately formulates a clot.
It is evident what happens once a clot formulates. A clot which occurs in the foot can flow upto the heart, since blood vessels are interconnected. These clots can get detached from the site and can obstruct the blood supply of the brain (stroke) or the cardiac muscles (Myocardiac infaction).
Interestingly, every nerve requires a blood supply for its survival. When a clot formulates in the blood vessel which provides nutrients to the nerve, it deprives of nutrients . once deprived of the nourishment, it ultimately dies. This leads to Neuropathy. Once this occurs, the nerves stop sending messages to the brain from the internal organs. In a nutshell, a patient won’t even be aware, if a sudden heart attack, or a stroke pops up.
Furthermore, high glucose concentration may damage the retina. It could potentially cause aneurysms in the inner layer of the eye ball. This is caused due to dilation of blood vessels which can cause internal bleeding (blood flowing into the eyeball). Once this condition manifests, the patient has to deal with visual impairments and blindness.
Once retinal complications occur, those blood vessels secretes endothelial growth factor which develop immature unhealthy blood vessels; which can potentially rupture and bleed into the eye. It is hard to recover if we delay the identification of the root cause, and therefore it is advised to visit regular eye screenings, and get checked by responsible specialists.
Wound care is of utmost importance for a diabetes patient. Foot hygiene should be given prominence. Since the body fail to respond to stimuli, the risk of injuries are extreme. Every night patients should do a thorough foot inspection for potential injuries as a habit. Once injured at this stage, the patient is prone to Cellulitis. This, supported by recurring wounds might potentially lead upto amputation of the organ under consideration.
As far as the diabetes complications are concerned, nephropathy plays a vital role. When the patient’s kidneys are exposed to a high sugar concentration, openings/ holes which filter out blood become enlarged, which in turn invites proteins to leak out/ excrete. This protein leak/ excretion is identified by conducting a urine microalbumin test.
Sexual dis-functionality is a complication which needs to be addressed; a condition which many refuse to acknowledge. Results of a majority of researches conducted regarding the topic reveal that sexual impotence for diabetic patients is a foreshadowing of a future potential heart attack or a stroke, which could possibly occur now, tomorrow, or even in 4 years into the future, given that hyperglycemia is not properly controlled.
It is evident as to why the disease is labelled as ‘the silent killer’. It is a terror which launches an attack when the patient least expects, and most of the time, the patient wont even feel it coming.
What treatments does Hemas Hospital provide to its patients?
Hemas Hospital targets the issue from the root cause, and that is to cultivate knowledge regarding the entire ordeal. Hemas Hospital Thalawathugoda started a Health Education program which is hosted on Saturdays, where I personally conduct seminars from 12.30pm -2.30pm. Here, diabetes isn’t addressed superficially; a deep insight is shared, starting from molecular levels of insulin production from the pancreas, procedure of glucose particles entering cells with the help of insulin and even how receptors are opened up. These information are presented visually (through videos). Diet and exercise plans are also formulated for each patient. These seminars are conducted as a social service, therefore it is offered free of charge.
In addition, the hospital offers a free session conducted by the psychologist and the dietitian on the very first day. Diabetic clinic attendees will be reminded their next clinic appointment by the responsible staff of Hemas Hospital, therefore the need to diarize the appointment day is redundant. Furthermore, the hospital maintains a thorough profile of all its patients within the database, therefore the need to bring past reports are made irrelevant.
Diabetes is a condition which should be
treated by a multitude of specialists. It is a multi-disciplinary team approach. This is a cluster of diseases. Once complications emerge, patients are prone for visual disturbances, heart conditions, kidney ailments and other physical ailments. Therefore, diabetes need to be treated with the support of Dietitians, Psychologists, Cardiologists, Eye Specialists, Kidney Specialists and Physical Trainers. Hemas Hospitals has reputed specialists in each field enlisted, and patients can receive the much needed consultation whenever it is required.
The American Diabetics Association, World Health Organization and the International Diabetes Federation has established educational systems in Europe; DESMOND program ( Diabetic Education and Self Management for Ongoing and Newly Diagnosed) focuses on type 2 diabetes patients and DAFNE program (Dose Adjustment For Normal Eating). These programs have been accepted as a global trend, and similar educational programs are rightly facilitated by Hemas Hospitals as well.
What is your professional opinion regarding the discussion?
Diabetes is a silent terror, and it needs to be controlled. Consuming a fiber enriched diet, which comprises 50% vegetables and fruits, 30% proteins and 10% carbohydrates. engaging in regular exercises (at-least for 20 minutes everyday), taking a brisk walk thrice a week on a jogging track or engaging in other similar cardio exercise for 45 minutes whilst remaining equipped with the knowledge of what is to come will give the society a better chance of facing off against this adversary.
Stress management plays an important role for a diabetic patient. Both physical (even a minor mundane cut ) or any sort of mental stress ( caused due to ongoing arguments, insecurities, suspense etc.) can induce cortisol(stress hormone) secretion from the patient’s adrenal glands (which are located on the kidneys). One molecule of cortisol can stimulate the patient’s body to produce a higher concentration of sugar internally.
Every 6 seconds, an unfortunate soul falls victim for this dreaded terror. The next victim can very well be you, and the saving grace which you ultimately need, is yourself. Therefore, make it a commitment to tame the silent killer, to make sure that you’re not the one to succumb within the next 6 seconds.