Diabetes is a lifelong disease you need long term care to control it

Piku Chowdhury (name changed) is 26 years old. She is on insulin. 20 years back, one day she was playing at her school playground in a village of Tamluk of Midnapur district, West Bengal. Suddenly she became sick and almost unconscious.

A big question came to their mind. What caused diabetes in their daughter?

This story is painful but true. Like her, there are many patients who are suffering from diabetes. This disease is appearing as epidemic.

WHAT DOES DIABETES MEAN?

Diabetes mellitus is a chronic disease in which blood sugar level of a person goes abnormally high due to decreased insulin production or due to insulin resistance or both. The common symptoms of diabetes mellitus include increased frequency of urination, increased thirst, hunger, and tiredness. Diabetes cannot be cured. It can only be controlled or managed.

WHAT IS DIABETES?

• A person’s blood sugar level goes abnormally high
• It happens due to insulin resistance or decreased insulin production or both
• Common symptoms: Frequent urination, increased thirst, hunger, tiredness
• Diabetes cannot be cured. It can only be controlled or managed.

TYPES OF DIABETES

1. TYPE 1 DIABETES: It is an autoimmune condition in which body’s immune cells destroy the insulin secreting cells of pancreas. There is absolute insulin deficiency and injectable insulin is the only medical way to control it.
2. TYPE 2 DIABETES: It is the most common type of diabetes and its primary cause is insulin resistance and amount of insulin production is reduced (no absolute insulin deficiency). Obesity, sedentary lifestyle and family history are the risk factors for diabetes. It is managed with lifestyle modification, dietary modification and oral drugs. If not adequately controlled, later on, the patients may need to be switched to injectable insulin.
3. GESTATIONAL DIABETES: When a pregnant woman develops high blood sugar levels for the first time during pregnancy, it is called gestational diabetes. Pregnancy is a state of insulin resistance and thus triggers diabetes. It generally manifests during second and third trimester of pregnancy. It is managed with injectable insulin.

WHAT CAUSES DIABETES?

• GENETIC SUSCEPTIBILITY

Heredity plays an important part in determining who is likely to develop diabetes. Genes are passed down from biological parent to child.

• OBESITY AND PHYSICAL INACTIVITY

Physical inactivity and obesity are strongly associated with the development of type 2 diabetes. People who are genetically susceptible to type 2 diabetes are more vulnerable when these risk factors are present.

• INSULIN RESISTANCE

Insulin resistance is a common condition in people who are overweight or obese, have excess abdominal fat, and are not physically active. Muscle, fat, and liver cells stop responding properly to insulin, forcing the pancreas to compensate by producing extra insulin. As long as beta cells are able to produce enough insulin, blood glucose levels stay in the normal range. But when insulin production falters because of beta cell dysfunction, glucose levels rise, leading to prediabetes or diabetes.

CASE STUDY

Mr. Murarka, 47 years old young healthy man is a senior business executive. He resides in a luxurious 18th floor flat. After a poor sleep at night he starts his day at 8 am with a cup of tea, gets prepared by 8.45 am, drives his car to attend his office at 9.30 am sharp. He is a successful icon in his domain. Today, he has three meetings of which he chairs two. In the evening flight he will leave for New York to attend an international business conference. He has responsibility to procure a business of Rs 250 crores. He will stay there for three days. This is his usual routine. He is overweight but has no disease at all. On corporate health checkup it is found that his results are as: fasting blood glucose 230mg/dl, postprandial blood glucose 329mg/dl, triglyceride 195mg/dl, and LDL 267mg/dl. His blood pressure is 156/94 mm of Hg. Though he has no symptom, his present condition is known as Syndrome X. There are genetic abnormalities in the background but his lifestyle indulges to develop his disease. His management plan will be different. He has to change his life style. In addition he may have to take some oral medicine.

According to World Health Organization in respect to syndrome X the normal levels are as: fasting blood glucose below 108mg/dl, postprandial blood glucose below 140mg/dl, triglyceride below 150mg/dl, and LDL below 100mg/dl and blood pressure is not more than 140/80 mm of Hg.

SOME OTHER CONDITIONS ALSO PLAY A ROLE IN DEVELOPING DIABETES:

• Gestational diabetes (in pregnancy)
• Hyperthyroidism
• Cushing syndrome
• Acromegaly
• Phaeochromocytoma
• Pancreatitis
• Cancer in pancreas
• Haemochromatosis
• Cystic fibrosis
• Some drugs, chemicals
• Infection like German measles, down syndrome, turner syndrome etc.

So, the target is: Control blood sugar and avoid cardiometabolic complications

EATING WELL WITH DIABETES

Taking steps to prevent and control diabetes doesn’t mean living in deprivation; it means eating a tasty, healthy and well balanced diet

You don’t have to give up sweets entirely or resign yourself to a lifetime of bland food. With these tips, you can still take pleasure from your meals without feeling hungry or deprived.

• Set timely reminder on when to eat! Your body is better able to regulate blood sugar levels—and your weight—when you maintain a regular meal schedule. Aim for moderate and consistent portion sizes for each meal or snack.
• Don’t skip breakfast. Start your day off with a good breakfast. Eating breakfast every day will help you have energy as well as steady blood sugar levels.
• Eat regular small meals—up to 6 per day. People tend to eat larger portions when they are overly hungry, so eating regularly will help you keep your portions in check.
• Keep calorie intake the same. Regulating the amount of calories you eat on a day-to-day basis has an impact on the regularity of your blood sugar levels. Try to eat roughly the same amount of calories every day, rather than overeating one day or at one meal, and then skimping on the next.

RATE YOUR PLATE

Take a good look at your plates -- the foods you choose and the portions you eat. Rate your plates to see if they measure up.

Try to eat a balance of food groups so as to obtain healthy combination of carbohydrate, protein & fat in your diet as described in the diabetic food plates below.

Reduce extra-large servings of less-healthful foods and increase servings of foods we're not eating enough of: vegetables, fruits, dairy foods, and whole grains.

Start by reducing your portions of less-healthful foods by 5 to 10 percent. You'll barely notice the trimming, but you'll immediately taper your intake of calories, carbohydrate, fat, and sodium. Over time, this portion slim-down will improve your weight, blood glucose, cholesterol, and blood pressure.

There is no one perfect food so including a variety of different foods and watching portion sizes is key to a healthy diet.

Lifespan diabetes & cardiometabolic clinic is world’s largest chain of diabetes management clinics and has a dedicated team of Specialist Diabetologists, Dietitians and Diabetes Educators who answer all your diabetes related queries and help you manage your diabetes.

For Full Care of Diabetes,
Visit www.lifespanindia.com

Call 1800 3000 1893