Diabetes Mellitus is a chronic and progressive disease characterized by hyperglycaemia( high blood sugar). As of 2015, it has affected 382 million people worldwide and this number continues to grow. It is estimated about 532 million will be affected with diabetes by the year 2030. According to the 2014 data provided by International Diabetes Federation around 700,000 people have diabetes in Nepal.
What are the symptoms of diabetes?
About 50% of patients may not have any symptoms at all. For those who have symptoms, they may complain of feeling tired, frequent urination, increased thirst, increased hunger, weight loss, burning sensation in feet/legs, slow healing wounds, frequent urinary tract infection and so on.
How is Diabetes diagnosed?
Simple blood tests can confirm whether you have diabetes or not. These tests are:
Fasting blood glucose
75 gm Oral glucose tolerance test
Any one of the above tests can be used for diagnosis.
What are the long term complications of Diabetes?
Diabetes can affect any part of the body. The organs that are most vulnerable to damage are eyes, kidneys, peripheral nerves, peripheral blood vessels, heart, brain, gastrointestinal system , genitourinary system etc. Patient with diabetes have four fold risk of having a heart attack compared to non diabetic population.
How can you prevent the complications associated with diabetes?
Keeping your sugar well controlled (that is determined by HbA1c <7%) is the only solution that can prevent or delay the risk of long term complications. If you have high blood pressure or high cholesterol you will be advised to take medications to keep them at target. Screening for complications should be done every year. Complication surveillance includes: eye (fundus) check, kidney function test, urine for microalbumin (protein), lipids test and feet examination.
When should you screen for diabetes?
There are various factors that can increase your risk of diabetes. You should screen for diabetes if you have any one of the following risk factors:
- Family history of diabetes
- If you are overweight/obese (if your BMI >23)
- If your blood sugar is borderline high (Prediabetes)
- If your blood pressure and/or blood cholesterol is high
- If you had diabetes during your pregnancy (GDM)
- In certain disorders such as Polycystic ovarian syndrome.If you do not have any risk factors you can check your blood sugar once you are 45 years old and every year thereafter.
If you do not have any risk factors you can check your blood sugar once you are 45 years old and every year thereafter.
How can we prevent/ delay diabetes?
There is no cure for diabetes. However, the good news is you can follow simple lifestyle changes to prevent diabetes. These lifestyle modifications are especially useful for people who have risk factors for diabetes. These changes include : dietary modification, exercise and weight reduction. Watching your carbohydrate intake, reducing animal fat (such as red meat, ghee, butter) and increasing the amount of high fibre food such as vegetables and fresh salad/fruits . Moderate intensity aerobic exercise such as brisk walking, dancing, swimming should be done regularly 30 minutes/day for atleast 5 days a week. Sitting time should be restricted to less than 90 minutes.
Why is it important to treat diabetes?
The goal of treating diabetes is to minimize the risk of long term complications associated with diabetes. Keeping your HbA1c (3 months’ average blood sugar) to less than 7% will drastically reduce or delay your future risk of chronic complications.
How often should you visit your doctor?
If your blood sugar is well controlled then you will be asked to follow up every 3-6 months. However, it is important that you monitor your blood sugar frequently . If your blood sugar is not satisfactory or poorly controlled then your doctor may ask you to come back more frequently till your blood sugar reaches target.