What is diabetes?

World Diabetes Day is on the 14th November - do you know what it is and the symptoms to look out for? Understand the causes, diagnosis and prevention with our handy guide… 

According to the International Diabetes Federation, one in 11 adults have diabetes leading to a total of more than 415 million people worldwide. By 2040, one adult in ten will have the disease, increasing the total number of diabetics to more than 642 million people.

Diabetes is a growing concern in the UAE and in the Middle East and North Africa region. In 2015, around 9.1% of adults aged 20-79 were labelled as diabetics, with over 40.6% of the cases being undiagnosed.

In 2015, 19.3% (almost one in five people) of the UAE population between the ages of 20 and 79 were found to be diabetic, with over one million people living with diabetes, placing the country 13th worldwide. It is also a regional concern with Bahrain, Saudi Arabia and Kuwait all featuring amongst the top 15 countries in terms of rates of diabetes worldwide. Diabetes in the UAE is rising at a faster rate than the rest of the world and the number of people with diabetes is expected to double to 2.2 million by 2040.

Diabetes basics
Diabetes is a disease in which your blood glucose or blood sugar levels are too high. Most of the food we eat is turned into glucose or sugar for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies.

When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes sugars to build up in the blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations.

There are three major types of diabetes: type 1 diabetes, type 2 diabetes and gestational diabetes.

Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease. In type 1 diabetes, the body does not produce insulin, a hormone that the body needs to get glucose from the bloodstream into the cells of the body. The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy.

The most common type of diabetes, more than 90% is type 2, which occurs when the body does not respond to insulin and doesn’t make enough insulin to control the blood sugar. At first, your pancreas makes extra insulin to make up for it but, over time it can’t keep up and can’t make enough insulin to keep your blood glucose at normal levels.

Pregnant women who have never had diabetes before but who have high blood sugar levels during pregnancy are said to have gestational diabetes. Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be changed to energy.

What are the causes?
Type 2 diabetes is thought to result as a combination of genetic and environmental factors. The risk of 
having diabetes is five to ten times higher in first-degree relatives of a diabetic person compared with a person without diabetes in the family. Those of Hispanic, African, and Asian descent increase their chances of having the disease. Environmental factors such as lifestyle, including diet and physical activity, impact the chances of having diabetes significantly. The increase in the rate of obesity worldwide is also contributing to the rise in the rate of diabetes. Other risk factors for developing diabetes include an age older than 45, having an inactive lifestyle, high blood pressure, abnormal cholesterol levels and a history of polycystic ovary syndrome.

What are the symptoms?
Typical symptoms include increased thirst, the need to urinate frequently, blurred vision, low energy along with unintentional weight loss. Most people with diabetes have no symptoms and therefore the disease takes a long time before it is diagnosed.

How is it diagnosed?
There are several ways to diagnose diabetes. Blood tests such as a Fasting Plasma Glucose (FPG) which checks your fasting blood glucose levels. This test is usually done first thing in the morning after not having anything to eat or drink (except water) for at least 8 hours; a Random Plasma Glucose test which can be checked at any time of the day and an A1C test which measures your average blood glucose for the past 2 to 3 months. There’s also an Oral Glucose Tolerance Test (OGTT) which involves drinking a special glucose solution and checking blood glucose levels before, followed by another one hour and two hours after drinking the solution.

How can it be prevented?
Genetics play an important predisposing role in type 2 diabetes, but there are many other factors such as obesity, inactive lifestyle, poor diet and smoking that can increase the chances of having the disease.

Maintain a healthy diet by eating a variety of foods including fresh fruits and vegetables, limiting fat intake to 30% or less of your daily calories, watching your portion size, avoiding processed and refined sugars and saturated fats. Healthy eating habits can go a long way in preventing diabetes and other health problems.

Regular exercise allows your body to use glucose without extra insulin. This helps combat insulin resistance and is what makes exercise helpful to people with diabetes.

Screening for diabetes is another essential element that could identify the pre-diabetic state, which can be reversed back to normal.

What are the complications?
Diabetes has serious long-term complications and can damage blood vessels which increases the risk of heart attacks by at least three times, the eyes (leading possibly to blindness), the kidneys (leading to kidney failure and dialysis) and the nerves.

Every six seconds, one adult dies from diabetes. Therefore, it is important to control blood sugar levels to prevent these complications from occurring.

How can it be treated? Diabetes requires regular monitoring and the treatment includes lifestyle changes, physical activity and glucose monitoring along with oral and/or injectable medications.

In summary, eat healthy, avoid weight gain, exercise regularly and get yourself checked for diabetes if you are at risk of having the disease or suffer from any of the symptoms.

With thanks to Dr Katia El Sibai, Consultant in Endocrinology, Diabetes and Metabolism, HealthBay Polyclinic, Well Woman and Child Centre, Al Wasl Road, Dubai. www.healthbayclinic.com

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