Diabetes And How To Prevent And Manage It

What Is Diabetes?

Diabetes is a disease which occurs because the body is not responding to or isn’t producing enough or any insulin. Insulin is the hormone responsible for regulating blood sugar levels. It is needed to let our bodies' cells feed on glucose, the main food of the body and brain, and if the body is not responding to it, it leads to elevated blood sugar levels.

Different Types Of Diabetes

There are 3 main types of Diabetes:

Type 1, Type 2 and Gestational Diabetes.

People with Type 1 Diabetes do not make enough insulin from their pancreas.

Type 2 Diabetes patients are not responsive to insulin and may or may not make enough of it. When there is too little insulin, or our cells do not respond to it, the glucose in the bloodstream increases.

Gestational Diabetes is the presence of Diabetes during pregnancy. This can then go away after delivery or may persist.

Who Are At Risk The Most From Diabetes?

Type 2 Diabetes is more prevalent and there are two major factors that make anyone at risk to the disease. One is lifestyle related and the other is related to the patient’s family history as well as their ethnic group.

“Family history of Type 2 Diabetes mellitus is a major risk factor to develop Diabetes mellitus. One study has shown a 40% risk to develop Type 2 Diabetes if one of the parents has DM”, says Dr Omar Dhaimat, Consultant Endocrinologist, Diabetes and Metabolism at Emirates Specialty Hospital. 
People are at increased risk of developing Type 2 Diabetes if they are overweight or obese, consuming excess calories or poor nutrition with lack of physical activity, advanced age, and are smoking”, says Dr Amal Yacoub Madanat, Consultant Endocrinologist at RAK Hospital

Sara Adhami, Credentialled Diabetes Educator (CDE) and Accredited Practising Dietitian (APD) at Mediclinic City Hospital explains that the risk factors can be divided into two categories: Modifiable and non-modifiable. 

“There are a combination of risk factors associated with Diabetes, particularly Type 2 Diabetes. Some are non- modifiable such as: a family history of Diabetes, age more than 45 years and ethnicity, Asian, South American, Pacific Islanders. Others, are modifiable and linked with lifestyle such as: poor eating habits, low levels of physical activity and higher BMI and waist circumference”, explains Sara Adhami of Mediclinic City Hospital. 

Women At Risk 

Women with polycystic ovarian syndrome or those who have a history of gestational Diabetes are at an increased risk too.

Others At Risk 

Additionally, people with a history of cardiovascular diseases, hypertension, increased blood levels of lipids and acanthosis nigricans - black thick skin behind the neck - are also at increased risk of developing Diabetes.

What Are The Early Signs Of Diabetes? 

Symptoms of Diabetes can vary from person to person. While symptoms of Type 1 Diabetes are more pronounced and visible, the symptoms of Type 2 Diabetes are discovered by chance and hence, early detection through routine tests is a must. 

Dr Katia El Sibai, Consultant in Endocrinology, Diabetes and Metabolism at HealthBay says, “ In early phases of Type 2 Diabetes and in the pre-Diabetes stage, there could be no symptoms at all. This is why screening and early detection in patients at risk is very important. In Type 1 Diabetes, symptoms tend to be faster and more severe. The signs and symptoms can include increased thirst, frequent urination, unintentional weight loss, low energy, blurring of the vision, frequent infections, delayed healing and extreme hunger.” 

Dr Sarla Kumari, Specialist Physician and Diabetologist, Canadian Specialist Hospital says, “Like most disease, Diabetes also has a certain set warning signs which people with pre-Diabetes - condition where the glucose levels are higher than normal but not as high to diagnose with Diabetes - must be on the lookout for: 

• Frequent urination 
• Increased thirst 
• Always hungry - even while eating
• Fatigued often 
• Blurry vision 
• Slow healing of cuts
• Tingling sensation in extremities
• Dark skin patches” 

Various Health Problems Associated With Diabetes

In the short-term, poor wound healing and higher risk of infections are associated with elevated blood glucose levels. In the long-term, high blood glucose levels over many years can affect the blood vessels in the eyes and other organs such as the heart. The kidneys can also lose their ability to effectively filter the blood.

Dr Katia El Sibai of HealthBay says, “If untreated, Diabetes can lead to severe complications such as blindness, kidney and heart disease, nerve damage, foot damage, loss of limb, stroke, dementia, depression and reduced life expectancy.”

Dr Sarla Kumari of Canadian Specialist Hospital states that diabetics are at risk of a few associated diseases including:

Diabetic Neuropathy is where high sugar levels can cause nerve damage, which can cause symptoms such as numbness especially in the extremities. Diabetic foot is a common problem associated with Diabetes where untreated cases may require amputation.

Diabetic Retinopathy refers to the cases where Diabetes has caused damage to the retina and may cause blindness. It affects most people who have had Diabetes for a longer duration of time, over 20 years. 

Diabetic Nephropathy refers to chronic loss of kidney function in diabetics. Diabetes is the most common cause of end stage kidney disease with patients requiring dialysis and transplant to recover from the condition. 

Heart Disease And Stroke has a high correlation with Diabetes. Over time Diabetes can damage blood vessels and the longer you have the disease the more chance there is of developing heart problems. People with Diabetes develop heart problems younger and are more likely to have a fatal heart attack or stroke than those without. 

“Obesity is the most important issue associated with Diabetes. Heart disease risk 
is 2 to 4 times more in patients with Diabetes. Poor dental hygiene due to poorly uncontrolled Diabetes is often neglected health issue related to Diabetes. Mental health complications as depression can be observed in patients with Diabetes”, says Dr Omar Dhaimat of Emirates Specialty Hospital. 

Can Diabetes Be Treated And Reversed?

Diabetes as a disease can be managed and controlled, however, there is no permanent cure for it. Some studies show that cases of Type 2 Diabetes are reversible through proper management of the disease in the early stages. It can be achieved with proper nutrition along with weight control and good physical activity.

Dr Omar Dhaimat of Emirates Specialty Hospital says, There is no permanent cure for the patient with Diabetes. To reverse Type 2 Diabetes and decrease the incidence of it, we need to fight obesity, focus on healthy diet and promote active life style. Finally, we need to educate our children at home and in school about this disease, so we can decrease the incidence of obesity and Diabetes early on.” 

Sara Adhami of Mediclinic City Hospital says, “ Both Type 1 and Type 2 Diabetes are not curable. They are however manageable, and if done so correctly, the person living with Diabetes can live a healthy life. Many people with Diabetes, especially Type 2 Diabetes, are able to reduce their medications and insulin requirements when they modify their diets and lifestyle and lose weight.

Education is key for the management of Diabetes as this empowers the person living with the condition, or their carers, to self-manage and understand the role of diet and lifestyle and medications and insulin. Regular screening of blood pressure, kidneys, eyes and feet are all part of excellent Diabetes care to help the person with Diabetes live a healthy life. Prevention is always priority and detecting Diabetes especially in the pre-Diabetes stage is always better."

Diabetes Figures In The UAE

The prevalence of Diabetes Mellitus Type 2 in the UAE was estimated in 2017 to be just 17% of the country's population. That means over 1 million people living in UAE have Diabetes. The country is ranked number 16 worldwide in the prevalence of Diabetes. This problem is not unique to the UAE but to all countries in the Gulf region, however there are encouraging signs of it reducing as the 2017 estimate for the UAE is down from the 19.3% estimated in 2013.

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