Diabetes: know your risk

By DR MAXWELL ADEYEMI

Diabetes is a chronic metabolic disorder that affects how the body turns the food we eat into energy. It affects the carbohydrate as well as lipid and protein metabolism in the body.

Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose, the principal source of fuel for our bodies. Glucose enters the blood stream but cannot enter our cells without the presence of a hormone called insulin, which is produced by the pancreas. A person with diabetes has a condition in which the quantity of glucose in the blood is too high. This happens when the body does not produce enough insulin, produces no insulin or has cells that do not respond to insulin. This causes glucose to build up in the blood and eventually become toxic to the cells. This condition is referred to as glucotoxicity.

Types of diabetes

• Type 1 diabetes is also known as insulin dependent diabetes and was previously called juvenile diabetes. This occurs mainly in children and accounts for five to ten per cent of diabetes. It is as a result of pancreatic beta cell destruction that prevents the production of insulin. There are two forms of Type 1 diabetes –

Type 1A due to autoimmune or self-destruction of pancreatic cells that causes the body’s immune system to destroy the insulin-producing cells of the pancreas, and Type 1B which has no known cause.

• Type 2 diabetes, previously known as adult outset diabetes or non-insulin dependent diabetes, amounts for 85-90 per cent of diabetes cases. It is characterised by insulin resistance and relative insulin deficiency, as some level of insulin is produced.

• Type 3 diabetes describes other specific types of diabetes which may include those caused by:

Genetic defects of beta cell of pancreas

Genetic defect in insulin actions

Diseases of the exocrine pancreas

Disorders of endocrine glands

Drug or chemical-induced diabetes (for example from steroid-based drugs)

Maturity onset diabetes of the young

Latent autoimmune diabetes of the adult

Mitochondria diabetes.

These forms of diabetes require specialised testing to identify and diagnose them, some of which may not yet be locally available.

• Type 4 diabetes or gestational diabetes occurs during pregnancy, and may be caused by hormones produced by the placenta or by too little insulin. Between five to eight per cent of pregnant women develop gestational diabetes. It usually resolves after delivery but about 25-50 per cent of women who had gestational diabetes eventually develop Type 2 diabetes later in life. Also, high blood sugar from the mother can pass to the baby, leading to growth and development problem if left untreated.

Risk factors for Type 1 diabetes

• Genetic and family history. The presence of the disease in first degree relative such as mother, father, sister, brother can put you at risk.

• Diseases of the pancreas. Injury, surgery or diseases of the pancreas can inhibit its ability to produce insulin.

• Infections through viruses like coxsackie virus B, congenital rubella, mumps, measles.

• Dietary and environmental factors.

Risk factors for Type 2 diabetes

• Obesity

• Impaired glucose tolerance or impaired fasting glucose

• Insulin resistance

• Ethnic background. Asian and African American are said to have higher incidence in their populations

• High blood pressure

• Low levels of high-density lipoprotein (good cholesterol) and high levels of triglyceride

• History of gestational diabetes

• Sedentary lifestyle

• Family history

• Polycystic ovarian syndrome

• Age

Risk factors for gestational diabetes

• Obesity

• Previous glucose intolerance or impaired glucose levels

• Family history

• Age. The older a woman is when she gets pregnant, the higher the risk of gestational diabetes.

Sign and symptoms of diabetes

The common signs and symptoms of diabetes include: excessive thirst, excessive hunger, excessive urination, fatigue, weight loss, recurrent infections, blurred vision, numbness and tingling in hands and feet, sexual dysfunction and poorly healing wounds.

Complications of diabetes

Untreated or poorly treated diabetes can result in complications such as heart disease, nerve damage, kidney damage, eye disease, foot ulcers, amputations, dental disease, erectile dysfunction, dementia and depression.

Prevention

Prevention of diabetes is always the best approach, but if you've already been diagnosed with diabetes, efforts should be focused on prevention of complications by effective management. Screening at regular intervals, especially for at risk people, is important. Eating a healthy and balanced diet, regular physical activity, maintaining a healthy weight, managing stress, limiting alcohol and avoiding smoking, as well as getting adequate sleep are all important preventive measures.

While diabetes does not unduly increase the risk of contracting covid19, if people with diabetes get infected the risk of morbidity, mortality and other adverse or negative outcomes are markedly increased.

Contact Dr Maxwell at 363-1807 or 757-5411.