Health: Family and diabetes - Ahmed Manjang
As we celebrate yet another World’s diabetes day, I feel obliged to share my little knowledge about this debilitating but managing disease. The theme for this year’s celebration is Family and Diabetes. The main objective of the chosen theme is to highlight the critical role family can play in the care and management of people with diabetes if they are familiar with signs and symptoms of diabetes. According to a study conducted by International Diabetes Federation; 4 in 5 parents would struggle to recognise warning signs of diabetes, that is an damning statistics.
First I would like to share some chilling stats about diabetes. These key facts were adopted from WHO’s 2018 reports about the world’s diabetes burden.
➢ diabetes case has risen from 108 million to 422 million between 1980 and 2014
➢ the number of cases over the same period among adults over 18 years old, has increased from 4.7% to 8.5%
➢ Diabetes incidences continue to rise more rapidly in the middle- and low-income countries
➢ Diabetes is a significant cause of kidney failure, heart attacks, stroke, lower limb amputation and blindness
➢ According to WHO estimates, in 2016, 1.6 and 2.2 million deaths were directly caused by diabetes and high blood glucose respectively
➢ According to WHO 2018 reports on diabetes, almost half of deaths due to high blood glucose occur before the age of 70, in 2016, diabetes wasthe 7th leading cause of death worldwide.
➢ Keeping fit, healthy diet, reduce body fat, and avoiding tobacco use are essential are preventing measures against diabetes
➢ Diabetes is treatable, and its’ complications avoidable with proper medication, physical exercise, medication, regular monitoring of the blood sugar and timely treatment of complications.
What is diabetes?
Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders characterised by elevated blood sugar level over a long period. Primarysymptoms of diabetes include; thirst, frequent animation, extreme hunger, unexplained weight loss, presence of ketone in the urine, irritability, blurred vision, slow healing sores, especially at the extremities of the body like feet, frequent infections, such as gum, skin or vaginal infections.
Causes of diabetes
For us to understand diabetes, we mush first understand how glucose usually is processed in our bodies. Insulin is a hormone that is excreted in the Islet of Langahands in the pancreas. The pancreas releases insulin into the bloodstream; the circulating insulin in the blood enable the sugar to enter our cells, where it is used as fuel for energy production. In essence, insulin lowers the amount of sugar in our bloodstreams, as the blood sugars levels drop, secretion of insulin from the pancreas also drop.
Glucose to us is what petrol is to cars, and it is the source of energy for the cells that make muscles and other tissues. Glucose in our bloodstream comes from two primary sources, directly from the food we eat and indirectly from the breakdown of glycogen from our livers. Our livers store excess glucose as glycogen and when we haven't eaten for a prolonged time, the liver breakdown the stored glycogen into glucose to keep glucose level within a healthy range.
Types of Diabetes
There are three classes of diabetes; Type 1, Type II and Gestational diabetes. Type I diabetes also refers to as insulin-dependent diabetes or juvenile diabetes. What exactly causes type I diabetes is not known. What is,however, known is that our body’s immune system, which usually fights harmful infectious agents, attacks and destroys insulin-producing cells and leaves the body with very little or no insulin at all. Since insulin acts as the vehicle that picks and transports glucose from the bloodstream into the cells, sugar accumulatesin the blood where it cannot be utilised; this is the diabetes condition.
In Type II diabetes conditions, our body cells become resistant to the actions of insulin, and our pancreas in the Islet of Langahands is unable to make enough insulin to overcome this resistance. Instead of being transported into our cells where it is needed for energy, sugar builds up in our bloodstream and cause diabetes condition. Exactly why this happens is still not clear, although it is believed that genetic and environmental factors play a role. Obesity and physical inactivity are also strongly linked to the development of type II diabetes
Gestational diabetes is unique to pregnant women only, during pregnancy, the placenta produces hormones to sustain the pregnancy. These hormones interfere with the typical actions of insulin. Usually, the pancreas will respond to this condition by producing extra insulin to overcome resistance, but sometimes the pancreas cannot keep up. Under this condition, too little glucose gets into the cells of the mother, and too much stays in the bloodstream, resulting in gestational diabetes.
Risk factors for type I diabetes include; family history, environmental factors, autoimmunity disease and geography, for example, Type I diabetes is prevalent in Sweden and Finland.
Among risk factors for Type II diabetes include obesity, physical inactivity, family history, race, high blood pressure, gestation polycystic ovary syndrome, abnormal cholesterol and triglyceride
Risk factors for gestational diabetes include; age higherthan twenty-five years old, family and personal history, weight, race
Complications of uncontrolled diabetes
Cardiovascular disease, nerve damage (neuropathy), kidney damage (nephropathy), eye damage (Retinopathy), foot damage, skin conditions, hearing impairment, Alzheimer’s disease, and depression. A complication of gestations diabetes, untreated or uncontrolled blood sugar levels can cause problems for the mother and the baby, example excess growth. During gestational diabetes, glucose bridge the placenta, which triggers the baby’s pancreas to produce extra insulin. This condition can cause the baby to grow too large (macrosomia). Huge babies are more likely to require C-section birth, which in itself is risky. On occasions, babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their insulin production is high. Risk of developing Type II diabetes is high for both the mother and the baby. Untreated, gestationaldiabetes can results in a baby’s death either before or shortly after birth.
Complications specific to the mother; preeclampsia, this is characterised by high blood pressure, excess protein in the urine, and swelling of the legs and feet. Subsequent gestational diabetes, once one had gestation diabetes in one pregnancy, the more likely to have it again with the next pregnancy, they are also more likely to develop Type II diabetes.
Eat healthy food such as food low in fat and calories and high in fibre, fruits, vegetables and whole grains. Keep fit, an average of 30 minutes moderate physical exercise a day is healthy, reduce body weight to acceptable Body Mass Index (BMI).
Ahmed Manjang is a Senior Medical Technologist and Research Coordinator at the King Fahad Medical Centre in Riyadh, Saudi Arabia. He hold a Bachelors and a Masters Degrees in Biomedical Science