Dr Raj Kumar Sharma
World Diabetes day is celebrated every year on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922.
What is Diabetes?
Diabetes mellitus is a persistent, long-standing disease where utilization of carbohydrates, fats, and proteins by the body is disturbed. This occurs due to:
1. Inability of the body to produce enough insulin (due to decreased functioning of beta cells in pancreas) or
WORLD DIABETES DAY
2. Inability of the body to use insulin (insulin resistance) or
3. Both 1 and 2
Insulin lack or insulin resistance prevents the efficient uptake and utilisation of glucose by most cells of the body, except those of the brain. As a result, blood glucose concentration increases (hyperglycaemia).
Signs and Symptoms of diabetes
The classical symptoms of diabetes include:
* Frequent urination (polyuria)
* Excessive thirst (polydypsia)
* Excessive hunger (polyphagia)
These are referred to as the 3 ‘P’s of diabetes
However, not all patients may have these classical symptoms.
It is important to understand that diabetes can also present any of the following symptoms like
*Weight loss
*Extreme fatigue
* Frequent infections, especially upper or lower urinary tract infections
*Slow healing of wounds
* Tingling/numbness in hands and feet
* Blurred vision
The last 4 symptoms indicate that diabetes in an individual has advanced, and has already the general immunity, nerve conduction (neuropathy), retina (retinopathy – a disease of the curtain at the back of the eyes), and kidneys (chronic kidney disease).
Why should diabetes be treated?
An individual with diabetes may live for several years. But, during that time high blood glucose silently damages the body and causes diabetes complications. Studies have found that many people with undiagnosed and untreated diabetes have complications such as chronic kidney disease (nephropathy), heart disease, eye disease and nervous disease. Early diagnosis and treatment of diabetes can help reduce the occurrence or severity of these complications. Diabetes is one of the most common non-communicable diseases. It is a leading cause of death in most high-income countries and has not spared even the economically developed and newly industrialized countries.
Prevention of Diabetes
Yes, diabetes can be delayed and prevented. Following simple lifestyle measures will reduce the future risk of diabetes:
*Intensive diet and physical activity, behavioural counselling programmes targeting loss of 7% of body weight
*Increasing moderate-intensity physical activities (such as brisk walking) to at least 150 min/week
*Healthy diet habits
*Smoking and alcohol cessation
* Follow-up counselling and yearly monitoring
As the theme of this year is The Nurse and Diabetes,
Diabetes Educator (DE) and Nurses plays an important role in management of diabetes. The DE should be well aware of the various non-drug and drug treatment options, and importance of medication in the overall management of diabetes.
DE to and Nurses should understand different pharmacological treatment modalities of diabetes, including different classes of oral anti-diabetic drugs and the role of insulin in diabetes management.
He/She should be able to make the patient understand how and when to take medicines, importance of timely and regular drug/insulin intake.
Also, a DE and Nurse should be aware and should be able to discuss the common adverse effects of anti-diabetic medications and ways to minimize the same, thereby improving patient adherence and compliance.
They can convey to the patients that there is no magical cure for diabetes. Patients have to adhere to the medicines prescribed to them by Doctors and not to change them on their own. The treatment has been prescribed keeping them in view and is not interchangeable.
For people with underlying health conditions, including diabetes, healthy family members in the household should conduct themselves as if they were a significant risk to them. For example, they should be sure to wash their hands before feeding or caring for them. If possible, a protected space should be made available for vulnerable household members, and all utensils and surfaces should be cleaned regularly. Your risk of getting very sick from COVID-19 is likely to be lower if your diabetes is well-managed. Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This can also be caused by above-target blood sugars, and that inflammation could contribute to more severe complications. Pay attention for potential COVID-19 symptoms including fever, dry cough and shortness of breath. If you feel like you are developing symptoms, call your doctor.
With proper diet, exercise, and medication from time to time, diabetics can achieve normal glucose levels and live normal and long life with minimum complications.
(The author is Senior Diabetologist)
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