According to World Health Organization (WHO), mortality due to non- communicable diseases accounts for 53%
deaths in India. One of the major contributors is diabetes - a condition of chronic increase in sugar levels in
the blood. Energy is required by our body to perform any work and the major source of this energy is the food
we eat, more precisely, the glucose (sugar) in the body.
It acts as a fuel which keeps the body engine moving.
This glucose is made available by a hormone, insulin, produced by cells of pancreas. Under normal circumstances,
insulin acts on the cells in the body, facilitating the absorption of glucose from the blood. The insulin is so
important that without it, our body cannot utilise sugar. In case of diabetes, glucose is not absorbed effectively
by the cells and thus continues to remain in the blood stream resulting in elevated sugar levels. The reason for non
absorption of glucose by cells may vary according to the type of diabetes and could be due to insulin insufficiency
or insulin resistance.
Types of Diabetes
- Type 1 diabetes which is also known as 'Juvenile Diabetes' is a result of autoimmunity wherein the beta cells of
pancreas responsible for production of insulin are destroyed. This condition is known as Insulin Dependent Diabetes
Mellitus (IDDM). It results in little or no production of insulin (insulin insufficiency). The exact cause of this
type of diabetes is still undiscovered.
- Type 2 diabetes is the most common and widely observed form of diabetes among the human populace. In this case, body
cells do not respond and show insulin resistance which results in 'hyperglycemia' (a condition in which the blood sugar
levels remain elevated as sugar does not enter the cells). This type of diabetes can occur at any age and does not
depend on the insulin produced. Thus, this type is known as Non-Insulin Dependent Diabetes Mellitus (NIDDM).
- Gestational diabetes is the term used to define the diabetic condition that occurs during pregnancy
. This type of
diabetes generally disappears after pregnancy. However, it may increase the risk of type 2 diabetes in the mother as
well as the child in future. An uncontrolled gestational diabetes could result in high blood pressure or may result
in some complications during pregnancy.
Importance of a Regular Health Checkup
Prediabetes is a significant term associated with diabetes and a major reason for prescribing regular health
checkup. It is an alarming condition, indicated by rise in sugar levels that occurs just before diabetes. In
this condition, the blood sugar is higher than normal which is alarming but not high enough as seen in a diabetic.
This situation, if controlled on time, may not lead to diabetes. Early diagnosis of prediabetes with preventive healthcare i.e. a regular health checkup could help in bringing down the blood sugar levels back to the normal
range.
Diagnosis
Fasting blood sugar, random blood sugar (RBS), post prandial blood sugar (PPBS), Hba1c test and ketone test are some
of the Diagnostic Test recommended for diabetes. Out of all these tests, testing HbA1c is considered as the "gold
standard marker" for the diagnosis of diabetes. HbA1c is the glycated form of hemoglobin in the Red blood cells
(RBC). Unlike fasting blood glucose test which only gives the current glucose levels in blood, HbA1c gives an
estimate of the blood glucose level over a period of three months as the excess glucose is non enzymatically
glycosylated with the haem part of RBC. As the average life span of RBC is 90120 days i.e. three months, HbA1c
value will reflect the amount of glucose glycosylated in last 90 days.
Diabetes - A silent killer
Diabetes is referred to as a silent killer because a chronic increase in blood sugar or hyperglycemia can
seriously damage body by causing failure of different vital organs and tissues. The diabetic patients are at
an increased risk of various conditions like cardiovascular diseases, neuropathy (nerve damage), ischemia
(blood supply problem to feet), to some infections which might lead to amputation (disability resulting from
loss of a limb or more).
Managing the Disease
Treatment for diabetes depend on the type of diabetes, the level of sugar diagnosed after monitoring, medication
and insulin intake. Maintaining your health is a generalised option which is used for treatment of any type of
diabetes. Maintaining a good health by exercising and healthy eating would help avoid complications of diabetes
to a larger extent and would also help in controlling the blood sugar levels.
Prevention
As diabetes can be asymptomatic and a risk factor for many conditions, it should be tested irrespective of age.
Diabetes test is recommended for people with a body mass index greater than or equal to 25 kg/m' and for adults
above age 45years, irrespective of symptoms. Ineffective use of glucose, a powerful energy source can thus result
in this dreadful disorder, diabetes.
The doctor of the future will give
no medicine, but will involve the
patient in the proper use of
food, fresh air and exercise.
