Don't we often hear these social misconception about Diabetes? It is a disorder in which the
response to insulin is impaired. High levels of blood sugar is associated with deficiency and
inactivity of insulin which includes disturbed metabolism of carbohydrate, protein and fat.
Insulin allows glucose to enter into the cells from blood, except the cells of the brain and central
nervous system which use glucose in the absence of insulin.
Diabetic individuals may develop diabetic retinopathy (diabetes complication
that affects eyes), nephropathy (kidney diseases that can affect diabetic people), neuropathy (nerve
damage due to diabetes), cardiovascular disease, amputations, premature death and pregnancy-related
complications in females during their reproductive age.
The life of a normal women often seems to have similar complaints. Do you relate to
them? Are these significantly considerable issues upsetting your apparently normal
life? Well, the statements mentioned above might exhibit four different health-related
situations but, all these are the symptoms of only one common condition - Diabetes.
Glucose stimulates the release of insulin from the pancreas. Insulin prompts the muscles
and fat cells to take up glucose from the blood for utilization and stimulates the liver
to store excess of glucose. As a result of this, the level of sugar (glucose) in blood is
balanced. Diabetes is a metabolic disease characterized by high level of sugar (hyperglycemia)
in the blood. The condition can result from the defects in insulin secretion or action or
both. Long-term elevated sugar levels in blood can cause damage to other organs predominantly,
the kidneys, liver, eyes, etc.
The very common signs and symptoms of diabetes include the following:
Tiredness/Fatigue
Elevated blood sugar levels, either due to lack of insulin hormone or insulin resistance,
can affect the body's ability to get glucose from the blood into cells to meet energy needs.
People on stronger diabetes medication such as insulin therapy may also experience fatigue
as a symptom of low blood glucose levels.
Blurred Vision
Long-term uncontrolled diabetes leads to damage of small blood vessels. This damage
might affect the retina of eye which in turn leads to blurred vision. The fluid shifts into
and out of the eye in diabetics causing the lens of eye to swell. This changes the shape
of lens and causes blurriness Delayed Wound Healing High blood glucose level causes
inhibition of reabsorption of water and sodium, inadequate passage of fluid through
the circulatory system into the tissue and oxygenation, thus leading to delayed wound
healing in diabetic patients.
Frequent Urination and Thirst
In diabetics, the kidneys are forced to work overtime to filter and absorb the excess sugar.
If kidneys are not able to keep up the excess sugar is excreted with urine, dragging along
fluids from tissues. This triggers more frequent urination and as you drink more fluids to
quench your thirst, you will urinate even more.
There are many other similar signs and symptoms that might not look indicative but can be
menacing in Diabetes. Therefore, anything unusual and deviating from normal healthy habit
and body routine warrants for immediate attention.
Diabetes in Women
Diabetes is not gender biased, but the risk of complications arising due to diabetes in women
is higher. Complications such as cardiovascular diseases, ischemic heart disease, blindness are
more frequent in women with diabetes than men. Diabetes also afflicts pregnant women thus
posing a risk to both mother and baby. Also, the risk factors of diabetes including weight gain,
obesity, and lack of physical activity are more common in women as compared to men.
This condition of diabetes in women stands distinctive because it can affect them in every
stage of their life-at adolescence, in adulthood as well as during pregnancy. Lifestyle, mental
stress such as hypertension and depression, disorders such as polycystic ovarian syndrome
(PCOS) and several others elevate the risk of diabetes in women. Some of the risk factors of
diabetes in women are explained below.
Polycystic Ovarian Syndrome (PCOS)
PCOS is a condition which is more common in women in their reproductive age. It is associated
with insulin resistance and poses a risk for long-term diabetes. PCOS is a disorder characterized
by enlarged ovaries with small cysts on their edges. Most likely to affect the level of female
hormone. Overweight and obese women with PCOS are highly prone to type 2 diabetes as
they express insulin resistance and compensatory hyperinsulinemia.
Stress
Stress is one of the major risk factors for diabetes. Studies associate stress with diabetes as
a neuroendocrine effect, which means neurological stress hormones (cortisol, adrenaline) are
directly linked with endocrine hormones (insulin). Stress hormones oppose the action of insulin,
thus increasing the risk of diabetes.
Excessive Alcohol Consumption
Consuming alcohol above moderate level affects insulin sensitivity. Also, with the increasing
amount of alcohol metabolites in the body, the concentration of high density cholesterol also
rises, thereby elevating the risk of diabetes.
Early diagnosis of diabetes is very important as it helps to prevent the complications which
are associated with it such as kidney diseases, cardiovascular diseases, etc.
Implications of Diabetes on Fertility
Infertility and Its Prevalence Infertility is defined as failure to achieve pregnancy in spite
of continuous attempts for over a period of 1 year Infertility can be very demoralising and
bring in a sense of failure and loss among couples. Due to childlessness, the relationship
between couples gets strained; and the blame game on who is defective begins. Not only
personal, infertile couples face social consequences as well such as couples with no children
are excluded from important family functions and auspicious events.
There are no barriers or
boundaries for infertility. It can affect anyone from any socioeconomic levels, ethnic, race or
religious group. As estimated by the World Health Organization (WHO), nearly 60 to 80 million
i.e. 8 - 12 % couples are affected by infertility problems worldwide. As per the report published
by The New Indian Express in 2014, around 15% of the Indian populations, both male and female
are infertile. In majority of infertility cases, there is a specific underlying cause that can be resolved
and only about 10% cases of infertility go unexplained. In most of the instances, the effects of
infertility can be reversed by simple lifestyle modifications or certain medications.
Pertaining to infertility fueled by diabetes, reports suggest nearly 40% of men affected by
erectile dysfunction are diabetic.
The pervasiveness of diabetes is now reaching epidemic proportions in developing countries
and India is also rising to become a major healthcare burden. Uncontrolled diabetes can lead
to secondary complications and many individuals fall prey to this menace. However, this
condition does not even spare the sexual prowess of both men and women. When it comes
to diabetes and infertility, there is a link between them. Both men and women with diabetes
do face fertility issues.
Diabetes is a condition usually caused due to insulin resistance or insulin imbalance.
One hormonal imbalance can trigger imbalance among others including progesterone,
estrogen and testosterone levels. Abnormal levels of these hormones in the body can
cause a wide variety of side effects such as erectile dysfunction, cyst formation culminating
into infertility issues.
Diabetes and infertility - Female
Type 1 and 2 diabetes has a strong association with female infertility. In case of type
1 being an autoimmune diseases mediated factor, affected women also develop eventually
autoimmune premature ovarian failure or thyroid disease. Diabetes has been shown to
alter the period of reproductive phase in woman (delayed menarche or early postmenopause).
Also, woman with type 1 diabetes suffer from high glucose levels which prevent implantation
of embryo in the uterus, thus increasing risk of miscarriage. Thus, the problem may not lie in
fertilisation but implantation. In case successful implantation does occur, the risk of birth
defects are high, and also the baby generally tends to be large, forcing a C-section on the
mother, increasing risk of infection.
However, other factors that can lead to infertility are insulin resistance and overweight.
Increased prevalence of obese individuals spikes up the risk factor for type 2 diabetes.
Polycystic ovarian syndrome (PCOS) and Dysmetabolic syndrome X are the two common
medical cause of infertility in affected women. PCOS is associated with oligomenorrhea
(irregular periods) and secondary amenorrhea (absent periods) during the reproductive
years. In PCOS, cysts or lumps are formed on the ovaries which trap eggs and prevent
ovulation and it is strongly correlated with insulinresistance, diabetes and especially
obesity.
Diabetes and infertility - Male
Infertility in males is characterised by an inability to produce enough quantity of sperm,
immobility or misshapen sperm, erectile dysfunction, presence of blockage preventing
delivery of sperm, retrograde ejaculation, etc. High blood glucose levels have been shown
to contribute to infertility in males. In diabetes, complication like vasoconstriction can slow
down blood circulation by narrowing blood vessels, Poor supply of blood further leads to nerve
damage (neuropathy) resulting in retrograde ejaculation, in which semen is redirected into
urinary bladder, instead of being ejaculated via the penis. Erectile dysfunction is also one of
the common complication caused by diabetes as well as medications used to control diabetic
condition. Males with type 1 diabetes have lower fertility quotient because of diabetes induced
mitochondrial DNA damage in the sperms. All of these together cause significant reduction in
chances of insemination, also reducing the chances of live birth of a healthy and normal child.
Pertaining to infertility fueled by diabetes, reports suggest nearly 40%
of men affected by erectile dysfunction are diabetic.
How to Manage Diabetes ?
Diabetes is a condition with no cure but can also be fortunately managed with proper medications
and diet. Every year, the prevalence rates of type 2 diabetes is increasing and as it can be silent
and is associated with many complications, timely diagnosis is recommended. Avoidance of alcohol
consumption or smoking has been recommended to manage erectile dysfunction in men.
The most
potent complication of diabetes is its negative effect on multiple organ systems and fertility is no
independent protected factor there. It's time to avoid/control the causative factors from a very
young age to retain the well-being of the nature's given trait!
Negative impact of Diabetes on Family
Diabetes running in family has a psychological impact on person's life, well before the signs are seen.
Communications and attitudes of family members have a significant impact on the psychological
behavior and clinical outcome of the patient. Sometimes, a nonsupportive behavior of family members,
some personal arguments and limited health literacy can be associated with depressive symptoms.
Lifestyle change of the patient, change in the type of foods consumed, time interval of food intake,
caring about regular medicines, exercise, medical visits with the patient, regular blood glucose
monitoring test all of which may affect family routine schedules, behavior of family members as
well as family finances towards the diabetic.
Family Support-A Mandate
Family support depends on many parameters. Availability of emotional support of family
members, flexibility with the daily schedule, communication patterns, response to symptoms
of medical conditions.
Good communications and positive attitudes of family members always motivate their
loved ones to cope up with diabetes. Educating family about diabetes-care help to manage
the diseases and related symptoms like stress, anxiety, shaking, sweating, hunger, etc.
better and improve quality of life. Also, it helps in reducing the chance of developing
diabetes in other family members.Awareness about the signs and symptoms helps in early
diagnosis of diabetes. Diabetes produces extreme thirst (polydipsia) to compensate for the
presence of a high level of sugar in the blood. A diabetic person may wake up during the middle
of the night to drink water. People with diabetes have increased urination (polyuria) as often as
once every hour. People with diabetes feel extremely hungry (polyphagia), sluggish, tired and
suffer from unexplained weight loss, blurred vision and are more susceptible to infections.
In a medical condition of type 2 diabetes, family, friends, and social support to follow a specific
diet and physical activities, reduced rate of smoking in adult thus play important role in the control
of blood glucose. The key strategies associated with the educating patients and their family with
chronic health conditions, encourage and support in timely, complete, and accurate care and
decision making. Training family members in managing psychological and clinical symptoms related to diabetes include
how to solve problems, to address and manage the behaviors and emotions. The involvement
of the family members associated with improvements in patient's clinical and psychosocial
outcomes, patient knowledge on diabetes, dietary habits, self-care.
Managing Diabetes Well
The treatment and management of diabetes depends on the type of diabetes a person has
and individual efforts towards lifestyle to reduce blood glucose and normalize Diabetes.
Diabetes Self-Management Education is the first step for the care of all individuals with
diabetes. Health care education to the patient reduces its impact on health. Family Approach
to Diabetes Management (FADM) mainly focuses to develop healthy family behaviors and
diabetes self-management." Family members can actively support diabetes-management in
many ways such as social, economic, emotional support, compliance with recommended
regular medication, diet and exercise.
Making a Proper Eating Plan
A diabetes-fighting diet is calorieconscious, high in fiber, adequateprotein, rich in whole
grains, vegetables, legumes, fruits, omega3 fatty acids other important nutrients, and low
in fats and sweets.
Following Healthy Eating Habits
Eat only when you are hungry. Eat slowly. Stop eating before you are full. Begin meals with
a large glass of water. Fill half of your plate with salad and vegetables. Eat only at certain
times of the day. Avoid eating outside. Avoid smoking and drinking alcohol.
Physical activity to prevent or delay the development of diabetes Physical activities make
cells more active which induced utilization of circulating blood sugar for energy production
making the cells more sensitive to the hormone insulin.
diabetes check up
Stress management
Any exposure to stressful situations can affect blood sugar levels. Do deep breathing
exercises, yoga, meditation.
Medical treatment of diabetes primarily aims to maintain normal blood glucose levels
and avoid change, which may lead to hyperglycemia or hypoglycemia condition. Most
physicians preferred glycosylated hemoglobin HbA1 or Hba1c values, which provides
information about the average state of the metabolism history for 2-3 months. If a
person is diagnosed with diabetes firstly doctor tries to control blood sugar with diet,
exercise, and weight management if still there are no improvements in blood glucose
levels than the doctor prescribes sugar lowering medicine.
Diagnostic Tests for diabetes check
Diabetic screen
Is a preventive strategy which helps to measure and determine diabetes even in its early stages.
Any symptom of diabetes prompts for an immediate diabetic screen testing.
Lipid Profile
In type 2 diabetic patients, abnormality of lipid levels are seen. High levels of LDL (low density
lipoprotein) promote cholesterol deposition in the arterial wall increasing the risk of heart diseases.
Whereas decrease in HDL (high density lipoprotein) levels as seen in diabetes can also increase the
risk of atherosclerosis.
kidney profile test
The health of kidney is at peril in diabetes. Kidney contributes to maintaining glucose homeostasis
such as release and uptake of glucose from the blood circulation. Thus, comprehensive testing for
kidney health plays a major role in diagnosing diabetes.
Fasting Plasma Glucose Test
Oral Glucose Tolerance Test
blood glucose
Blood pressure
Cholesterol Profile
Evaluate Body mass index
Treatment success depends on how well the patient and their family have been instructed
about care regimes and understood about treatment. Adhering to diet and checking blood
and urine glucose levels regularly.
