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NAVIGATING THE WORLD OF DIABETES: AN INTRODUCTION

Updated: Dec 6

Diabetes mellitus, a silent yet formidable adversary, demands our unwavering attention. While it may not be entirely preventable, its progression can be effectively managed through a pro-active approach.



History of Diabetes Mellitus

History of Diabetes mellitus dates back to 1552 BC. The observations related diabetic symptoms like excessive thirst, frequent urination & sweetness of urine, were made by ancient Egyptian, Chinese & Greeks. The Ebers Papyrus, an ancient Egyptian medical text, mentioned these symptoms alongwith excessive weight loss.


Ancient Indian physicians, known for practicing Ayurveda, recognized the condition and referred to it as “Madhumeha”, meaning “honey urine”. The ancient Indian medical texts of Charaka & Shushruta (500BC to 400BC) give detailed descriptions of it.


What is Diabetes Mellitus?

Diabetes Mellitus (DM) is a chronic conditions that is characterized by raised blood glucose level. The American Diabetes Association (ADA) in 1997 defined DM as “A group of metabolic disorders characterized by chronic raised blood glucose resulting from defects in (a) insulin action, (b) insulin secretion, (c) or both.


Pancreas & Insulin: A Dynamic Duo

The pancreas is a vital organ located behind stomach. It plays a crucial role in both digestion and regulations.

Being a multitasker, on one hand it releases digestive juices & on the other, important hormone like insulin, glucagon & somatostatin which play major role in blood sugar management.

Pancreatic hormones functions















Epidemiology of DM:

Due to epidemiological transition, the whole world has observed rise of more & more Non Communicable Diseases (NCDs) as a result of gain in overall life expectancy.


Among the different NCDs, DM is very special as in majority of cases it is ‘preventable’, and if left untreated, due to sedentary lifestyle & unhealthy diet with other lifestyle risk factors’ contribution, it may develop micro & macro vascular complications:


  • Silently

  • Invisibly

  • Intangibly


Diabetes mellitus is one of the most important global health emergency of 21st century. Globally it affects 425 million people. India alone is house of 73 million diabetes patients (and 24 million people with prediabetes).


The Global Burden of Diabetes

382 million people worldwide have diabetes. By 2035, the number is expected to increase to 592 million, or more than 10% of the global adult population.


According to International Diabetes Federation (IDF), By 2045, India will overtake China with 134.3 million PWD to regain the dubious title of the “Diabetes Capital of the World”.


• 50%–70% of the subjects in China and 30%–80% of the individuals in India, are not diagnosed and are therefore left untreated.


• World Health Organization prediction of losses in national income for China exceeds USD378 billion, and for India USD237 billion.


The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030”.


List of countries with the highest numbers of estimated cases of diabetes for 2000 and 2030.

3 Ps of Diabetes

Common symptoms of Diabetes:

  • Increased urination (polyuria),

  • Increased appetite (polyphagia),

  • Excessive thirst (polydipsia),

  • Visible weight loss

  • Blurred vision

  • Skin infection

  • Fatigue

  • Slow wound healing

 


 

Types of Diabetes:


Type 1 Diabetes Mellitus (T1DM) people can be thin to normal build and are prone to develop ketoacidosis. The autoantibodies are commonly seen in their blood.


People with Type 2 Diabetes Mellitus (T2DM) are mostly normal to obese with almost no cases of ketoacidosis. Autoantibodies are not present in their body. This is most commonly seen diabetes seen worldwide.


Gestational Diabetes Mellitus (GDM) may put more risk to the baby than mother due to overly large size of the body, damage to its vital organs. It should be controlled to protect the growth and development of the baby as well as the mother as in the future the development of T2DM can be seen.


Types of Diabetes

Causes of Diabetes:

While the exact causes can vary here are 8 key factors that contribute to its development.


  1. Genetics: Family history of DM significantly increase risk and make individual more susceptible due certain genetic predisposition.


  2. Obesity: excess body weight, especially abdominal obesity is a major risk factors fat cells interfere with insulin’s ability to regulate blood sugar.


  3. Physical inactivity: A sedentary lifestyle reduce insulin sensitivity. Regular physical activity helps to improve insulin action.


  4. Age: the risk of development of T2DM increase with age. Older adults may experience age related changes in insulin production & sensitivity.


  5. Ethnicity: Certain ethnic groups, such as Africans, Americans, Hispanic Americans can Native Americans have higher risk of developing T2DM. But nowadays it is not limited in specific ethnicity, it has become global health issue.


  6. Dietary factors: A diet high in processed foods, sugary drinks and unhealthy fats can contribute to insulin resistance. A diet rich in fruits, vegetables, whole grains and lean proteins can help to prevent diabetes.


  7. Lifestyle factors: Stress, smoking and excessive alcohol consumption can increase the risk of diabetes.


  8. Certain medical conditions: Conditions like PCOS and high blood pressure may increase the risk of diabetes.


It’s important to note that while these factors can contribute to the development of diabetes, not everyone with these risk factors will develop the disease. Lifestyle modifications such as regular exercise, a healthy diet and weight management can help reduce the risk.


Early detection and management are crucial for preventing complications associated with diabetes.


Dietary Management:

There are different types of diets are being practiced all over the world like keto diet, Mediterranean diet, blood group diet etc. among these many are focused for being diabetic friendly. But dietary management for DM should not be this complicated as PWD already may have to deal with diabetes complications.


The daily food intake or Diet (or total energy Requirement) depends on variety of factors like Body size, age, height, weight, activity level, gender, other conditions, such as pregnancy & lactation.


Key Nutrients of Diabetes

A well planned balanced diet is a cornerstone of diabetes management. This means making smart & healthier food choices from different food group that can help control blood sugar level, reduce risk of complications, and improve overall health.


Make Your Meal Easy

A well balanced diet for DM should contain several key principle:



  • Carbohydrates quality & counting, complex carbs are better than simple sugar, these also should be portion controlled


  • Protein intake: diet should contain lean protein sources and should be well distributed throughout the day.


  • Healthy fat: All type of fats e.g. saturated & unsaturated should be well balanced, Trans fat should be avoided.


  • Dietary fibre: required amount of soluble & insoluble fibre should no doubt important in regular diet.


  • Vitamins & minerals: these are important for blood sugar control, hormonal sensitivity and metabolism.


  • Hydration: optimum water intake helps regulate blood sugar level and overall health.

 


Practice Good Habits

Modify Lifestyle Habits:


Quit smoking: it increase cell degeneration that aggravates the diabetic complications.


Limit alcohol: these are empty calorie, so it should be consumed in a limited manner.

Increase physical activity: regular exercise may help in controlling blood sugar level & other complications.


Reduce stress: involve in activity like yoga, meditation, gardening, music, games and hobbies, spend quality time with family, friends and pets.



Useful tips:

  • Avoid junk & fast foods.

  • Avoid food containing high amount of preservatives, sodium, calories & fats like tinned food, canned food, ready to cook food, carbonated beverages, pickles & papads etc.

  • Practice small amount frequent meal to avoid blood sugar peak in regular interval.

  • Self-monitoring of blood glucose (SMBG) is highly needed.

 

We should remember diabetes is not a death sentence, but a condition that, with proper care and awareness, can be lived with comfortably. By adopting a healthy lifestyle including balanced diet, regular exercise and stress management, we can significantly reduce our risk of developing this chronic condition. Regular health checkup & early detection are crucial for those at higher risk. Let’s empower ourselves and our communities to combat this disease and lead healthier, happier life.

 

Sources:

* https://medium.com/@suhailahmad74141/10-essential-steps-to-control-diabetes-

715b284c7a8e

* https://sugarmds.com/insulin-plant-for-diabetes-does-it-work/

* https://fusion2011.org/easy-approaches-to-lower-your-cholesterol/

* www.cadiresearch.org

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