BITTER-SWEET! DIABETIC WOES!

“Roses are red and

Violets are blue,

Sugar is sweet,

But not really good for you!”

Diabetes mellitus* is a dreaded name and one that sends chills down spines, because its presence in one’s life takes away thefreedom, the care-free freedom, to eat and relish whatever and how-much ever one wishes to devour!

With urbanization, increasing stress, unhealthy dietary practices, sedentary life-style, lack of exercise and surging obesity, the number of people affected with diabetes are on a rapid rise, already affecting an estimated 200 million people globally and the World Health Organization predicts that by the year 2030, the numbers would reach a staggering 366 million.

Diabetes and complications:Broadly, diabetes mellitus is a disorder characterizedby abnormally high sugar levels in the blood, which arises from inability of specific cells of the pancreas to secrete the hormone insulin which reduces blood sugar levels to normal levels or can also be from the inability of the body or the cells to utilize the insulin that is already present, called insulin resistance. What makes diabetes a destructive disease is that it affects majororgans and organ-systems including the heart, kidneys, eyes, nerves, and arteries or the blood-vessels producing life-threatening complications and also causes a predisposition to infections.Diabetes,if undetected or uncontrolled for a long time can lead to blindness, kidney failure needing dialysis and kidney transplantation, nerve damage or neuropathy causing loss of sensation or the ability to feel things and thus resulting ininjuries, non-healing ulcers and infections requiring amputation of toes and legs. Pertaining to the heart and the cardio-vascular system, uncontrolled blood sugar causes increase in triglyceride levels in the blood and also increases the damaging potential of the bad LDL cholesterol, promoting atherosclerosis or the formation of blocks inside the arteries resulting in heart-attacks and also causing heart-failure or diabetic cardiomyopathy by reducing the pumping efficacy of the heart. The ravage to health from diabetes is especially amplified and severe, when diabetes occurs in combination with high blood-pressure or hypertension resulting in accelerated organ damage especially of the heart, kidneys and eyes.

Diabetes and prevention:However, even with all its potential for organ damage, there is no reason for dismay or despair for diabetics. Of course, there are strict restrictions in diet for diabetics, but still most of them can enjoy a good life and indulge within limits by leading a more disciplined life, with healthy life style modifications, a tailored diet and regular exercise.But, I would say, that the key to defeating diabetes is in its prevention. No step taken in the prevention of diabetes can be small considering the limiting impact of this disease on one’s routine and life itself. Periodic screeningwith check-ups help in the early detection of diabetes itself and in the detection of those who have not yet developed diabetes, but are at a risk for developing diabetes, called “pre-diabetes”. Such periodic check-ups are especially useful in those who have risk factors for developing diabetes. People with obesity and a higher body mass index (BMI) or a body-weight much greater than expected for height, have a higher risk of developing diabetes. Also, it is to be noted that, the genetic predisposition for diabetes is rather strong, so much so, that if one parent has diabetes, the risk of diabetes in the progenyis 10% and if both parents are affected,the risk of diabetes in their child isscaringlyas high as 40%.

Who are the people at risk for diabetes and need periodic screening? American Diabetes Association has formatted a Diabetes Risk Test (Table 1) with a seven set questionnaire, where by a score of ≥5 points places the person at a high risk for developing diabetes. Increasing age, male-sex, a family member with diabetes, presence of high blood pressure, physical inactivity, having had diabetes at pregnancy (gestational diabetes) and being over-weight are all considered as risk factors for diabetes.

DR. BINOY JOHN

MD DM (CARDIOLOGY) FCSI FACC FESC FSCAI FAPSICDIRECTOR & HEAD: DEPT OF CARDIOLOGY, INTERVENTIONAL CARDIOLOGY, ADVANCED HEART-DISEASES, HEART-FAILURE AND CARDIAC TRANSPLANT MEDICINE.

MIOT International, CHENNAI