There is a pandemic going on right now. No, it’s not something you can prevent by putting on a protective suit or by taking antiviral drugs. We see it every single day. It’s present in almost every place or country you go. It doesn’t give credit to your status on Facebook. It’s diabetes mellitus.
People, this isn’t a new disease. Diabetes mellitus (DM) is a chronic debilitating disease that happens when an organ inside your body called the pancreas doesn’t produce sufficient amounts of insulin OR when your body doesn’t know how to handle the insulin it makes.
There are two types of diabetes you need to concern yourself with. They’re called DM type 1 and DM type 2. Here are the differences between the two types:
||Type 1 Diabetes
||Type 2 Diabetes
||You may be born with this or develop it as a child or young adult.
The onset is usually sudden.
|You may develop this as an adult (though children are now developing this also).
The onset is gradual.
|When the disease starts to manifest or age of onset
||Majority of cases start in childhood.
||Majority of cases appear in adults.
But DM type 2 is on the rise in children and adolescents. This is primarily due to poor diet.
|Common body type affected
||Majority are normal to thin people.
||Mostly overweight or obese (80% of them).
|Division of cases
||About 10% of cases.
||About 90% of cases.
|Insulin production by the pancreas
||Absent or low.
||Insulin production is present and can be normal, increased or decreased.
||Less than 20 percent of patients have a positive family history of diabetes.
||More than 60 percent of patients have a positive family history of diabetes.
(i.e. nobody knows…yet)
|Primarily due to lifestyle factors and genetics.
||Insulin-dependent diabetes mellitus (IDDM), juvenile diabetes, childhood onset diabetes.
||Noninsulin-dependent diabetes mellitus (NIDDM), adult-onset diabetes.
|Comments on Treatment
||Exogenous insulin is required
||Exogenous insulin is usually not needed especially at the early stages.
Weight loss and dietary changes will improve it and may even reverse it.
|Copyright © Return2Health Limited. All Rights Reserved.
Note: There are other types of diabetes such as gestational diabetes mellitus (GDM) and latent autoimmune diabetes of adults (LATA). But the two mentioned above are the most common.
The Statistics on Diabetes mellitus: These Numbers are NEVER Sweet
- The world population had reached 7 billion, and approximately 382 million are suffering from the effects and long term complications of diabetes mellitus.
||No. of People Afflicted with Diabetes
||World Population at the time
||552 million (predicted)
|Copyright © Return2Health Limited. All Rights Reserved.
- Nearly 10% of the adult population of the world has diabetes. Ninety percent of these cases are type 2 diabetes (lifestyle and diet related).
- The WHO (World Health Organization) has predicted that by the year 2030, the 7th leading cause of death worldwide will be diabetes mellitus. It’s already the 8th right now!
- Diabetes is 1 of 4 top non-communicable diseases (the others are chronic obstructive pulmonary disease, stroke and ischaemic heart disease) which kill people globally.
- On a worldwide scale, the prevalence of diabetes mellitus in men 25 years and older increased from 8.3% in 1980 to 9.8% in 2008. For ladies 25 years and older, it increased from 7.5% to 9.2%.
- In New Zealand there is an estimated number of more than 240,000 people living with diagnosed diabetes.
For this article, we’ll be focusing our attention on DM type 2 because we can prevent it unlike DM type 1. Type 2 diabetes is predominantly caused by lifestyle factors and isn’t simply something you can blame on your bad genes. So stop making excuses please.
Know YOUR risk factors for developing DM type 2. I’m not just saying know THE risk factors, I’m saying know YOUR risk factors. See the difference? Take note of your lifestyle and dietary habits that could be contributing to you developing DM type 2. Then, take steps to change those factors.
Here are the risk factors for DM type 2:
- 1. Excess body weight or obesity. If you have excess adipose tissue in your body (aka visceral and subcutaneous fat), you’ll also have an excess of hormones called adipocytokines. Some of which are thought to make your tissues become resistant to insulin so that the actions of insulin are ignored. As you can see obesity and diabetes go hand in hand.The WHO predicts that by 2015, 700 million adults worldwide will be obese or overweight, that’s next year!New Zealand isn’t spared from obesity. According to the Ministry of Health 2011 survey, 28% of New Zealand adults are obese or overweight.
- 2. Don’t forget about body shape. What’s your body shape by the way? If you accumulate fat in the abdomen (apple shaped) compared to accumulating it in your thighs, buttocks and hips (pear shaped), then you’re at a higher risk for developing DM type 2.
- 3. Physical inactivity or sedentary tendencies. We are spending more and more time sitting on our butts staring at our various gadgets, computers and TV’s. Adults, please get off the couch and get some exercise and sunshine outside. Take your kids with you and try out some new and fun types of exercise.
- 4. Poor diet. A diet rich in carbohydrates (grains, starches and sugars) will seal the deal for you when it comes to developing diabetes. Learn which food groups you should really be concerned about by keeping yourself updated. Remember fat is not the bad guy, sugar is. Check out our second part to this article for some great health tips.
- 5. Stress. Learn to classify stresses in your life as either physiologic (good) or pathologic (bad). Read more about the two by clicking here.
- 6. Genetic predisposition. Someday, you’re going to be a father, mother, grandfather or grandmother. Take good care of your body, remember, you’re going to pass on your genes someday. Exposure of the foetus to diabetes during pregnancy is thought to be a contributing factor to the increase in type 2 diabetes in children. Scary huh?
- 7. Stop smoking. Actively smoking is now a risk factor for developing DM type 2. If you smoke, it’s time to add smoking cessation to the top 3 of your bucket list, ASAP.
Be your own Sherlock Holmes, know the symptoms of DM type 2. The signs and symptoms of DM type 2 can be gradual making it hard for you to detect if you have it. People can also experience different signs and symptoms in varying degrees. Some people may not experience any symptoms at all until a late complication develops (such as a wound that won’t heal on the toe or even a stroke).
DM type 2 is most often detected in routine blood glucose screening. But if symptoms do manifest themselves, they may include any or a combination of the following:
- 1. You urinate more often or in larger volumes compared to usual (also known as polyuria). This can occur especially at night to the point that it keeps you up all night because of frequent trips to the loo.
- 2. Excessive thirst. This is a consequence of the increased urination. The need to replenish lost fluids makes you drink more than usual. This is medically known as polydipsia.
- 3. Increased appetite or a huge appetite (polyphagia). Your cells aren’t able to get enough energy (glucose) because insulin is not doing its job properly. As a consequence, your unsuspecting body tries to find more food. More food can mean more weight gain, another symptom of DM type 2.
- 4. You get tired easily. This isn’t a surprise since your cells aren’t getting the fuel, hence they lack energy. You can also get irritable.
- 5. Have you cut yourself lately? Did you notice that it doesn’t heal as quickly as it used to? Poor wound healing is another symptom of diabetes.
- 6. You have difficulty in concentrating and you show less interest in things.
- 7. You feel tingling sensations in your hands and feet.
- 8. Your eyesight may become blurry
- 9. You may experience stomach pain and vomiting.
Note: The classic triad of symptoms of diabetes are excessive urination, excessive thirst, and excessive hunger. But this triad is seen more often among diabetics who don’t manager their blood glucose levels well and also in type 1 diabetics.
Insulin isn’t your enemy, glucose is. Insulin simply does its best to escort the glucose in your blood into your cells where its either used as fuel or stored as fat. Take a look at the infographic below to understand insulin’s important role ferrying glucose out of the blood and into the cells:
However if your cells become insulin resistant the insulin has a hard time unlocking the door to let the glucose into your cells. So the glucose stays in your blood causing your blood glucose levels to increase (hyperglycaemia).
Hyperglycaemia caused by long term (years) insulin resistance leads to the complications of diabetes mellitus type 2. The infographic below shows you that DM type 2 doesn’t paint a pretty future for you if you choose to let it overcome your health.
Get tested EARLY. Don’t wait for DM type 2 to settle in before you get tested. Go to your health practitioner and get yourself tested right away. Here are some of the more important tests:
- Test for fasting blood glucose. This simply measures the level of glucose in your blood after you have fasted (not eaten) for 8 to 10 hours. It’s usually done first thing in the morning. If your test results are greater than or equal to 7 mmol/L, you have diabetes. However if you’re not experiencing any symptoms, a repeat of the test should be done the following morning.…but, if you have fasting blood glucose levels that fall between 6.1 mmol/L and 6.9 mmol/L, don’t rejoice just yet, you may have a condition called PRE-diabetes. This is not a good result either. Your doctor will probably request another test called an oral glucose tolerance test (OGTT) to confirm whether you have pre-diabetes or diabetes. Getting a diagnosis of pre-diabetes should make you even more proactive to making the necessary dietary and lifestyle changes to prevent yourself from developing full blown diabetes.
- The details of the OGTT will be explained by your doctor, but suffice it to say, if your blood glucose level after 2 hours is equal to or greater than 11.1 mmol/L (after OGTT), then you have diabetes.
- HbA1c. This test measures your average blood glucose levels over the past 2 to 3 months. HbA1c is important because it tells you how well you are managing your blood glucose levels (i.e. keeping them in the normal range). Usual complications like eye and nerve damage, stroke, heart disease and kidney problems will be kept to a minimum if you do your best to keep your glucose levels on track and within the normal range. This test is repeated every 3 to 6 months. Ideally you want to keep your HbA1c level below 53.
- Glucose meter or glucometer for short. There are several devices available. Some models are even designed to plug into your IPad, IPod Touch or IPhone. A glucometer is used to measure your daily glucose levels. You can use the glucometer just before a meal and 1-2 hours after a meal to find out how the meal has affected your blood glucose levels. You can then adjust your diet to foods that do not send your blood glucose levels through the roof. You will be able to work out which foods are best for you personally and which to steer clear of. For an average person, the normal average range of blood glucose is between 4 – 7.5 mmol. Why it’s in a range? Because you’re not a robot and your blood glucose levels will vary throughout the day. Measuring your blood glucose after you eat will give you a different reading than the one you took before the meal.
Other tests. There are other tests your healthcare practitioner may send you for. One in particular is your triglyceride levels (a type of lipid in your blood). If your triglycerides are high your risk for developing both DM type 2 and heart disease is greatly increased.
Hopefully this has convinced you that improving your diet, lifestyle and overall health are much easier and definitely the preferred option. You don’t want to become just another number in the history of the diabetes pandemic do you? Visit your doctor and get screened for diabetes and pre-diabetes. Though you don’t have to have diabetes to start making better dietary and lifestyle choices. Lookout for part two of this article with secrets to preventing diabetes or maybe even reversing it if you already have type 2 diabetes.
- Bernstein, Richard K. Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars. 4th Ed. New York: Little, Brown and Co., 2011.
- Williams Textbook of Endocrinology. 12th ed. Philadelphia: Elsevier/Saunders, 2011.
- Robbins Basic Pathology. 9th ed. Philadelphia, PA: Elsevier/Saunders, 2013.
- Strayer, David S. Rubin’s Pathology: Clinicopathologic Foundations of Medicine. 7th ed. Philadelphia: Wolters Kluwer Health, 2014.
- Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier/Saunders, 2011.