Diabetes
A Sweet and Simple Look at

When we eat, our body turns food (carbohydrates) into glucose, which is a type of sugar that the cells in the body use for energy. A hormone called insulin assists in allowing glucose to enter the body’s cells. In diabetes, the high level of blood glucose usually results from the body failing to secrete sufficient insulin or the body failing to respond to the insulin that is present.

There are many different types of diabetes, the most common being Type I and Type II. Other less common types include ‘gestational diabetes’ (diabetes caused by pregnancy) and diabetes due to other diseases, for example pancreatitis.

Who develops diabetes?
Type I diabetes usually occurs in people younger than 30 years, but can occur at any age. The problem here is too little insulin, so the treatment of Type I diabetes usually requires insulin therapy.

Type II diabetes is by far the most common type of diabetes. It tends to occur in individuals older than 30 years. In this case, the body produces insulin, but the cells do not respond in the normal way (and may be ‘insulin resistant’). One may be at an increased risk of developing diabetes if one has affected family members and if one is obese and does not exercise.

In both types of diabetes, the cells of the body become starved for energy, because the insulin effect is insufficient. The body responds to this situation by increasing the amount of glucose in the blood (the liver being one organ that releases glucose into the blood). This is one of the explanations for the high blood glucose in diabetics.

Over time, the high blood glucose levels can damage the nerves, eyes, kidneys, heart and blood vessels.

What are the symptoms of diabetes?
In some cases, diabetics have no symptoms at all and their diabetes may be detected during a routine visit to the doctor. Usually, however, diabetics do have some symptoms, typical indicators being excessive thirst, passing a lot of urine, blurred vision, headaches and fatigue.

How is diabetes treated?
Diabetes is one of the so-called ‘chronic’ diseases. This means that it can be effectively controlled, but is often not cured.

As a diabetic’s treatment and/or management may be complex, it is always necessary to consult one’s doctor and follow their advice. The following, however, are some of the aspects of a diabetes management programme:

Glucose testing
Glucose levels should be tested regularly to ensure that they are under control. This can be done at home with a small device, at the pharmacy or at a doctor. A small drop of blood is required to test the glucose levels and this can be obtained by pricking the skin and using a testing device.

Medication
Type I diabetics often have to take insulin daily. Insulin is available in many different convenient forms, such as an injectable ‘pen’ set.

While Type II diabetes can sometimes be well controlled on diet alone, some may require additional diabetic medication. These pills do not contain insulin, but help the body better utilise the insulin it produces. In some cases, these pills are not enough, and a Type II diabetic may need to take insulin, too.

Being on insulin does not necessarily mean that the diabetic’s condition is very severe, but merely means that insulin is required to control the blood glucose.

Following a healthy diet
Since one’s body changes food into glucose, what one eats is very important when trying to control glucose levels. Generally, it is important to reduce sugar and fat intake and to consume moderate amounts of protein (such as white meat). As we all have individual dietary preferences, it is often advisable to consult a dietician to formulate an eating plan that suits the specific diabetic.

Exercise
Exercise may assist in controlling blood glucose levels. It also helps with weight loss, reducing stress, blood pressure and cholesterol and improves cardiovascular function. Ideally, one should exercise three to four times a week for at least 20 minutes. Remember, however, before starting any exercise programme it is vitally important to consult your doctor.

Good foot care
In the case of diabetes, the feet may be affected on various levels. Firstly, diabetics may develop infections more easily than non-diabetics. The blood supply to the foot may also be compromised, as the accelerated atherosclerosis blocks vessels running to the legs.

The nerve supply to the feet may also become damaged. Due to this, the foot becomes very dry and the skin tends to crack. Certain muscles may weaken due to the damaged nerve supply. This alters the natural arches of the foot and places abnormal pressure on certain tissues within the foot.

Finally, the sensation of the foot is decreased. Diabetics sometimes cannot feel that they are damaging their feet, for example if there is a stone in their shoe or if they unintentionally put their foot in a very hot bath.Diabetics should avoid tight fitting shoes. Walking barefoot should also be avoided and diabetics should clean and inspect their feet every day.

Eye testing
The blood vessels of the eye are very sensitive to the effects of diabetes. Regular visits to the ophthalmologist are recommended, because vision is only affected late in the course of the disease.

Treating other medical conditions
Recent studies have highlighted the importance of treating other diseases in diabetics to improve life expectancy and quality of life. Hypertension and high cholesterol must be controlled in conjunction with diabetes for significant benefit.

In conclusion
Diabetes is a serious disease with potentially dangerous complications. However, with good education, proper responsible holistic management, a healthy lifestyle and some smart choices, its effects can be avoided and a completely normal life may be led. Should you require more information, speak to your doctor or contact the South African Diabetes Association (0800 117 575).