Diabetes is a condition where there is an absence or inadequate secretion of insulin. Insulin is a hormone made by our organ called the pancreas. The function of the insulin is to absorb the glucose from our diet and turn it into energy. In a diabetic patient, the pancreas does not produce enough insulin or the available insulin is blocked or inactivated by other substances thus preventing it from performing this function. This causes excessive glucose in the blood and after a period of time it can lead to serious complications.

The most common symptoms are: 1] excessive urination 2] tiredness 3] constant thirst 4] frequent hunger and strong appetite 5] weight loss despite the heavy appetite 6] frequent fungal infections especially in the genital areas and 7] blurred vision.

There are two types of diabetes:

1] Type 1: It is insulin dependent diabetes mellitus (IDDM). No insulin is made in the body and can occur at any age but especially in the young. Treatment is in the form of dietary controls and injections.

2] Type 2: It is non-insulin dependent mellitus (NIDDM). This accounts for 90% of all cases. In type 2, the pancreas produces insufficient insulin. It usually occurs in people over the age of 40 and very often other members of their family also have it.

Additional demands on the pancreas can also cause some pregnant women to develop diabetes. This is gestational diabetes (GDM). About 20% - 50% of GDM patients will develop diabetes in later life.

Diabetes patients should be aware that low blood sugar could occur with the use of tablets or insulin. This condition could be due to: 1] eating too little or too late 2] too much insulin and 3] not enough food before exercise.

Adjustments need to be made if there are variations in the diet or amount of exercise done by the diabetic patient as this can lead to too little glucose in the bloodstream and excess of insulin, thus giving rise to hypoglycaemia (low blood sugar).

Symptoms of hypoglycaemia include: 1] lack of concentration 2] sweating 3] irritability 4] blurred vision and 5] shaking and weakness.

The treatment is to promptly take sugar by mouth (in the form of glucose tablets, sugar lumps or glucose drink). Recovery is usually very fast. Occasionally, unconsciousness can occur and hospital treatment is necessary.

Both insulin dependent and non-insulin dependent diabetes are susceptible to complications. Many complications may be serious and can affect almost every part of the body. Long term damage to the feet, eyes and blood vessels are perhaps the most devastating complications to the diabetic patient. Although early detection helps, it can be difficult because many of these complications do not show any obvious symptoms until the problems are well advance and the damage has been done.

The complications are:

1] Retinopathy Disease of the back eye. May cause impaired vision and lead to blindness.

2] Neuropathy Nerve damage that can lead to pain or lack of sensation in the hands and feet. May cause problems with digestion or the heart (irregular heart beat).

3] Nephropathy May lead to kidney failure and cause early death.

4] Large blood vessel damage Leads to heart attacks, stroke and/or lower limb amputation.

These complications may occur singly or combination. The extent of damage is very much dependent on the duration of the diabetes and its degrees of control. This makes controlling of the blood sugar very important.

Regular exercise helps the insulin to work better and keeps the diabetic healthier. For patients above 45 years old, exercise should be at least half an hour daily walk or very light jogging on the spot if space is limited. Heavy exercise is not advisable so as to avoid injury.

Diet plays a very important part in the management of diabetes. Diabetes is a disorder of glucose utilization; it is incorrect to assume that they need to avoid sweet foods and drinks to manage the conditions. There is more to managing diabetes than that. It is important to remember that healthy eating is the key to a diabetics diet and he can eat the same type of diet that everyone should be eating. Starchy foods which are high in fiber should form the basis of a diabetics diet. Such foods are wholemeal bread, noodles, oats, unsweetened crackers, potatoes, lentils, fruits, vegetables and dried beans.

Foods that are high in sugar and fats should be kept to the minimum. Alcohol consumption should be kept to minimum as too much alcohol can upset the blood sugar level. Diabetic should have three meals daily and do not miss any meals, it would be better to have more of smaller meals at shorter intervals.

Author: T.A Chew