Diabetes

Diabetes is a lifelong disease in which the body cannot process sugar properly. Diabetes is also called diabetes mellitus or sugar diabetes. When people who have diabetes eat glucose, which is found in foods such as breads, potatoes and sweets, it can't be converted into energy. Instead of being converted

into energy, the glucose stays in the blood. This is why people who have diabetes have blood sugar (glucose) that is too high.

Your blood needs to always contain sugar as available energy. But too much sugar is not good for your health as it may damage your heart, kidneys, eyes, nerves, teeth and gums.

This is commonly diagnosed in children, teenagers and young adults. People with this type of diabetes do not produce insulin which is used by the body to lower sugar levels in blood. These patients need to take insulin injections every day.

This is the most common type of diabetes. People with this type of diabetes do not make enough insulin and/or the body's cells do not respond to insulin. Therefore they need to take tablets to help the body to make more insulin or that help insulin to do its job; or they may need to take insulin injections every day. People who are overweight and inactive have an increased risk of developing type 2 diabetes.

Complications of Diabetes

If diabetes is not diagnosed early or is not adequately controlled, the risk of complications increases. The following are some of the major complications of diabetes:

Are you at risk for Diabetes?

The likelihood of developing diabetes is much higher if you:

Are 40 years or older
Are overweight
Are Black or Indian
Have a parent, sister or brother with diabetes
Have high blood pressure (above 140/90 mmHg)
Have low HDL (good cholesterol) and high levels of other lipids (fats)
Have had diabetes during pregnancy and delivered a large baby (4 kg or more)

How do I know If I have Diabetes?

The symptoms of high blood sugar are:

Being very thirsty
Bassing urine more often, even at night
Feeling hungry or tired more often
Losing weight without trying to
Having sores that heal very slowly
Having dry and itchy skin
Losing feeling in your feet or feeling a tingling sensation in your feet
Having blurry vision
You may have one or more of the symptoms mentioned above or there may be no symptoms at all. It is advisable to visit your doctor so that he/she can decide on the appropriate test for testing your blood sugar.

Blood sugar (glucose)

Your blood sugar can be tested following an overnight fast (the blood is tested first thing in the morning before eating and drinking anything). Your doctor may however choose to test a random blood sugar level that can be drawn anytime without prior fasting.

Glucose tolerance test (GTT)

This is also known as a glucose loading test. For this test you need to fast overnight and have the test done before you eat anything in the morning. A blood sugar sample is taken first, before you are given a solution mixed with 75 g sugar to drink. You need to stay seated for the duration of the test. A second blood sugar sample is drawn at the end of a two hour period after you ingested the solution.

HbA1c

You do not have to fast to do this test. This test may be used for both diagnosis as well as monitoring of diabetes. This test represents time-averaged highs and lows of your blood sugar over a period of three to four months.

Urine micro-albumin

This test is done in the urine. It is the earliest way of testing for the presence of complications caused by diabetes i.e. end-organ damage like kidney disease. This test is also used to estimate the severity of kidney disease as a complication of diabetes.

Serum creatinine

This is a blood test that is used to assess for kidney disease, and can be collected at any time of the day.

Lipogram

Total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides form part of a standard lipogram. These lipids are used to estimate the risk of heart disease (e.g. heart attack and stroke).

Managing diabetes means that you need to:

- Eat healthy foods every day
- Be physically active
- Where applicable, take your diabetes medication as prescribed
- Test your blood sugar levels
- Move your body for at least 30 minutes every day, for example, by walking
- If you are overweight, aim to lose 5 to 10 percent of your present weight
- Stop smoking (smoking increases the chance that you will develop heart disease and cancer)
- Avoid alcohol as it can increase blood sugar and blood pressure
NB: You need to work with your healthcare provider to create a plan for managing your health.

Eating plan for type 2 diabetes

- Eat three balanced meals a day, not more than six hours apart. Limit added sugars and sweets.
- Eat a variety of vegetables and fruit each day.
- Eat your fruit rather than drinking it as juice.
- Include whole-grain starchy foods at each meal.
- Choose low-GI foods.
- Drink water instead of a fizzy or fruit drink.
- Always choose lean protein at each meal
- Make low-fat choices and cut down on added-on fat, particularly saturated fats (butter, margarine and cheese).
- Include beans and lentils in your diet.
- If you choose to drink alcohol, do so only in moderation
- Reduce your salt intake.

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