what are diabetics

ByHawya

Dear friends, today I’d like to share my journey of understanding diabetes. It all began with my neighbour, Uncle Li. He was always robust, but suddenly started making frequent trips to the bathroom, struggled with sleep, and lost noticeable weight. This caused considerable concern. After a hospital visit, he was diagnosed with diabetes. From that moment, my curiosity about this complex yet common health issue grew, prompting me to delve deeper.

Understanding Diabetes Basics

What is Diabetes?

Diabetes mellitus (DM) occurs when the body struggles to regulate blood sugar levels effectively. It encompasses several types: Type 1, Type 2, Maturity-Onset Diabetes of the Young (MODY), gestational diabetes (affecting some expectant mothers), neonatal diabetes, and steroid-induced diabetes. For instance, my cousin developed gestational diabetes during her pregnancy, requiring careful management throughout.

Diabetes involves problems with insulin – either insufficient production or ineffective use. Insulin acts like a key, allowing glucose from the blood to enter cells for energy. Without enough insulin or if cells become resistant, glucose accumulates in the blood. Over time, this can lead to serious complications like heart disease, vision loss, and kidney disease. A relative of mine experienced severe vision deterioration due to poorly managed diabetes, significantly impacting their life.

Key Causes of Diabetes

While the exact causes of most diabetes types remain unclear, insufficient insulin production by the pancreas is central. Both Type 1 and Type 2 diabetes likely result from a combination of genetic and environmental factors. Take Uncle Li; despite no family history, his lifestyle and environment may have contributed.

The cause of Type 1 diabetes is particularly fascinating. The body’s immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. Genetic and environmental factors, such as living and working conditions, can trigger this autoimmune response. I recall a child developing Type 1 after significant environmental changes and exposure to new substances.

Diagnosis, Symptoms & Impact of Diabetes

How is Diabetes Diagnosed?

A fasting plasma glucose (FPG) test is a key diagnostic tool. Results below 100 mg/dL (5.6 mmol/L) are normal. Levels between 100-125 mg/dL (5.6-6.9 mmol/L) indicate prediabetes. Two separate tests showing 126 mg/dL (7.0 mmol/L) or higher typically confirm diabetes. A colleague’s FPG result of 110 mg/dL served as a wake-up call about his prediabetic state.

Long-Term Effects of Diabetes

Over time, diabetes can damage blood vessels in the heart, eyes, kidneys, and nerves. It increases the risk of heart disease, stroke, and kidney failure. Damage to eye vessels can cause permanent vision loss. An elderly gentleman I know requires weekly dialysis due to diabetes-related kidney damage, severely affecting his quality of life.

Recognising Diabetes Symptoms

Be aware of these signs:

  • Frequent urination, especially at night (a neighbour experienced this, though tests were clear).
  • Excessive thirst (I once had a period of unquenchable thirst, fortunately not diabetes-related).
  • Unexplained weight loss (a friend initially celebrated weight loss, only to discover it was a diabetes symptom).
  • Constant hunger (a colleague reported persistent hunger despite eating).
  • Blurred vision (sometimes first detected during an eye exam).
  • Numbness or tingling in hands/feet (an elder relative experienced this as a complication).
  • Persistent fatigue (beyond normal tiredness).
  • Very dry skin (a classmate found skincare ineffective until diabetes was diagnosed).

The Global Picture of Diabetes

Country with the Highest Diabetes Prevalence

According to the US National Institutes of Health (NIH), China has the highest number of people with diabetes aged 20-79 globally, approximately 140.9 million. India ranks second, particularly prominent in Southeast Asia, with 74.2 million. These staggering figures highlight diabetes as a major global health challenge.

Countries with the Lowest Diabetes Prevalence

In 2022, nations in Western Europe and Eastern Africa generally reported the lowest diabetes prevalence for both men and women. For women, Japan and Canada also showed relatively low rates. Dietary habits and lifestyle factors in these countries likely contribute to this, offering valuable lessons for prevention.

Prevention, Management & Living with Diabetes

Preventing Diabetes

Effective prevention strategies include:

  • Losing excess weight: Significantly reduces risk (a friend improved all health markers after substantial weight loss).
  • Regular physical activity: Offers multiple benefits (daily running helps me maintain good health).
  • Prioritising healthy plant foods: Rich in beneficial nutrients (I incorporate ample vegetables and fruit into meals).
  • Choosing healthy fats: Such as olive oil for cooking.
  • Avoiding fad diets: Opt for sustainable, healthy choices (a colleague learned this after a restrictive diet weakened him).

Is Diabetes Curable?

Currently, there is no cure for diabetes. However, many people can achieve remission. Remission means maintaining normal blood sugar levels without medication, sustained through healthy eating and exercise (a fellow patient now rarely needs medication thanks to diligent management).

Best Treatments for Diabetes

Treatment often involves insulin injections or other medications, but it extends far beyond drugs. Crucial elements include healthy eating/drinking, regular exercise, sufficient sleep, and stress management. Additional therapies may also help (a patient finds complementary rehabilitation treatments beneficial alongside medication).

Living with Diabetes

Most people with diabetes lead full lives. It doesn’t necessarily prevent you from doing things you enjoy, though it requires adjustments in diet and health maintenance, potentially impacting work and sexual health (one diabetic I know continues participating in sports with careful management).

First Steps After Diagnosis

If diagnosed: adopt healthy eating habits, increase physical activity, monitor blood sugar regularly, and take prescribed medication consistently, even when feeling well (a friend learned this the hard way after initial neglect led to complications).

Diabetes & Related Factors

Can Stress Cause Diabetes?

Stress alone doesn’t directly cause diabetes. However, evidence suggests a link between stress and increased risk of Type 2 diabetes. Researchers believe high levels of stress hormones may impair insulin-producing beta cells, reducing insulin output (a highly stressed friend was advised to manage stress to mitigate diabetes risk).

Who is at Higher Risk?

Factors increasing diabetes risk include:

  • Overweight or obesity (friends actively work to lose weight for prevention).
  • Age 45 or older (family elders prioritise regular check-ups).
  • Family history of Type 2 diabetes (a colleague with this history is very cautious).
  • Physical activity less than 3 times per week (I encourage an inactive friend to move more).
  • Non-alcoholic fatty liver disease (NAFLD) (associated with increased diabetes risk).

Is High Blood Sugar the Same as Diabetes?

Hyperglycaemia (high blood sugar) is common in diabetes, but various factors can cause it, including diet, activity levels, illness, or non-diabetes medications (a patient’s blood sugar spiked significantly after overindulging in sweets).

What Does High Blood Sugar Feel Like?

Hyperglycaemia symptoms include excessive thirst, hunger, fatigue, and frequent urination (I experienced this discomfort once after poor dietary choices).

Why is Diabetes Prevalence High in China?

The rising prevalence of overweight and obesity among Chinese adults correlates strongly with increased insulin resistance and diabetes incidence. High BMI is a major individual risk factor driving this trend (sedentary lifestyles and weight gain among busy professionals contribute significantly).

Beneficial Foods for Diabetes

What Foods Help Manage Diabetes?

Excellent food choices include:

  • Fruits and vegetables: Rich in vitamins and fibre (I regularly include apples and broccoli).
  • Whole grains: Such as whole wheat, brown rice, barley, quinoa, and oats (wholemeal bread and porridge feature in my breakfasts).
  • Lean proteins: Includes poultry, fish, eggs, nuts, beans, lentils, and tofu (essential parts of my protein intake).
  • Low-fat or fat-free dairy: Milk, yoghurt, and cheese (I include a daily glass of milk).