Diabetes can occur at any age, from birth to over 70 years old. Often there are no symptoms and the person is shocked when the blood sugar comes back around 300 or 400. In disbelief, they say, “How is that possible?” I don’t eat sweets. I put very little sugar in my tea and coffee. “
We must not forget that in India, out of a total population of 1.4 billion, 101 million people suffer from diabetes. This represents 11.4 percent of the population. There are two basic types of diabetes: patients who are completely insulin dependent (requiring injections) and those who can manage on tablets alone or a combination of both.
Two hormones secreted by the pancreas control blood sugar levels in the body. Insulin is secreted into
response to high sugar levels. This reduces sugar levels. When sugar levels are low, glucagon is released. It releases sugar from liver stores to restore blood sugar levels.
The pancreas may not produce insulin. The cells that perform this function may not be present at birth or may be damaged. This can be due to a viral infection at any age or an autoimmune reaction in which the body fails to recognize its own cells, mistakes them for genetically different cells and destroys them. This type of diabetes can be hereditary because members have inherited a trait that makes their cells sensitive. Diet or lifestyle has nothing to do with the onset of this type of diabetes.
Normal blood sugar is 90 to 130 mg/dL (5.0 to 7.2 mmol/L). Fasting and post-meal levels should be well controlled by the body’s insulin and glucagon, whether you are eating a large meal or fasting. Once this ability is lost, diabetes sets in.
In diabetes, blood sugar levels exceed 200 mg/dL after a meal. In prediabetes, it is between 125 and 200. Gestational diabetes occurs when high blood sugar values appear during pregnancy. Prediabetes and gestational diabetes are reversible.
Diabetes can remain asymptomatic for several months. After this, there may be unintentional weight loss, increased thirst, appetite and urination, constant hunger, unexplained fatigue, wounds that do not heal, and frequent infections. One of the first visible signs is the appearance of darkened areas of skin, most often around the neck or in the armpits and groin. It looks like dirt but feels like velvet and cannot be cleaned. In adolescents, this indicates a propensity to develop diabetes later in life.
Diabetes was once considered a disease of middle age, but now it appears in children and adolescents. Children are less active these days. Instead of games and sports, they are addicted to media. They are obese. Many have a family history of diabetes. The same factors predispose them to developing metabolic syndrome X and polycystic ovaries. These are two precursors of diabetes.
The two most important steps in diabetes management are a healthy, balanced, calorie-controlled diet and 30 to 40 minutes of daily walking. Insulin sensitivity increases with exercise.
After about a week, sugars should be re-evaluated. If they are still high, medication should be started to prevent damage to the eyes, kidneys, heart and nerves. If control is not satisfactory even with medication, insulin should be started.
Unlike a fever or a fracture that heals over time, diabetes is a chronic disease that requires lifestyle changes, regular monitoring and self-control. Even though there is a strong family history of diabetes, it is possible to try to prevent children from becoming diabetic by feeding them a healthy diet with limited snacks and sugary cola soft drinks. Children also need an hour of physical activity per day.
The writer has a family practice in Vellore and is the author of Staying Healthy in Modern India. If you have any questions regarding health issues, please write to email@example.com