Diabetes

Gone are the days when the diabetic patient had to be shuffled from one clinic to another for medical care with little coordination between the different specialists.
Diabetes is a disorder in the body’s ability to use blood sugar (glucose). Glucose is the main source of energy for the human body. It is taken from the starches and sugars that people eat.

Normally, the body’s tissues can absorb the glucose and use it for energy with the help of insulin. Produced by the pancreas (an organ behind the stomach), insulin is a hormone secreted in response to the natural increase in blood sugar after a meal. Unless the body has enough insulin and the ability to use insulin properly, glucose will simply build up. People with untreated diabetes may have high blood sugar levels. These high blood sugar levels can lead to a variety of symptoms (e.g., weakness, thirst) in the short-term, and serious consequences such as heart attack, stroke or Kidney problems in the long-term.

Diabetes affects 15 – 20% of the population of the UAE. Because diabetes has a significant genetic component, those with one or more diabetic relatives are advised to be especially vigilant in maintaining a low-fat, low-to-moderate sugar diet and exercise regularly. A quick, simple blood test can check for diabetes.

There are two types of diabetes: type 1 and type 2. Type 1 is thought to be caused by a combination of genetic and environmental factors that results in a lack, or complete absence, of insulin. For reasons largely unknown, the body’s immune system attacks itself, destroying its own insulin-producing beta cells in the pancreas.

Much more common, type 2 diabetes has been linked to obesity (a body mass index or BMI of 30 or greater), inactivity and being over 40 years old. Because of increasing incidence of obesity, DM-2 is being seen in teens and young adults also. Diabetes can also be caused by drug use, the use of steroids, or pregnancy (known as gestational diabetes)

Before the discovery of insulin in 1921, the long-term prognosis for diabetics was poor. Today diabetics can be managed and controlled with lifestyle modification and if needed medications (drugs & insulin injection). Other methods of administering insulin, such as nasal sprays and skin patches, are currently being researched.

Q)Link b/w Diabetes & cholesterol?
A)Patients with diabetes are 2-4 times more at risk for cardiovascular diseases.The reason behind it is increased incidence of high blood pressure and cholesterol abnormalities in diabetics.Diabetics have high triglyceride level,high levels of LDL or bad cholesterol and low values of good cholesterol or HDL.The common link among all these medical problem is imapired action of Insulin or insulin resistance,this needs to be diagnosed at an early stage so that all of these above mentioned complications can be prevented.

Q)What is gestational diabetes, how do we control it?
A)Gestational diabetes is high blood sugar first noted during pregnancy and limited to pregnancy. the incidence of GDM ranges from 2-8% of pregnancies thru’ out the world. The best therapy for GDM depends on level of blood sugar .patients should be seen by dietician and blood sugar monitoring should be done, patients should be followed aggressively and insulin started if diet fails.

Q)My mother has type 1diabetes,i am 35 yrs old, what is the risk of me getting diabetes?
A)Type 1 and Type 2 diabetes have different causes. You must inherit predisposition to the disease to develop either type of diabetes and secondly there is a trigger (may be environment or virus) for diabetes. In general if woman has type 1 diabetes and children were born before the age of 25,child’s risk is 1 in 25,if child is born after you age of 25 yrs, the risk for child is 1in 100.If your mother developed diabetes before the age of 11,risk of getting diabetes is doubled.

Q)Recently we have heard about type 2 diabetes becoming an epidemic in near future, can it be prevented?
A)According to recently released reports diabetes is becoming major concern because of the associated complications. Measures to prevent diabetes should be taken on a priority basis. Type 2 diabetes has strong genetic basis but the onset depends more on environmental factors. Modest changes in lifestyle including physical activity and healthier diet can help prevent the onset of type 2 diabetes.

Q)We have heard about a new way to cure patients who are on insulin by surgery, what is it, can my 12 yrs old son be treated with it?
A)Pancreas contain insulin producing cells, the new method that u r interested to know about is called islet cell transplantation and is a way of treating diabetes by giving a person new insulin secreting cells. So far all the patients who have received transplant (new insulin making cells) have not remained off insulin. It is still in early stages of development and extensive work is being done to make it increasingly safe and reliable in the long run. so for now it is not a cure ,we will have to wait till we hear about results of this procedure on large number of patients.

Q)I have diabetes and I am concerned about increased risk of getting heart attack if you have diabetes, is it true and what can i do about it
A)It is true that patients with diabetes are 2 to 4 times more likely to develop cardiovascular diseases than patients without diabetes. The risk of having a heart attack is the same as people without diabetes who have already had a heart attack. There is a lot of evidence that by controlling blood glucose, high blood pressure and cholesterol risk can be substantially decreased. Please talk to your doctor about cholesterol lowering medicines, your blood pressure should be very tightly controlled and you should be on regular exercise plan.

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