The full name ‘diabetes mellitus’ derives from the Greek word ‘diabetes’ meaning siphon – to pass through – and ‘mellitus’ – the Latin for honeyed or sweet. This is because not only is excess sugar found in the blood but it may also appear in the urine, hence it being known in the 17th century as the ‘pissing evil’. If your body isn’t making any insulin, or isn’t making enough, then your body can’t convert blood sugar – glucose – into fuel for your body’s cells. This condition is diabetes.
Diabetes has emerged as a major health care problem in India. According to Diabetes Atlas published by the International Diabetes Federation (IDF), there were an estimated 40 million persons with diabetes in India in 2007 and this number is predicted to rise to almost 70 million people by 2025. The countries with the largest number of diabetic people will be India, China and USA by 2030. It is estimated that every fifth person with diabetes will be an Indian.
The Risk Factors for Diabetes in Indians Are:
Indians develop diabetes at a very young age, at least 10 to 15 years earlier than the western population. An early occurrence of diabetes gives ample time for development of the chronic complications of diabetes. The incidence of diabetes increases with age. In India, the life span has increased; hence more number of people with diabetes are being detected.
The prevalence of diabetes increases with a family history of diabetes. The risk of a child developing diabetes with a parental history increases above 50 per cent. A high incidence of diabetes is seen among the first degree relatives. Indians have a high genetic risk for diabetes as observed in Asian Indians who have migrated to other countries. They have been found to have a higher rate of diabetes as compared to the local population.
The association of obesity with Type II Diabetes is well known. Even with an acceptable body weight range, weight gain could increase the risk of diabetes. An excess of body fat specially concentrated within the abdomen has an increased risk of diabetes. The cut-off limit for waist circumference for Indians has been recommended to be 90 cm for males and 80 cm for females. Abdominal obesity is defined by waist circumference above these limits.
Physical Inactivity and Sedentary Living
There is enough evidence to demonstrate that physical inactivity as an independent factor for the development of type II diabetes. The availability of motorized transport and a shift in occupations combined with the plethora of television programmes has reduced the physical activity in all groups of populations.
Asian Indians have been found to be more insulin resistant as compared to the white population. They have a higher level of insulin to achieve the same blood glucose control. A cluster of factors consisting of abnormal fats (Dyslipidemia), high blood pressure, obesity, and abnormal glucose levels known as metabolic syndrome is highly prevalent in Asian Indians.
The developing countries like India are undergoing rapid urbanization. Urbanization is associated with increasing obesity, decreasing physical activity due to changes in lifestyle, diet and a change from manual work to less physical occupations.
The impact of stress both physical and mental along with lifestyle changes has a strong effect of increasing incidence of type II Diabetes amongst persons is a strong genetic background.
Having diabetes increases the risk of other health problems but there are lots of things you can do to minimize them, such as maintaining a healthy lifestyle, attending regular check-ups and monitoring your sugar levels.
Once diabetes is diagnosed, it’s very important to attend regular check-ups, at least annually, so the patient remains symptom-free and to prevent possible complications.
These check-ups will include:
- Blood tests to monitor the level of glucose in the blood, how well the diabetes has been controlled over the previous two to three months, cholesterol levels, and kidney function.
- Blood pressure measurement.
- Eye examinations, at least annually because diabetes can damage the back of the eyes (called retinopathy) but laser treatment can be used to treat this when it’s caught early enough.
- Examinations of the feet and nerves.
People diagnosed with diabetes should see a dietitian to be advised about a healthy diet and which foods are best for people with their condition.
They should also visit a chiropodist as good foot care is essential to prevent infections and ulcers developing, which may be slow to heal.
Take regular exercise
Walking, swimming, dancing or cycling, for example, will help keep your weight at an ideal level and assist in keeping blood sugar levels under control.
Avoid smoking and alcohol
Smoking should be completely avoided since it greatly increases the risk of many health problems, including damage to the blood vessels.
Drink alcohol in moderation. Never drink on an empty stomach because this can cause hypoglycaemia. Excess alcohol also contributes to high blood pressure.
Maintain a healthy diet
A healthy diet is essential. This should include regular meals that are low in fat and high in fibre, such as fruit, vegetables and pulses (beans, lentils and peas).
It’s important to cut down on sugar and to have reduced-sugar foods and drinks. Have chocolate, cakes and sugary drinks as a treat occasionally.
The amount of salt in your diet also needs to be reduced, since this contributes to high blood pressure that in turn may cause heart disease and strokes.
Check blood pressure
Blood pressure levels should be checked regularly to ensure they’re at a safe level. Current guidelines recommend that someone with diabetes should have a blood pressure level below 130/80.
Watch cholesterol levels
A high cholesterol level damages the blood vessels and is another risk factor for heart and circulatory diseases. It’s important that the cholesterol level for someone with diabetes is not too high; ideally it should be below 4.0.
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