DIABETES AND YOU

DIABETES MELLITUS (HIGH BLOOD SUGAR LEVEL)

Definition:
A disease of the body where the individual affected does not get the energy stored in the food he /she eats to do the daily works because of total lack of what breaks the food to give the energy called insulin or abnormal body condition that does not work well with this insulin resulting in the food accumulating in his/her blood as glucose.

Such individual apart from the drugs/medicines being used should regularly do exercises he/she can tolerate; and be careful on what to eat, how much to eat, and when to eat it.

TYPES:
Two types are basically recognized:
- Type 1 or Early onset, are usually found more in young people
- Type 2 or Adult onset, are usually more in the elderly people but now seen also in young people, partly because of our careless eating habits.

PATHOPHYSIOLOGY

- Unavailability or non-response to the key that unlock the cell for utilization of the food we eat by the blood.
- Unrestricted breakdown and wasting with release of harmful substances and production of acidic environment for the body.
- Very high sugar level in blood and body weakness.
- Increase urge to drink water
- Frequent passage of urine with sugar in the urine
- Loss of water and salt in the body
- Low Blood pressure, fast heart rate.

The increased acidic substances deposited in the body with the low blood pressure and lack of water and salt will lead to combined signs and symptoms which if not given prompt and emergency medical care may lead to death.

SIGNS AND SYMPTOMS

Some affected persons do not complain of the common health problems used in recognizing it until it has spoiled an important part of the body (a condition called complication) and then resulting in life threatening conditions.

Some of the early complaints common to the sufferers are:
- Excessive urination even in the night
- Excessive drinking of water
- Excessive eating without the food showing on you i. e despite the much you eat, you will be losing weight.
- Always feeling tired
- Itching of private parts

After affecting some important parts of the body, the individual complains of the following:
- Feeling as if water proof is covering the legs and hands
- Loss of libido/poor erection
- Sores and boils on the legs that does not heal easily
- As it worsens, the individual becomes very sick, confused, feels as if he/she is sleeping, hungers for air and finally becomes unaware of the environment (coma); a condition called Diabetic Keto-Acidosis (DKA).

To some people, this may be the first sign and it is a very serious medical problem requiring very urgent medical attention (medical emergency)

DIAGNOSIS

To find out and say for sure that one has diabetes, we combine the common health problems it comes with and the level of sugar in the blood.
Using the World Health Organization (WHO) diagnostic criteria.

- Single abnormally raised blood sugar with symptoms
- Abnormally raised blood sugar in 2 occasions

ACCEPTABLE METHODS OF CHECKING FOR LEVEL OF SUGAR IN BLOOD

- FSB – Taking a patients blood early in the morning when he/she has not eaten to check for the sugar with values: >= 7mmol/L(126mg/dl).
- 2HPP – Taking the blood at exactly 2 hours after eating a starchy (sugar containing) food with values: >= 11.1mmol/L (200mg/dl).

In summary, any individual with either of the health problems mentioned earlier plus either of the above abnormally raised blood sugar once; or the abnormally raised sugar checked differently in 2 occasions is concluded to have diabetes mellitus and should immediately identify himself/herself for management (these include advice on good healthy living-regular and tolerable exercise, good eating habit, general health education and self care, and if need be medication).

COMPLICATIONS

This occurs in 3 different ways; namely:
Drug Treatment:
- Hypoglycaemia: This is a state of low blood sugare. It can come when a patient takes diabetic drugs in excess of prescription or without food. This is because the medicines works by lowering the high blood sugar condition in diabetics. Feasures of this include:
- Sweating
- Hunger
- Pounding heart
- Trembling/shaking
- Lack of concentration
- Confusion
- Feeling of drunkenness
- Difficulty in speech
- Headache
- Urge to vomit.

Treatment:
i. lick some cubes of sugar immediately
ii. see your doctor

Late Stage:

- A life threatening condition that consists of a confusion state, feel of drunkenness, lack of water, generalized body and abdominal pain, feeling of cold, air hunger, smelling breathe among others and in extreme cases unaware of the environment; a condition known as diabetic keto-acidotic coma or Non ketolic diabetic coma if there is no smelling breathe.

Long Standing:

- Impaired/blurred vision, some may manifest as cat’s eye (cataract)
- Kidney failure
- Weakness of muscles and body
- Feeling of water proof covering on your hands and feet
- Foot ulcer
- Abdominal disturbances
- Heart diseases
- Fainting (TIA)
- Stroke

MANAGEMENT:

Treatment:
Diabetes is a medical condition whose permanent cure in orthodox medicine has not yet been proved.
Hence, understanding the mode of occurrence to prevent it or living a positive life style to prevent aggravating its attack for those that have been diagnosed is the best treatment.

The following goals are aimed to achieve in the management plan:
- To maintain normal blood sugar
- To reduce and maintain ideal body weight in the obese and non-obese respectively
- To live a completely normal life (i.e improve quality of life)
- To remain not only symptoms free but in good health
- To achieve normal handling of the food eaten by the body for optimal utilization of energy
- To escape the long term complications mentioned earlier and thereby live not only long but happy life.
- Reduce mortality and concomitant morbidity.
Management options available for diabetes patients include:

a). Dietary: Recommended here is;
- Low energy, weight reducing diets
- Weight maintenance diets.

An ideal plate model meal plan should contain the following:

Beans, Bread, Unripe Plantain, Potatoes, vegetable and fruits, fish, meat, eggs, cheese.

However, the meal should be in regular pattern with snacks in between for constant maintenance of daily carbohydrate intake and to prevent hypoglycaemia.

Diabetic individuals should follow the same advice or precautions given to the general public but should note the following:

- Diabetics with co-existing hypertension should reduce salt intake to half (1/2) the normal requirement.

Alcohol can cause accumulation of acid in blood in different ways can also cause low blood sugar (hypoglycaemia).

b). Exercise:

Studies conducted by the World Health Organization has confirmed that consistent and continued combined tolerable aerobic and resistance exercises has gone a long way to achieve good sugar control, healthy and happy life in people with diabetes.

The key facts about this exercise are that it must be:
- Tolerable
- Consistent or regular
- Continued
- Combined aerobic aid resistance types

These when maintained helps the individual to achieve the following:
- Better working condition of the body and hence good food utilization and energy output
- Loose unhealthy weight
- Keep fit and strong
- Reduces stress and helps in drug utilization by the body; among others.

c). Drug Treatment:
This is given with respect to the blood sugar. It aims at reducing a high blood sugar and hence should be given only by the doctor who matches the level of blood sugar of the patient to the dosage and class, and drug of choice.

NB: Patient should not take anti- diabetics out of prescription as they are at risk of low blood sugar and they are problems.

ANTI-DIABETIC DRUGS

Several of them are available and most are unsuitable or even dangerous for use by different patients with different grades or types of diabetes. They are not to be substituted for one another. All should only be taken on prescription at the normal dose.

They include:
Insulin Preparations- This is given only by injections
Oral Preparations – These are tablets of different classes prepared in different doses.

Alternate Medicine:

Presently, researchers have confirmed and produced a lot of alternatives to orthodox medicine from our natural herbs and plants that are very good in the management, control, and even prevention of early onset of diabetes in individuals at risk.

PREVENTION:

Routine screening of asymptomatic adults, especially those with family history is a grade one recommendation by WHO.

Screening of adults with hypertension has also been found to be important and both have gone a long way in preventing early onset of those at risk and early diagnosis and prompt treatment.

These have been confirmed to drastically minimize mortality and concomitant morbidity with high improvement in the quality of life for those diagnosed.

CONCLUSION:
Diabetes mellitus is a medical condition whose permanent drug cure has not yet been proved but routine screening of asymptomatic adults and adolescents at risk which leads to early diagnosis and subsequently prompt and regular management with life style changes, exercise, diet, orthodox medicine and alternative medicine has gone a long way to preserve quality of life as well as drastic reduction of mortality and concomitant morbidity in the obedient patients.

Thank you and God Bless.