Diabetes Mellitus: An overview
A couple of weeks ago I watched an episode of the sitcom Blackish that tackled diabetes. In all of twenty-three minutes, they moved from the male lead being diagnosed to his struggles with accepting his chronic illness, to his refusal to take medications (and resulting complications) and the eventual epiphany and commitment to improving his health, complete with a tiny science lesson and ample doses of comedy. All in all, it was a great episode, and informative in a way so little of what we consume is. The only unfortunate thing is how increasingly necessary it’s becoming to know about it.
According to the World Health Organization, there are over 420 million people in the world with diabetes, an over four-fold increase from the estimated 108 million people only 30 years ago. 8.5% of adults worldwide are living with diabetes currently, and that value is rising rapidly, especially in low- and middle-income countries (yes, us) that previously had a low incidence of so-called “lifestyle-related diseases.” In Ghana alone, over half a million people are currently living with diabetes, an incurable disease they will have to deal with for the rest of their lives.
So what exactly is Diabetes?
Diabetes in the local Twi language is “esikyire yareɛ” which translates literally into sugar disease. But while that basic understanding of what diabetes is can be helpful, it can also be misleading, especially since people equate the sugars being referred to as sweet drinks and snacks, which isn’t only the case.
In fact, a large number of the foods we eat are composed of complex sugars, especially carbohydrates like yam and rice. Excess simple sugars, broken down from the food we eat are stored at various sites in the body under the influence of a hormone called insulin. (still with me?)
Diabetes happens when there’s too little insulin in the body, or the body can’t make good use of the insulin it has, which means the sugars, which are the body’s main energy source are left in the blood. This doesn’t sound too scary right?
Except it is! High levels of sugars in the blood are toxic to almost all the body’s tissues and organs, from the brain to the heart and kidneys and skin and blood vessels and nerves and on and on and on. This leads to widespread organ damage that is sometimes too gradual to notice until you end up in a hospital, which can be years after the disease process starts and a lot of damage has been done.
Types of diabetes
If you’ve heard anything about diabetes, then you’ve probably been told there are two types, creatively named type one and type two diabetes.
Type one is far less common and is described as a genetic autoimmune disease, where the body’s immune system attacks and destroys the cells that produce insulin.
Type two diabetes is way more common, and, thankfully, not as inevitable. In type two diabetes your body makes enough insulin, but your body’s cells can’t detect it well enough, like a blind man in an art museum.
This type of diabetes is strongly linked to unhealthy lifestyle habits like a poor diet and little exercise. A family history is also a pretty strong risk factor, as well as obesity. Type two diabetes used to be reserved for the middle-aged and elderly but the age groups affected keep getting younger and younger, even teenagers. Which means that no matter how old you are, you should keep a lookout.
So how do you keep a lookout?
Well, you can check your sugars. It’s a pretty simple, cheap test you can do if you don’t mind a needle prick every once in a while. This can be helpful if you have a lot of family members with diabetes or other factors which mean you have a high risk of the disease. The problem with blood sugar testing is that it’s a little bit too little too late, and blood sugar values fluctuate widely with food. This is why some patients with diabetes will starve themselves for a full day before going to their doctors to give themselves false low sugar levels that are far from their normal values.
What are some symptoms and signs of diabetes to look out for?
- Increased thirst
- Frequent urination
- Extreme hunger
- Unexplained weight loss
- Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin)
- Blurred vision
- Slow-healing sores
- Frequent infections, such as gums or skin infections and vaginal infections
So what is the best way to deal with diabetes and prevent complications?
Avoid it! The best way to deal with diabetes is not to get it.
How do you do that? We will discuss that in our next post here on thetropicalmd