5th year medical student
Diabetes Mellitus (Djabett), alias ‘Sukurr Kurango’ in Mandinka, ‘Febarr Sukurr’ in Wollof, and ‘Nyaw Sukurr’ in Fula. The word ‘Sukurr’ translates to sugar in English, but how is sugar associated with Diabetes? This article answers this question. It also delves into the complications, risk factors and treatment of this disease. Of recent, diabetes has become a prevalent non-communicable disease in The Gambia.
Diabetes is a common condition that affects people of all ages. It is a condition that happens when your blood sugar is too high. Diabetes develops when your pancreas doesn’t make enough insulin or any at all, or when your body fails to respond to the effects of insulin. Insulin is a hormone that facilitates the entry of glucose from the bloodstream in to the tissues and cells.
Types of diabetes mellitus
Type 1: Type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys cells in the pancreas, where insulin is made. This leads to build up of sugar in the bloodstream.
Type 2: Type 2 diabetes occurs when your body becomes resistant to insulin, and sugar builds up in your blood. It is the most common type.
Gestational diabetes: This refers to high blood sugar during pregnancy. Insulin blocking hormones produced by the placenta cause this type of diabetes. Most people who develop gestational diabetes don’t have any symptoms.
Risk factors for diabetes
The following factors contribute to the risk of developing diabetes:
1. Family history of diabetes
2. Disease of the pancreas
3. Obesity
4. Ethnic background, African American at higher risk
5. Old age
6. Hypertension
7. Being overweight before becoming pregnant
8. Having gestational diabetes during a previous pregnancy
9. Giving birth to a baby over 4kg
10. Smoking
Symptoms of diabetes
1. Weight loss
2. Frequent urination
3. Excessive thirst and hunger
4. Weakness and Fatigue
5. Nausea and Vomiting
6. Blurred Vision
7. Delayed wound healing
8. Numbness in the hands or feet
Complications of diabetes
1. Kidney Disease (Diabetic nephropathy)
2. Blindness (Diabetic retinopathy)
3. Heart diseases and stroke. Diabetics are 2 to 4 times more likely to have a heart disease and suffer a stroke.
4. Nerve damage
5. Sores on feet and skin possibly resulting in amputations
6. Diabetic coma due to extremely high blood sugar (hyerglycaemia)
How is diabetes diagnosed?
1. Fasting blood sugar level is the preferred method of determining diabetes in children and non-pregnant adults. Diabetes is diagnosed if blood glucose level is 126mg/dL or higher after an 8-hour fast. Levels between 100-126 mg/dL are considered pre-diabetes, a condition where individuals have high blood sugar but not high enough to be classified as diabetes. Individuals with pre-diabetes have higher elevated risk of developing type 2 diabetes.
2. Hemoglobin A1c Test is a blood test that shows how well you are controlling diabetes. It shows the average level of blood glucose over the previous 3 months.
3. Oral glucose tolerance test is a test to check how well your body breaks down sugar. Diabetes is diagnosed if blood glucose level is 200mg/dL or higher after drinking a beverage containing 75grams of glucose dissolved in water. Gestational diabetes is diagnosed based on blood glucose levels measured during oral glucose tolerance test. Screening for type 2 diabetes in people who have no symptoms is recommended for overweight children, overweight adults who have other risk factors and adults over the age of 45.
Treatment and management of diabetes
Although there is no cure for diabetes, treatment and control of diabetes involves the following:
1. Weight loss
2. Insulin injections
3. Oral medications to lower blood glucose
4. Exercise
5. Constant monitoring of blood glucose through frequent blood glucose tests or self-monitoring equipment such as glucometers.
6. Healthy diets including foods with fewer calories, an even amount of carbohydrates and healthy monosaturated fats. Foods such as wheat, millet, brown rice, eggs, fish, milk, yoghurt, etc.
