By Chukwuemeka John Amamdikwa
It’s been a long time since I wrote an article for this column but I am sure the other writers have been doing awesome educating you on various diseases and how to manage them. My today’s topic is related to a non-communicable disease that we might be aware of—’diabetes mellitus’. This topic is kind of personal because I have a close family member going through this, and I have witnessed first-hand the effect of excess blood glucose and what it can cause to an individual. It is also important to note that the main cause of diabetes isn’t known and a cure isn’t available, but proper management is key to long life.
So let’s begin…
Diabetes mellitus is from a Greek word meaning sweet urine, this is because it was first discovered by noticing sugar in the urine of the patients suffering from it, but now with better understanding diabetes can be defined as a medical condition in which the pancreas (beta cells) produces, no insulin or insufficient amounts of insulin, or in which the body’s cells fail to respond appropriately to insulin (insulin resistance), leading to persistently high blood glucose level (hyperglycemia). It’s important to note that high blood glucose isn’t diabetes but persistent high blood glucose is, that is even after an 8 hour fast the glucose level in the blood is still high. The normal blood glucose range is generally 5-7mmol/dl or 80-100mg/dl, but after meals the blood glucose level could rise to 11mmol/dl or 185mg/dl.
We generally hear about two types of diabetes but there is a third one, which is also important. The types of diabetes are; Type 1 (insulin dependent), Type 2 (non-insulin dependent) and Gestational diabetes, which can occur during pregnancy. Type 1 diabetes is the most serious type of diabetes because here the pancreas does not secret any form of insulin due to a defect in the in the insulin secreting cells (beta cells), it can occur at any age but two third of most cases starts at a very young age, as young as 9 years old. The cause is still unknown but it can be as a result of genetic predisposition that is it can be inherited, it can also be as a result of environmental assault on the genes of the individual or as result of an autoimmune defect (the body defence cells attacking healthy cells). Type 2 on the other hand is non-insulin dependent, because the pancreas does secrete insulin but it is enough to meet the body general requirements.
This type of diabetes is called adult onset diabetes because it’s most prevalent at an adult age, even though most recently younger individuals have been diagnosed with it because of obesity and inactiveness. Some of the risk factors are obesity, hypertension, increasing age, body cells being insulin resistance, history of gestational diabetes. The other form of diabetes is Gestational diabetes, this type of diabetes can occur during pregnancy, here the insulin being produced is not sufficient for the mother during pregnancy. It should be detected and mange properly to avoid complications. Gestational diabetes usually reverses after pregnancy, but sometimes can lead to type 2 diabetes.
Diabetes can show various symptoms and some of the most common are excessive urination, excessive thirst, excessive water intake, hunger, weight loss (depending on the type). Diabetes could give rise to various complications, most of these complications are not fully understood. They are extremely harmful if not handled and managed properly, some of these complications are high blood pressure which could lead to stroke, heart attack and poor blood circulation, kidney malfunction is another complication and so once this noticed the patient should reduce protein consumption or as being advised by their physician another complication is nerve damage this is dangerous because the patient is prone to injury and poor wound healing, furthermore skin sores if not properly managed lead to death of the cells affected and infection. Sexual dysfunction is also a problem affecting diabetics also not excluding retinopathy.
But diabetes is not a death sentence, if properly managed individuals can live long fulfilling lives, in this article I would be sharing some few dietary and lifestyle changes an individual with diabetes can carry out to stay healthy and fit. Patients with diabetes must know when to eat, how to eat, what to eat, how much to eat, and stay physically active, this would help the patient be in control of blood glucose, fat and pressure levels and in general make the patient feel good and stay healthy.
The first point to note is that glucose is not the enemy but not knowing your blood glucose level and maintaining a balance is. Glucose is the most preferred source of energy to the brain and the red blood cells can only survive on glucose and nothing else, so it is very important in the body. So how should glucose be consumed, well food which have low glycermic index, mostly carbohydrate food rich in fibres example whole grains, vegetables and fruits have shown to be a good source of glucose, while still lowering the blood glucose levels, helps control appetite and delays hunger and prevents most common diseases related to diabetes like coronary heart diseases, obesity and so on. A good nutritionist should help designs ones diet using the glycermic index.
So now let’s talk about protein, protein used to be believed to be taken to reduced blood glucose level but this has be found out not to be true and the effect of a food on blood glucose won’t be changed whether or not protein is present in the food. Good sources of protein are fish, yogurts, nuts, dry beans, eggs etc. Proteins are useful for body building and tissue repair and they make up the body enzymes. It is recommended that proteins accompanied with saturated fat or cholesterol should be avoided, also to eat one or two low-fat vegetarian meal a week and one or two fish meal to reduce cholesterol in the blood. Kidney problems are associated with diabetes so if this problems arises, the protein intake should be reduced to 10% of calorie intake.
Most with diabetes tend to eliminate to all fats but this is wrong because their some essential fats needed by the body because it cannot produce them (linoleic acid and arachidonic acid) instead there should be a decrease in saturated fat. The best form of fats to take are mono-saturated or polysaturated fats like olive oil, sunflower oil and so on also increase the intake of High Density Lipoprotein (HDL) cholesterol. Blood fat level test should be done regularly to be on track. Fats calorie intake should be 7-10%.
Minerals and vitamins are important for diabetics but research is yet to show that they reduce blood glucose levels, however it is some required minerals and vitamins for diabetics are, magnesium, chromium, folate, iron, zinc and niacin. Sodium levels in diabetics should be watched because of its high relationship with the increase in blood pressure.
Lifestyle changes cannot be overstressed in diabetics particularly in type 2 as this supports nutrition. Staying active is a powerful tool in caring for ones diabetes especially people with type 2 diabetes “Most do”. Its part of the treatment plan for diabetes type 2 because it helps improve blood glucose levels, reduce insulin resistance, promotes weight loss and weight maintenance. It should go hand in hand with your food plan, proper diet with physical activity makes one in control of its diabetes. An activity plan should be created, making commitment, select doable activity, select a time. Glucose levels should be checked during exercise or activities to prevent hypoglycemia (low blood glucose level). Also life style changes should include proper care to prevent ulcers in part of the body.
A lot of has been said in this article to better understand diabetes and managing it, but what’s most important as a diabetic or someone looking after a diabetic is that life style and diet changes are compulsory and monitoring your glucose levels helps you stay healthy and leave a beautiful life.