Diabetes – a growing concern

According to the World Health Organisation, diabetes is on the rise. No longer a disease of predominantly rich nations, the prevalence of diabetes is steadily increasing everywhere, most markedly in the world’s middle-income countries.

14 November is World Diabetes Day. In South Africa about six million people suffer from this disease – of these 90% are adults and 10% are children. Between 80 and 90% of diabetics in South Africa suffer from Type 2 diabetes. Although there is a hereditary predisposition, it is not a given that offspring of a diabetic will develop the disease.

What is diabetes?

“Diabetes is a chronic disease characterised by high blood glucose values which can cause severe complications in the eyes, kidneys, heart, circulation, nerve endings and brain,” explains Razana Allie, diabetes nurse educator with the Diabetes Association of South Africa.

There are two types of diabetes: Type 1 is when the pancreas, the organ in the body responsible for the production of insulin, fails to produce the hormone. Type 2 diabetes is when the body produces less insulin, and is not able to use the insulin correctly. “Type 1 diabetes is mostly an autoimmune condition,” says Allie. “Type 2 is directly influenced by lifestyle.”

Gestational diabetes usually occurs in the second half of pregnancy. Although symptoms mostly disappear after the birth of the baby, women with this kind of diabetes are at risk of developing Type 2 diabetes later in life.

What causes Type 2 diabetes?

A diet high in sugars, fats and overprocessed food can be a contributing factor to diabetes. There is global concern amongst health care workers about the considerable rise in children presenting with diabetes. A sedentary lifestyle and poor eating habits which cause people to become overweight are cited as some of the main causes for the onset of Type 2 diabetes amongst the young.

Type 1 diabetes is mostly diagnosed in the period shortly after birth to young adulthood, while Type 2 is mostly diagnosed in adults. “However, we are seeing more cases of teenagers (13 years and older) being diagnosed with Type 2, because of unfavourable lifestyles,” says Allie.

Studies have shown that up to 65% of women in certain areas in South Africa are obese, putting them at high risk for becoming diabetic or contracting other lifestyle diseases. The importance of following a balanced diet cannot be overstressed. According to an article in the magazine Diabetes Focus, studies have shown that overweight people who lose 9.8% body weight within a year and a half after being diagnosed with Type 2, were better able to achieve their blood glucose and blood pressure goals.

How is diabetes treated?

Type 1 diabetes is treated with insulin. The patient may need to inject him/herself once, twice or more frequently daily. Type 2 diabetes can mostly be treated by oral medication. In some mild cases a change of lifestyle has helped bring the disease under control. “Efficacy is largely influenced by patient compliance. If instructions are followed carefully, these treatments can be highly effective,” says Allie.

What are the symptoms?

Symptoms of diabetes include blurred vision, extreme thirst, a need to urinate frequently, unexplained loss of weight or weight gain, hunger, loss of libido, and recurring infections. Diabetes can also lead to a loss of sensitivity in the extremities, due to impaired blood circulation. Those suffering from diabetes are advised not to walk barefoot as they might not notice cuts or lacerations to their feet, and if left untreated, the injuries could become infected and, in extreme cases, lead to gangrene.

Testing for diabetes

Blood glucose levels in people who do not have diabetes, are between 3,3 mmol/l and 5,9 mmol/l. Diabetes is diagnosed if the fasting blood glucose level (a blood test carried out after an overnight fast) is higher than 6,7 mmol/l on two separate occasions, or when random tests show levels of more than 10 mmol/l.

It is important for the diabetic to test his/her blood sugar levels frequently. When the blood glucose level rises too high, the patient becomes hyperglycaemic – which can lead to coma. If it is too low, the patient become hypoglycaemic – which can also lead to coma and seizures.

When should one be tested for diabetes? “It is difficult to say when one should be tested, as the symptoms can appear at any time,” says Allie. “The best would be to test immediately when symptoms appear, as well as every three to six months if you know you are at high risk. Doctors could also test patients at each visit, even if the reason for the visit is unrelated to diabetes.”

It might be a good idea to request a blood glucose test when next you visit your GP.

The information and other content provided in this article are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. If you think you may have a medical emergency, call your doctor or emergency services immediately.