Diabetes
Overview of Diabetes Mellitus
Diabetes mellitus (DM) is a metabolic disorder in which blood glucose levels become too high, as the body produces little or no insulin (a hormone produced by the pancreas that aids in the utilization of glucose for energy), or cannot use insulin properly. The disorder has been growing at an alarming
pace not only in the developed countries but also in the developing countries where noncommunicable diseases are rapidly surpassing communicable diseases as the commonest cause of death.
The World Health Organization (WHO) has suggested that over the next two decades, DM in the developing countries will be seen more in the lesser age group ranging from 20 to 45 years.1 India, with a population over 1 billion has the largest number of diabetic patients in the world, (estimated over 32 million in the year 2000) and this figure is predicted to increase to nearly 80 million by the year 2030.1,2
Characterized by chronic hyperglycemia (high blood glucose), long-term DM is associated with damage to various organs such as the nerves (neuropathy), eyes (retinopathy), kidneys (nephropathy) and the heart (cardiovascular diseases). The cornerstone of therapy revolves around disease prevention, motivation toward healthy lifestyle choices and complication surveillance. Education of partner or caretakers is important in maintaining positive lifestyle changes in diabetic patients. Oral hypoglycemic agents (OHAs) are the primary treatment of type 2 DM. Intensive treatment with insulin has been shown to have significant benefits in both type 1 and type 2 diabetic patients.3
Self-Monitoring of BloodGlucose
Self-monitoring of bloodglucose (SMBG) is a componentof effective diabetic management. Through SMBG patients can evaluate theirindividual response to therapy and assess whether glycemic targetsare being achieved. Daily SMBG
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Diabetes Prevention
Recommendations for diabetes treatment and prevention are the following
- Maintain a healthy body weight (body mass index of 20–25 kg/m²).
- Be physically active.
- Eat a healthy and balanced diet—high fiber, whole meal products, more fruits and vegetables (at least 5 portions a day).
- Reduce intake of fatty and sugar-containing foods.
- Consume low-fat dairy foods such as skimmed or semi-skimmed milk.
- Avoid smoking and alcohol intake.
Micro- and Macrovascular Complications of Diabetes
Diabetes significantly increases an individual’s risk of developing multiple microvascular and cardiovascular complications. The long-term microvascular complications of diabetes include retinopathy, nephropathy and neuropathy. Retinopathy can result in loss of vision, therefore early diagnosis of retinopathy is essential as early use of laser photocoagulation may delay and prevent visual loss. This early detection can only be achieved by a program of routine screening.
Nephropathy may lead to end-stage renal disease. The rate of decline in renal function is accelerated by the presence of hypertension. Peripheral neuropathy which is complicating diabetes most commonly affects the sensory and motor nerves of the lower limbs. Neuropathy poses the risk of foot ulcers, limb amputation, neuropathic joint damage, sexual dysfunction and dysfunction of other internal organs such as the stomach, bowel and bladder.
The macrovascular complications of diabetes include atherosclerotic cardiovascular, peripheral vascular and cerebrovascular diseases. Diabetes is a major risk factor for the development of atherosclerosis of the major vessels especially coronary and aorto-ilio-femoral systems. These in turn are the major cause of premature death in people with T2DM. Prevention of the cardiovascular complications is a major goal of current therapeutic policy. Although reduction in macrovascular complications depends on tight glycemic control, modification of other risk factors such as smoking, hypertension and dyslipidemia is also equally important.
Diabetes complications can be avoided and even if they occur, their progress can be prevented through early surveillance and treated. The appropriate approach to treat the diabetic complications is first ensure appropriate implementation of the therapies that can avoid the complications and also to detect the complications at the earliest possible time so that treatment can be initiated.
Living with Diabetes
Quality of life is an important health outcome measurement in T2DM. In addition to medical therapy, social support, health education and psychological care are also required in improving the overall quality of life in diabetic
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Living with Diabetes...
Inspect feet daily for checking for scratches, cracks between toes, blisters, corns, sores, temperature changes, color changes and swelling.Your doctor should perform a foot inspection at each appointment.
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Self care of the feet for Diabetic patients...
Diet for Diabetic Patients
Diabetes is a disorder characterized by abnormalities in the utilization of glucose obtained from the diet. A hormone known as insulin is essential for the effective utilization of glucose and is either present in low amounts or is
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Diet for Diabetic patients...
Role of Insulin in Managing Blood Sugar
Diabetes is a debilitating illness that requires lifelong treatment. The American Diabetes Association has recommended insulin therapy only when medical and/or nutritional therapy fails to maintain the blood glucose
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