Prevention is better than the cure

It has been said that diabetes is developing into the next western world’s epidemic. As sedentary lifestyles increase (excessive use of TV, Video, Computers etc) it is essential for health professionals to promote the risk factors that can lead to diabetes and target primary health education, rather than tertiary exacerbation’s.
The term diabetes mellitus means ‘the running through of sugar.’
In the first century AD, Aretaeus the Cappadocian described the disorder as a chronic affection characterized by intense thirst and voluminous honey-sweet urine: ‘the melting down of flesh into urine.’ (Porth 1988, p810)
Diabetes is a disorder of diet where carbohydrate, protein and fat are not used correctly by the body as a result from an imbalance between insulin availability and insulin need.
Insulin is used by the body to transport glucose (a by-product of digestion) into cells where it is used for cellular energy. A person with uncontrolled diabetes is unable to transport glucose into fat and muscle cells; as a result, the body cells are starved, and the breakdown of fat and protein in increased.
It is important for health professionals to teach their clients who are at risk, about the signs and symptoms of diabetes for early detection and treatment of the disorder.
The genetic link – if there is diabetes in your family, YOU ARE AT RISK
If you are over-weight, YOU ARE AT RISK
If you eat a high fat, high sugar diet, YOU ARE AT RISK
If you do not exercise, YOU ARE AT RISK
Some of the first signs and symptoms of diabetes include:
Uncontrollable thirst (polydipsia)
When glucose is not being removed by insulin, it accumulates in the blood – this is called hyperglycemia. The body tries to compensate this high concentration by drawing fluid out of the tissues and diluting the high blood glucose concentration - this in turn makes your body feel like it is getting dehydrated, so you drink more.
Excessive hunger (polyphagia)
Insulin is not doing its job by getting glucose into the cells for cellular energy, your body feels like it is being starved so it wants you to eat more to provide more glucose to transport into the cells.
Excessive urination (polyuria)
Because you are drinking more, your kidneys are working overtime trying to process the extra fluid in your body. As it does this, extra glucose can leak through into your urine (glucosuria) making it sweet. If you see ants in your toilet, this can be a first sign of diabetes.
Weight loss, when it occurs for no apparent reason.
Fat and muscle cells are broken down by the body to produce glucose in a time of starvation. When weight loss occurs for no apparent reason (not dieting or exercising), even if you are eating more lately and still loosing weight – this can be a sign.
Excessive unexplained changes in eyesight.
As blood glucose increases the fine arterioles in the retina of the eye may develop small tears, blurry sight can result from focusing through small amounts of blood being leaked into the back of the eye.
Are you seeing your optometrist more often than usual?
If you are experiencing any of these symptoms and are in a ‘AT RISK’ group – please see your doctor for possible diagnosis and early management.
Diabetes Mellitus is a complex disease and includes two types.
Type I diabetes is usually a disorder you are born with or have a tendency to develop early on in life. The body seems to attack the Beta cells of the pancreas which produce insulin, the person is then required to inject themselves with insulin – sometimes several times a day for the rest of their lives.
Most persons with type II diabetes are older and overweight. The extra cells provided by obesity put a strain on the pancreas, and either not enough insulin is produced or the receptor sites of the cells do not allow insulin to transport glucose into the cell.
The modern day take-away diet (high-fat) combined with a sedentary lifestyle has meant that there is an increase in younger people being diagnosed with type II diabetes, which in the past was a disorder of those aged 40+.
The treatment of diabetes includes diet, exercise and in many cases, the use of an antidiabetic agent.
Oral hypo-glycaemics require a functioning pancreas and may be used in the treatment of type II diabetes – to increase insulin production at the site of the pancreas.
Dietary management focuses on maintaining a well balanced diet and controlling weight. By feeding the body on correct amounts of carbohydrate, protein and fat, near normal blood glucose levels can be achieved. Prevention and treatment of chronic diabetic complications is optimum when blood glucose levels are normal.
The benefits of exercise are accompanied by a risk of hypo-glycaemia in the type I diabetic. Exercise uses up glucose as cells work harder to maintain the body at working level. For the type II diabetic, exercise is essential to making the receptor sites (that receive insulin and glucose into the cell) more receptive to insulin.
Diabetes takes a long, debilitating course for which there is no cure – by targeting primary health education we will be preserving people’s quality of life and saving the government/country millions of dollars in the health budget.


References:
Porth 1988, PATHOPHYSIOLOGY – concepts of altered health states,
5th edition, Lippincott, Philadelphia.