Diabetes Diagnosing, why early?

I had spent 60 years in India till I came to this Island recently, I used to hear that India has been pronounced as diabetic capital of the world. This was almost authentic, coming from various medical organizations at national and international level. It is estimated to between 10 to 15% incidence in urban areas. If we take the absolute figures out of the 1 billion and odd population, it is definitely number one in the world. I do not know whether we should be proud of this dubious distinction.

After coming over here, I have seen few things very obvious. Entire cultivable land is filled with sugar cane and nothing but sugar cane. People are very disciplined, and at the same time fun loving. It is a five day working week and after 4 pm you cannot expect any body to work, it is even difficult to find shops open. The incidence of diabetes here is between 20 to 25%. It is unbelievable! Is there any connection between Ubiquitous presence of sugar cane and extremely high incidence of diabetes.

With this I want to proceed to the next discussion on diabetes.

I know many of you are very keen to know about “How to diagnose Diabetes Mellitus?” But before that, there is this all important question we need to ask first “Why to diagnose Diabetes and why early?”

There are clear and proven advantages to the individual and the family when diabetes is detected at the early stage. Even before Diabetes manifests in some form, or before the body gives us signals about the presence of this disorder, we stand to be at advantage, if we take pro active steps towards diagnosing early.

Almost all chronic diseases like Diabetes Mellitus, Hypertension, Heart disease, Cancers etc run sub clinically for quite some time before our body sends out signals or show early symptoms. By that time it may be late to achieve control and by then, our body would have had some damage done already.

If we look at the major contributing factors for diabetes, we can point fingers at obesity, hypertension, stress and other modern lifestyle activities. Plus, a very important factor being family history. If a person has a family history of diabetes, with parents or grand parents known to be diabetic, he or she is a potential diabetic. It means he or she can become a diabetic any time.

Being a potential diabetic and not taking measures to prevent, is like detecting the presence of a rat in the house only after the riot. We need not wait till the damage is done, to start corrective measures.

Which is why we should diagnose / detect or look for the presence of Diabetes at early stage. Early detection can be easily done through periodic or annual check up. Through regular and periodic checks, the earliest warning signals can be detected so that steps can be taken by that potential diabetic to postpone or prevent the occurrence.

Hence there is a great need for regular Annual health checks for all the people above 30 years of age.

But on the other hand, although diabetes is believed to be genetic, there is no guarantee that it cannot occur in other individuals. Because of the high and increasing incidence of Diabetes among all the populations of the world. Nowadays it is seen to occur in individuals where it is not known to be in the family.

As we already saw, below are the Types of Diabetes:

1. Type 1 Diabetes/childhood Diabetes/Insulin dependent Diabetes
2. Type 2 Diabetes/Adult Diabetes/Maturity onset Diabetes in young (MODY).
3. Gestational Diabetes-that occurs only during pregnancy.

I would be talking more about how to Diagnose - Type II / Adult Diabetes / "Maturity onset Diabetes in young" and its nature.

Classical symptoms:
Poly urea – frequent urination
Poly phasia – frequent hunger
Poly dypsia – frequent drinking (Excessive thirst)

By the time these classical symptoms appear, it is very sure the diabetes must have established in the body and some organs must have been damaged already.

Apart from the above, you can also look out for these are other symptoms & Signs:

Giddiness, tingling and numbness in the palm and soles, itching in some parts of the body, loss of weight, gaining weight, lung infections especially tuberculosis, fungal infections in the female genitalia, itching and fissures in the tip of the skin of male genitalia, any wound in the body not healing in time, blurring of vision and diminishing vision.

Some other signs & symptoms :- That like symptoms one may notice fatigue, weakness and loss of appetite, Red swollen and tender gums, gum infections, loosening of teeth and infections in the mouth.

Among some sections of Indians, there is a belief that if there is tingling in the palms, they are going to get some money, but infact it may be the hint given by the body to indicate that he a diabetic.

Diabetes has no racial or religious or regional discrimination or sexual discrimination but ladies have an additional risk of becoming diabetic during pregnancy (Gestational Diabetes) Also the dietary habits of certain regions makes the inhabits prone to diabetes sooner than others. For example people who have excessive consumption of Tapioca, are at higher risk of developing the disorder than others.

But let me again reiterate, Diabetes is not a disease, but a metabolic disorder. If one gets awareness and knows how to prevent, it can be controlled.

Now that we know that the sub clinical diabetes can slowly damage almost all the organs of the body, we can be sure our body will give out hints or signals about the imminent occurrence of the overt Diabetes.

But in our so called fast life, we tend to ignore these symptoms and some times hush them with self medications.

During my collage days, there was a saying among the medicos, “If one knows fully about syphilis, he knows full medicine”.

But now that the incidence of syphilis has almost come down to zero, the saying is applicable to Diabetes.
We can confidently say that “If one knows fully about Diabetes, he knows full medicine”.

Because the diabetes affects all systems of the body and spares nothing. It affects the family system and social system also.

And, I used to say that “A diabetic should know more than what a doctor knows about diabetes”
It means a Diabetic should ultimately become a doctor whether a doctor becomes a Diabetic or not, for better living.

In the coming sessions, we will see about how to clinically diagnose diabetes.

Source: Written for Spice your Life, by Dr. Nagarathnam Jetty, MBBS,DPH,DIH,FIAOH.