Diabetes Diagnosing, why early?

>>  Thursday, March 26, 2009

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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.

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

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An Introduction to Diabetes ~ What is Diabetes?

>>  Monday, March 16, 2009

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I know its been a while since the first article on the introduction and I haven't made any progress with the topics. I am sure with this post, I will progress more in covering most of it.

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

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What is Diabetes?

Diabetes is a metabolic disorder. Metabolism is the way the body uses digested food for growth and energy. Glucose is the end product of our food after all the processes of ingestion, digestion, assimilation and absorption. Which means anything that is consumed, finally breaks down into glucose, the form of sugar in the blood.

Glucose is the main source of fuel for the body and is required for the production of energy. Once digestion is over, next comes the process known as the assimilation. After the digestion process, the glucose that passes into the bloodstream needs to be utilized by cells for growth and energy. To aid the glucose getting into the cells, we require a hormone called the insulin. Insulin is a hormone produced by the pancreas (islets of Langerhans), a large gland behind the stomach.

In normal conditions, the pancreas automatically produces the right amount of insulin required for our body to absorb the glucose. In the diabetics, however, the pancreas either produces little or no insulin and in some cases there is insulin resistance and hence the glucose is not utilized. In that situation, glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine.

Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Before we proceed to know how to diagnose, lets take a brief look at the types of diabetes prevalent.

What are the types of diabetes?

The three main types of diabetes are

* type 1 diabetes
* type 2 diabetes
* gestational diabetes

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease. Humans have a great Immune system to fight infection. But when this system turns against and starts attacking, especially the insulin producing beta cells, it results in type 1 diabetes. When this happens, the pancreas produces little or no insulin. A person diagnosed with type 1 diabetes must take insulin daily to live.

We do not know exactly why and what causes the body’s immune system to attack the beta cells, but they believe that autoimmune, genetic, and other environmental factors, could attribute to this condition.

Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes. We can easily say about 90 to 95 percent of people with diabetes have type 2. The major contributing factors for this form of diabetes is most often associated with older age, family history of diabetes, obesity, history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.

In the case of type 2 diabetes, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. When this happens over a period, insulin production decreases gradually. As in the type 1 diabetes, in type 2 too, glucose builds up in the blood and the body is not able to make efficient use of its main source of fuel.

Gestational Diabetes

Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.

In the coming articles, we will see more about How to diagnose and other facts related to Diabetes.

Though most of it may sound very technical, I have tried writing in a style that can be understood by everybody.

I want everybody who reads this be benefited, to take action and act accordingly!

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Looking forward to your feedback and suggestions.

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