Diabetes is a chronic or long-lasting health condition that affects how your body turns food into energy. It is a common ailment among many today. Your body breaks down most of the food you eat into sugar (glucose) and releases it into your bloodstream.  When your blood sugar goes up, it signals your pancreas to release insulin. We had a chat with Dr Shehan Silva, a Consultant Physician with a special interest in Geriatrics and a Senior Lecturer in Medicine on Diabetes.

Q CAN YOU GIVE A BRIEF DESCRIPTION AS WELL AS SAY WHAT CAUSES DIABETES?

Diabetes is the black death of modern times. It is a longstanding metabolic disorder characterized by high blood sugar levels over a prolonged period. There are mainly two types: Type 1 and Type 2.

1. Type 1 Diabetes: It is a condition where the immune system attacks (autoimmunity) and destroys insulin-producing beta cells in the pancreas. Without insulin, cells cannot absorb sugar (glucose) properly, leading to high blood sugar levels. The exact cause of Type 1 Diabetes is still not fully understood, but genetics and environmental factors like viral infections might play a role.
2. Type 2 Diabetes: This is the most common form of Diabetes, typically occurring in adulthood. In type 2 Diabetes, the body becomes resistant to insulin or does not produce enough insulin to maintain normal glucose levels. Risk factors for type 2 Diabetes include obesity, sedentary lifestyle, genetics, and certain medical conditions. Both types of Diabetes can lead to serious complications if not managed properly, including heart disease, stroke, kidney damage, nerve damage, and vision problems. Management usually involves lifestyle changes (diet, exercise) and, in some cases, medication or insulin therapy.

Q WHAT ARE THE FIRST SIGNS THAT SOMEONE IS DIABETIC?

The signs and symptoms of diabetes can vary depending on the type and the individual. However, some common early signs and symptoms include:

1. Frequent Urination: Excessive urination, especially at night is a common symptom. This occurs because the kidneys are working to filter and absorb excess sugar in the blood.
2. Increased Thirst: Excessive thirst (polydipsia) often accompanies frequent urination. Dehydration resulting from increased urination prompts the body to signal for more fluid intake.
3. Unexplained Weight Loss: Despite eating more than usual, some individuals may experience unexplained weight loss. This is because the body can’t utilize glucose properly, so it starts breaking down fat and muscle tissue for energy.
4. Fatigue: Feeling tired or lethargic is a common symptom of Diabetes. Without adequate glucose entering the cells, the body’s energy levels drop.
5. Blurred Vision: High blood sugar levels can cause fluid to be pulled from the lenses of the eyes, affecting their ability to focus properly, and resulting in blurred vision.
6. Slow-Healing Sores or Wounds: Diabetes can affect blood circulation and impair the immune system, leading to slow healing of cuts and bruises.
7. Frequent Infections: High blood sugar levels can weaken the immune system, making individuals more susceptible to infections, especially yeast infections (such as thrush)  in women.
8. Sexual Problems: These include issues such as impotence, premature ejaculation, and loss of libido, which people may be silently suffering from.

It is essential to note that these symptoms can develop gradually and may not be immediately noticeable. If you or someone you know is experiencing these symptoms, it is crucial to consult a healthcare professional for proper diagnosis and management. Early detection and treatment can help prevent complications associated with Diabetes.

Q WHAT ARE THE DIFFERENT STAGES OF DIABETES?

Diabetes does not have distinct stages like some other diseases, but it does progress over time, and its management may change accordingly. However, we can broadly discuss the progression and management of Diabetes:

1. Pre-Diabetes: This stage occurs before a diagnosis of Type 2 Diabetes. Individuals with pre-diabetes have blood sugar levels higher than normal but not high enough to be diagnosed with diabetes. Pre-diabetes increases the risk of developing Type 2 diabetes, but lifestyle changes such as diet and exercise can often prevent or delay its onset.
2. Type 2 Diabetes Diagnosis: Once blood sugar levels reach a certain threshold, a diagnosis of Type 2 Diabetes is made. At this stage, lifestyle modifications such as dietary changes, weight management, and increased physical activity are typically recommended. Some individuals may also require oral medications to help manage blood sugar levels.
3. Progression of Type 2 Diabetes: Over time, if Type 2 Diabetes is not adequately managed, blood sugar levels may continue to rise. This can lead to increased reliance on medications, including insulin, to control blood sugar levels.
4. Complications: If Diabetes is not managed effectively, it can lead to various complications affecting different parts of the body, including the eyes, kidneys, nerves, and cardiovascular system. These complications can range from minor to severe and may significantly impact a person’s quality of life.
5. Type 1 Diabetes Management: For individuals with Type 1 Diabetes, the progression involves ongoing management with insulin therapy, blood sugar monitoring, and lifestyle adjustments. While there may not be distinct stages in the progression of type 1 Diabetes, the goal of management is to maintain stable blood sugar levels and prevent complications. Throughout Diabetes, regular monitoring, adherence to treatment plans, and lifestyle modifications are essential for managing the condition effectively and reducing the risk of complications.

Q CAN YOU MENTION HIGH DIABETES-INDUCING FOODS  IN ADULTS?

1. Sugar-Sweetened Beverages: Regular consumption of sugary drinks like aerated beverages/ soda (high fructose content), sweetened tea, and energy drinks can lead to weight gain and elevated blood sugar levels.
2. Candy and Sweets: Foods high in refined sugars like candies, chocolates, and pastries can cause rapid spikes in blood sugar levels.
3. Processed Snack Foods: Many processed snack foods like chips, crackers, and cookies are high in refined carbohydrates and sugars, which can impact blood sugar control.
4. White Bread and Pasta: Foods made from refined grains, such as white bread, white rice, and pasta, have a high glycemic index, causing quick spikes in blood sugar levels.
5. Fried Foods: Fried foods like French fries, fried chicken, and fried snacks are high in unhealthy fats and can contribute to insulin resistance and weight gain.
6. Fruit Juices: While fruit juices contain vitamins and minerals, they are also high in natural sugars (i.e. fructose) and lack the fibre found in whole fruits, leading to rapid increases in blood sugar levels. 
7. Alcoholic Beverages: Excessive alcohol consumption can disrupt blood sugar levels and increase the risk of developing Type 2 Diabetes.
8. High-Fat Dairy Products: Some high-fat dairy products like full-fat milk, cheese, and ice cream can contribute to insulin resistance and weight gain when consumed in large amounts.
9. Sweetened Breakfast Cereals: Many breakfast cereals are high in sugar and refined grains, leading to rapid spikes in blood sugar levels.
10. Sweetened Yoghurts: Flavoured yoghurts often contain added sugars, which can negatively impact blood sugar control. 
11. Packaged Snack Bars: Many packaged snack bars marketed as healthy options can be high in added sugars and refined carbohydrates.
12. Honey and Treacle: While natural sweeteners like honey and treacle may seem healthier, they still contain high amounts of sugar and can impact blood sugar levels.
13. Dried Fruits: Dried fruits such as dates are concentrated sources of sugar and can cause rapid increases in blood sugar levels when consumed in large quantities.
14. Sugary Condiments: Condiments like ketchup, barbecue sauce, and sweet chilli sauce often contain added sugars, contributing to higher blood sugar levels.
15. Processed Meats: Processed meats like bacon, sausage, and deli meats often contain added sugars and unhealthy fats, which can increase the risk of insulin resistance and Diabetes when consumed regularly.

It is important to note that while these foods can contribute to high blood sugar levels and increase the risk of Diabetes, moderation is key. A balanced diet that includes plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats is essential for maintaining optimal blood sugar control and overall health.

Q CAN YOU MENTION 10 THINGS TO DO TO  PREVENT IT?

• Promote a Balanced Diet: Offer a variety of nutritious foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit sugary snacks, processed foods, and beverages high in added sugars.
• Encourage Regular Physical Activity: Make physical activity a fun part of daily life by encouraging active play, sports, dancing, or family outings like hiking or biking. Aim for at least 60 minutes of moderate to vigorous activity each day.
• Limit Sedentary Time: Reduce screen time, including TV, computers, smartphones, and video games. Encourage activities that involve movement and limit sedentary behaviours.
• Promote Healthy Snacking: Provide healthy snack options like fresh fruit, and vegetables with hummus, yoghurt, nuts, or whole-grain crackers. Avoid keeping sugary snacks and drinks readily available at home.
• Model Healthy Habits: Be a positive role model by practising healthy eating habits and being physically active yourself. Children are more likely to adopt healthy behaviours when they see adults around them doing the same.
• Encourage Family Meals: Enjoy meals together as a family as often as possible. Family meals provide an opportunity to model healthy eating habits, bond, and communicate.
• Promote Adequate Sleep: Ensure enough sleep each night according to their age. Establish a consistent bedtime routine and limit screen time before bed to promote better sleep quality.
• Educate About Nutrition: The importance of balanced nutrition, portion control, and making healthy food choices is paramount.
• Regular Health Check-ups: Schedule regular consultations with a doctor for routine check-ups and screenings. Discuss any concerns about weight, nutrition, or physical activity during these visits.
• Foster Positive Body Image: Encourage a positive body image and healthy attitudes toward food and physical activity. Avoid making negative comments about weight or appearance and instead focus on promoting health and well-being.

By Kshalini Nonis