The early Signs of Diabetes Mellitus
WITH TODAY’S MORE SEDENTARY LIFESTYLES AND STRESS LEVELS AT AN ALL TIME HIGH, IS IT ANY WONDER THAT DIABETES MELLITUS IS BECOMING INCREASINGLY COMMON? HEALTH TAKES A CLOSER LOOK AT THIS DILEMMA AND FINDS OUT HOW YOU CAN UNDERSTAND THE VERY EARLY SIGNS OF DIABETES AND TREAT THE DISEASE ACCORDINGLY.
WILLIAM KEYSTONE FROM DUBAI SAYS HE NEVER DREAMED HE WOULD BECOME A DIABETIC AND WAS SHOCKED WHEN THE DOCTOR TOLD HIM HE NEEDED TO BE ON MEDICATION TO CONTROL THE PROBLEM. HE SAYS, “I DO LEAD A SEDENTARY LIFESTYLE DUE TO MY WORK. I SIT FOR HOURS IN MY DESK CHAIR AND GET UP ONLY TO TAKE A BREAK OR HAVE A SNACK. I ADMIT MY DIET IS ALSO NOT AS HEALTHY AS IT SHOULD BE; BUT WHEN I STARTED SUFFERING FROM FATIGUE AND EXCESSIVE THIRST, I CHALKED IT DOWN TO BEING OVERWORKED. NOW I FEEL LIKE I NEED TO SHIFT MY LIFESTYLE ENTIRELY…”
What it is
Diabetes mellitus or DM, defines Dr. Shaikh Altaf Basha, Professor and Head of the Department of lnternal Medicine, is a group of metabolic diseases in which a person has high level of blood sugar, either because the pancreas does not produce enough insulin or because the cells do not respond to the insulin that is produced. He tells that there are essentially three main types of DM; “One is Type 1 DM which results from body’s failure to produce insulin,” he says and this form was previously referred to as insulin dependent diabetes mellitus or juvenile diabetes. “The second type is Type 2 DM which results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency,” he says and this form was previously referred to as non-insulin dependent (NIDDM) or “adult onset diabetes”. And finally, the third main form Gestational Diabetes occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of type 2 DM.
You may discover you have diabetes mellitus from some early symptoms of the disease if you recognize the symptoms. According to Dr. Basha, the early symptoms of untreated diabetes are related to elevated blood sugar levels and loss of glucose (spillage of sugar) in the urine. “High amounts of sugar in the urine cause increase urine output (polyuria) and leads to dehydration,” he says and dehydration causes increased thirst and water consumption (polydipsia), and dryness of mouth and throat. “Other symptoms include frequent passing of large amounts of urine (polyuria), getting up frequently in the night to pass urine (nocturia), tiredness, fatigue, lethargy, and/or weight loss despite good appetite,” he says. “Also included is blurring of vision, change in the power of lenses, itching in the genitalia (pruritus vulvae), hyperphagia, predilection for sweet foods and/or mood changes, irritability, difficulty in concentration and apathy.” In fact, having diabetes and not knowing it can be dangerous. “Several well designed clinical trials involving large number of diabetes have shown that good control of blood sugar in a diabetic shows the disease progression significantly lowers micro vascular complications such as involvement of retina, kidneys and heart,” he says.
Unfortunately, Dr, Basha says that people can have diabetes and not even be aware of it. “This is especially true of type 2 DM,” he says as it takes several years—around four to seven years–before the typical symptoms develop. “However, this can be checked by regular screening of all the vulnerable groups for diabetes,” he says.
Rates of diabetes are increasing worldwide, points out Dr. Basha. “One important reason for this is increase in obesity,” he says while other reasons are decreased physical activity, adoption of Western lifestyle, change in food habits, lack of exercise, increased facilities for checking blood sugar and so forth. “The cause of diabetes appears to involve complex interaction between environmental and genetic factors,” he says and it is presented that the disease develops when a diabetogenic lifestyle is superimposed on a susceptible genotype. “This lifestyle includes excessive caloric intake as in an excessive consumption of carbohydrate rich junk foods, fast foods, an inadequate caloric expenditure such as sedentary lifestyle, and/or obesity,” he says.
While the genetic factors cannot be modified, the environmental factors can be tackled to some extent in helping prevent the onset of diabetes, says Dr. Basha. “One way is to be sure to maintain ideal body weight of a BMI 25 or less,” he says and another way is to eat a well-balanced food and avoid energy rich foods, fast foods and junk foods. And aim to partake in regular exercise and avoid a sedentary lifestyle. “Also screen the first degree relatives of diabetic patients,” he says. “Educate yourself and others about diabetes, its complications and management.”
Strictly follow the dietary measures as prescribed by my physician or nutritionist
- Stick to the medications as prescribed by my physician.
- Periodically check your blood for sugar control, for lipid levels and attend regularly the diabetic clinic/physician for follow up.
- Exercise regularly and remain physically active.
- Learn to monitor blood sugar by yourself using a glucometer under the guidance of my physician.
Who Should be Screened?
Screening for Type 1 DM:
- Screening asymptomatic low risk individuals – not recommended
- High risk individuals ( those who have first degree relatives with type 1 DM – should have annual screening for anti-islet antibodies before the age of 10 year along with one additional screening during adolescence
For type 2 DM indications for diabetic screening include:
- People with sustained blood pressure of >135/80mmHg
- Overweight Individuals
- People with first degree relative with type 2 DM
- ADA recommends screening at age 45 in the absence of the above criteria