We will not sugar-coat this, because we are talking about diabetes. He is what you need to know about diabetes.
Diabetes mellitus, commonly referred to as diabetes, is a chronic metabolic disease that is characterized by high levels of sugar (glucose) in the blood. This can be due to lack of the hormone insulin, or the body’s inability to effectively use the insulin.
Quick facts about diabetes:
- It is one of the “big four” non-communicable diseases alongside cardiovascular diseases, chronic obstructive respiratory diseases and cancer.
- The World Health Organization estimates that 3.3% of Kenyans suffer from Diabetes, and predicts a rise to 4.5% by 2025. These numbers are estimates because the majority of the cases are undiagnosed in the country, as the Kenya Diabetes Management and Information Centre states that 1 in 2 people with diabetes is undiagnosed. According to the International Diabetes Federation, there are about 552,400 adults in Kenya living with diabetes today.
- Uncontrolled/ poorly controlled diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, nerves damage and legs amputation.
Types of diabetes:
There are three major types of diabetes based on their causes: type 1, type 2 and gestational diabetes. There are other specific types due to other causes.
Type 1 diabetes: It occurs mostly in childhood but may occur at any age. It is characterised by the destruction of insulin-producing cells in the pancreas. It accounts for about 10% of all diagnosed cases.
Want a diabetes joke? What did type 2 diabetes say to type 1? “you are so juvenile.”
Type 2 diabetes: It is the most common type diagnosed in adults, and accounts for about 85% of all diabetes cases. It is characterised by insulin resistance by the body cells, and or a progressive decline in insulin production by the pancreas.
Gestational diabetes: This is high blood glucose levels during pregnancy that disappears after pregnancy. It poses risks to the mother and foetus during pregnancy, and the mother remains at risk of developing type 2 diabetes later in life.
Type 2 diabetes
This is the most common type of diabetes in the population. It is characterised by progressive insulin resistance and a decline in insulin production, leading to the high levels of sugar in the blood, called hyperglycaemia.
The insulin hormone is produced by the beta cells in the pancreas. Its main action is to lower the blood sugar levels. It is produced after meals and causes cells to take up glucose for their energy production. It also causes the liver cells to store excess glucose as glycogen and fat cells to store fat. Without insulin most body cells cannot take up glucose from the blood, keeping the blood glucose levels within the normal levels.
Body cells become resistant to insulin through different complex mechanisms, and this causes the pancreas to produce more insulin as a compensatory mechanism. The pancreatic cells then gradually wear out and the insulin production declines.
Risk factors for type 2 diabetes.
You may have heard this joke: “Jack has 50 sweets. He eats 20 sweets. What does he have now?” “Jack has diabetes”. This is pegged on the line that taking sugar will cause diabetes. This, however, is a half-truth. Eating high amounts of sugar may cause you to be overweight, which is a risk factor, and not a direct cause of diabetes.
The risk factors are a combination of one’s genetics and lifestyle. They include:
- A family history of diabetes type 2.
- An unhealthy diet.
- Physical inactivity
- Tobacco use
- Increasing age
- Impaired glucose tolerance, or pre-diabetic states. This is blood glucose levels higher than normal but below the level necessary for a diabetes diagnosis.
- History of gestational diabetes
What are the symptoms of diabetes?
The main symptoms of diabetes are commonly referred to as the 3 P’s: Polyuria (excessive urination), Polydipsia (excessive thirst sensation), and Polyphagia (excessive, constant hunger). Other symptoms include unexplained weight loss, fatigue, slow healing of wounds, recurrent fungal infections, blurred vision and numbness or tingly sensation of the feet.
Acute complications of the disease may lead to one losing consciousness or going into a coma.
The disease is silent over time and the symptoms appear when the disease is in an advanced state. Routine blood sugar screening will help pick the disease early,
Diabetes Screening and Diagnosis.
1 in 2 people with Diabetes is undiagnosed in Kenya.
The symptoms manifest several years after the onset of insulin resistance. According to the American Diabetes Association (ADA), the average age of type 2 diabetes diagnosis is 45 years. They recommend blood sugar levels screening annually for adults over 45 years of age and in younger patients at a higher risk of developing the disease.
Diagnostic tests are carried out when one has symptoms of the disease, or when the screening tests show high blood sugar levels. They are simple blood tests called random blood sugar test, fasting blood sugar test and oral glucose tolerance tests.