1. Is diabetes fatal?
Diabetes is a progressive condition. That makes it difficult to track the disease from the beginning. It is not easy to revert to a normal condition once the disease starts yet a patient can lead a healthy life for a long time thanks to proper treatment. This long-term disease could lead to several complications in various stages. Diabetes is never fatal if you identify the complexities and seek timely treatment. In the absence of treatment, the disease can affect multiple organs and lead to death. There is no room for concern if diabetes is treated in time.
2. Does sweet consumption trigger diabetes?
Eating a lot of sweets alone cannot lead to diabetes. There has to have other conditions leading to the onset of the disease. For instance, a person with a family history of diabetes can aggravate his condition if he consumes a lot of sweets and becomes overweight. Sweets are high in calories in poor in fibers. This increases the possibility of adding weight. Overweight persons tend to skip physical exercises. So cutting down on sweets is a good idea.
3. Why should a diabetic reduce sweet intake?
The carbohydrates in our food is converted to glucose before entering our blood stream. The main carbs in sweets are glucose, lactose and sucrose. Glucose is directly absorbed into the blood. Sucrose and lactos are converted to glucose before they are absorbed. That is the reason for the sugar level in blood to go up as soon as we eat something sweet. Diabetes patients are unable to regulate the sugar in their blood because they do not produce enough insulin. Diabetics should stay away from sweets that are easily digested.
4. Can a diabetic eat wheat products?
When you eat any food made of wheat, the conversion of glucose happens slowly and gradually, giving your system enough time to process the sugar level in the blood. That is why diabetes patients are advised to eat a lot of food with complex carbohydrates that are not easily broken down. They also need a lot of fiber in their food.
5. What is Type 1 diabetes?
The ordinary diabetes is called Type 2 diabetes. Type 1 diabetes is seen in children whose pancreas ceases to produce insulin. This could happen anytime between 1 and 20 years. These make up 2 to 4 percent of all diabetes cases reported in Kerala. This is not genetic. The patients may not be overweight. They might need insulin injections through their lives. If they are not assured of enough insulin, they might be pushed to a fatal condition known as diabetic ketoacidosis. They might need insulin injection two to four times a day. They could be assured of a usual life and normal level of growth with insulin supplementation.
6. What is Type 2 diabetes?
Diabetes in adults is mostly Type 2. Though genetic, the disease sometimes advances due to many favorable factors. Children with diabetes history from both father’s and mother’s families, are at a high risk of getting the disease if they become overweight due to overeating and a lack of physical exercise. Insulin resistance and insulin deficiency cause Type 2 diabetes. The best way to deal with the disease is to change your lifestyle, avoiding high-calorie high-sugar food and increasing the intake of fiber-rich food. Better to exercise 30 to 40 minutes per day.
7. Do ants feed on a diabetic’s urine?
A diabetic’s urine may contain sugar once the level reaches 180 milligram. At that stage, the urine may attract ants. Some people realize that they are diabetic when they see the ants but that cannot be considered a reliable measure because even some kidney diseases could cause an increased level of sugar in urine. You have to test the sugar level in the blood to diagnose diabetes.
8. Can diabetes be controlled by lifestyle changes?
Not all Type 2 diabetes can be controlled by changes in lifestyle. Some patients might require medicines such as metformin and glitazone that increases insulin production. They might also need glibenclamide (Daonil), glimipiride (Amaryl) or even insulin shots. Hypertension and cholesterol have to be kept in check.
9. Can diabetes be diagnosed and treated by sugar test?
Blood sugar level has to be analyzed to diagnose diabetes and recommend the proper treatment. If the “fasting sugar” is above 126 mg and “non-fasting sugar” is above 200, he can be safely assumed to be diabetic. A more accurate test is Hb Alc, an average test of sugar levels over three months. A reading of 6.5 or more belongs to a diabetic.
10. How to detect prediabetes?
Prediabetes is a condition in which the blood sugar level is above normal but not enough to be called diabetic. If fasting sugar is between 111 mg and 125 mg and non-fasting sugar between 141 mg and 199 mg, it could be prediabetes. There are two varieties of this stage. If the fasting sugar is between 111 mg and 125 mg, the condition is called impaired fasting glucose. If the non-fasting sugar is between 141 mg and 199 mg, it is called impaired glucose tolerance. The prediabetes stage could be either of these or a combination of the two.
11. Is the prediabetic stage dangerous?
During the prediabetes stage, chances are high for fat to get accumulated in the arteries. That could increase the chances of heart diseases. So blood sugar and cholesterol should be firmly kept in check to prevent any heart diseases. Blood pressure should also be controlled. In the absence of any precautionary measures, one in three prediabetic people proceed to be diabetics. One of them will continue to be in the prediabetes stage while the other one becomes normal again. Up to 80 percent of people in prediabetes stage can be brought back to normal blood sugar levels with proper treatment.
12. Is it safe for a diabetic to become pregnant?
Nothing stops a diabetic woman to become pregnant. If she controls her blood sugar level before conceiving, chances are high that she will give birth to a healthy baby. This is applicable to Type 1 patients as well. Diabetes patients should strictly control the blood sugar levels before conceiving. There are prepregnancy clinics in several countries to ensure this.
13. How to save an unborn baby from gestational diabetes?
There are two kinds of diabetes that appear during pregnancy. One is genetic Type 2 diabetes. This will last even after the pregnancy. The other kind, gestational diabetes mellitus (GDM) appears first during pregnancy and goes away six weeks after delivery. To diagnose GDM, a GIT test is done by giving the patient 75 grams of sugar. A reading of 95 mg fasting sugar, 180 mg sugar after an hour or 155 mg sugar after two hours is a clear indication of GDM. The GDM, if not kept under check, could affect the baby’s growth and organs. This could even lead to diseases or deformities later.
14. How to prevent prediabetes?
Diabetes could be kept at bay if treated at the prediabetes stage. This is your golden opportunity to win the fight against diabetes. The main strategy is to control your diet and do regular exercise. You have to cut down your food intake, especially sweets and fried items. At least half an hour of exercise is a must. These simple changes in lifestyle can save 65-70 percent of people in the prediabetes stage from advancing to diabetes. Medicines such as metformin have been proved effective in the prediabetes stage as well. Acarbose drug has saved 50-60 percent of people from advancing to diabetes, studies show.
15. Is insulin injection effective to treat gestational diabetes?
As far as gestational diabetes is concerned, the mother and baby will be safe as long as the fasting blood sugar is kept below 95 mg and the sugar level is kept below 130 mg after two hours. The mother has to be tested six weeks after the delivery to make sure that she is free from GDM. Injecting insulin is a crucial step in keeping GDM under check, apart from diet control. Oral pills are being tested for the condition but no conclusive data is out yet.
16. Does a newborn’s weight point to chances of diabetes?
About 10 percent of babies who weighed less than 2.5 kg at birth are more likely to have Type 2 diabetes when they become adults. The babies who weighed more than 4 kg are also more likely to have diabetes when they grow up. If a diabetic mother gives birth to an underweight or overweight baby, it suggests that her treatment was not effective.
17. Can diabetes be diagnosed without examination?
A blood test is inevitable to diagnose diabetes. However, some symptoms could also point to the existence of the disease. Excessive thirst and frequent urination should be a concern. If a person has been losing weight rapidly, it is better to subject him to a test. Itching and fungal infection in the private parts are another symptoms. But the disease can only be confirmed after a blood test.
18. Should I tell the others if I have diabetes?
Definitely. Diabetes patients are prone to hypoglycemia, a condition in which the blood sugar level is decreased uncontrollably. They might show symptoms like blurred vision, dizziness, shaking, palpitation, headache and fits. Blood sugar level drops because of a change in food habits, unusual physical exertion, skipping meals after consuming insulin or medicines, or overdosing medicines. A diabetes patient can be assured of immediate treatment only when the people around him are aware of his condition. Type 1 diabetes patients on insulin treatment definitely need to let the others know he is on medication. Children’s condition should be made known to school authorities and close friends.
19. Does high blood pressure and cholesterol reasons for diabetes?
No one can be a diabetic only because he has high blood pressure and cholesterol but all three conditions stem from the same circumstances. A person who has one condition is likely to have the other two. When all these three happen together, it is called metabolic syndrome, whose root cause is the dysfunction of insulin. If you have high blood pressure and cholesterol, you are more likely to have diabetes. So better to regulate your diet and exercise to keep you from adding weight.
20. How does overweight contribute to diabetes?
Overweight is a major cause of Type 2 diabetes. Overweight persons are less likely to do exercise. They tend to eat high-calorie food. Because of the excess fat, their body will have free fatty acid. A lack of exercise contributes to insulin resistance. When the resistance increases, the mechanism to regulate glucose is hampered and the chances of diabetes are increased.
21. When am I most susceptible to diabetes?
Type 1 diabetes is more likely to start when sexual changes happen, say between 11 and 14 years of age. Type 2 diabetes is more likely to start when a person ages. However, women who are more prone to diabetes may get the disease during pregnancy. Type 2 diabetes can show up during the time of chronic illnesses or heart attack. It can also be triggered by cortisone.
(Dr R V Jayakumar, professor, endocrinology, AIMS, Kochi)