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World Diabetes Day 2021: Effective Management of Diabetes

Diabetes mellitus is a metabolic disorder in which the body does not produce enough insulin (Type 1 Diabetes) or respond normally to insulin (Type 2 Diabetes), causing blood sugar (glucose) levels to be abnormally high.

According to experts, an estimated 463 million people worldwide suffer from diabetes, with Type-2 diabetes making up about 90 per cent of the cases. In 2019, diabetes was the 9th leading cause of death with an estimated 1.5 million deaths directly caused by diabetes. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

Every year, on November 14, the international community commemorates World Diabetes Day to raise awareness and strategies to prevent and treat the disease. The theme for this year commemoration is “Access to Diabetes Care – If Not Now, When?”.  The theme encourages people to be aware of diabetes as a metabolic disorder so that they can benefit from the education on disease and treatment, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. This year also marks the centenary of the discovery of insulin by Sir Frederick G Banting, Charles H Best and JJR Macleod at the University of Toronto in 1921. This scientific achievement changed the lives of millions people living with diabetes. Before 1921, it was very rare for people diagnosed  with type 1 diabetes to live more than a year or two.

Symptoms of Diabetes

The symptoms of high blood glucose levels include

  • Increased thirst (polydipsia)
  • Increased urination (polyuria)
  • Increased hunger
  • Weight loss
  • Blurred vision
  • Drowsiness
  • Nausea and vomiting
  • Fatigue
  • Abdominal pain (Particularly in children)
  • Decreased endurance during exercise

In people with type 1 diabetes, the symptoms often begin abruptly and dramatically. A serious condition called diabetic ketoacidosis, a complication in which the body produces excess acid, may develop rapidly. Symptoms of diabetic ketoacidosis include nausea, vomiting, fatigue, and abdominal pain which accompanies the usual diabetes symptoms of excessive thirst and urination. Diabetic ketoacidosis can progress to coma and death, if left untreated.

People with type 2 diabetes may not have any symptoms for many years before they are diagnosed. Symptoms may begin to develop subtly. Increased urination and thirst are mild at first and gradually worsen over time. Eventually, people feel extremely fatigued, are likely to develop blurred vision, and may become dehydrated. Sometimes during the early stages of diabetes, the blood glucose level is abnormally low at times, a condition called hypoglycemia. Because people with type 2 diabetes produce some insulin, ketoacidosis does not usually develop even when type 2 diabetes is untreated for a long time.

Complications of diabetes

Diabetes damages blood vessels, causing them to narrow and therefore restricting blood flow. Many organs can be affected, particularly the following:

High blood glucose levels also affects the body’s immune system, so people with diabetes are susceptible to fungal and bacterial  infections.

Diagnosis

People with symptoms of diabetes can be screened by measuring the blood glucose level. Diabetes can be diagnosed if fasting blood glucose levels (FBS) are higher than 125 mg/dL. Diabetes can also be diagnosed if a random (not done after fasting) blood glucose level (RBS) is higher than 199 mg/dL (11.0 mmol/L).

Oral Glucose Tolerance Test, may be done to screen pregnant women for gestational diabetes or elderly people who have symptoms of diabetes but normal glucose levels when fasting. In this test, people fast, have a blood sample taken to determine the fasting blood glucose level, and then drink a special solution containing a large, standard amount of glucose. More blood samples are then taken over the next 2 to 3 hours and are tested to determine whether the glucose in the blood rises to abnormally high levels.

Treatment of Diabetes Mellitus

The goal of diabetes treatment is to keep blood glucose levels as close to the normal range as possible because complications are less likely to develop if blood glucose levels are strictly controlled. Experts recommend that people keep their blood glucose levels

  • Between 80 and 130 mg/dL (before meals)
  • Less than 180 mg/dL 2 hours after meals

Lifestyle management

Diet, exercise, and education are the bedrock of the  treatment of diabetes and often the first recommendations for people with mild diabetes. Understanding how diet and exercise affect blood glucose levels, and knowing how to avoid complications is very important in managing the disease. Weight loss is important for people who are overweight. People who continue to have elevated blood glucose levels despite lifestyle changes, or have very high blood glucose levels and people with type 1 diabetes (no matter their blood glucose levels) will require medication.

It is recommended that people with diabetes should stop smoking and consume only moderate or little amounts of alcohol

Use of Medications

  • Kidneys (diabetic nephropathy), causing chronic kidney disease
  • Eyes (diabetic retinopathy), causing blindness
  • Heart, causing heart attack
  • Brain, causing stroke
  • Nerves (diabetic neuropathy), causing decreased sensation in feet

There are many drugs used to treat diabetes. People with type 1 diabetes require insulin injections to lower blood glucose levels. Most people with type 2 diabetes require drugs by mouth to lower blood glucose levels but some also require insulin or other injectable drugs.

Treatment of high blood pressure and high cholesterol levels, which can contribute to circulation problems, can help prevent some of the complications of diabetes as well. A low dose of aspirin taken daily is recommended in people with risk factors for heart disease. All people with diabetes who are between 40 and 75 years are given a statin (a drug to decrease cholesterol levels) regardless of cholesterol levels. People younger than 40 or older than 75 years and with an elevated risk of heart disease also should take a statin.

Immunozin Capsules

Health experts and nutritionist have encouraged the use of nutritional supplements for people managing diabetes because they may not be able to get all the nutrients they need from their diet due to their dietary restrictions. There are many supplements available that have shown to be very helpful for Diabetics. A very good example is Immunozin Capsules which helps to boosts body immunity and protects against a wide variety of ailments and diseases. Immunozin Capsules contains extracts that help in the management of chronic diseases including diabetes, asthma, and sickle cell.

Other health benefits of Immunozin Capsules include: Stabilising Hormone, Easing menstrual cramps (with Fortrezin), Aiding of Recovery from stroke, and paralysis by increasing nutrient and oxygen perfusion through blood, Stress prevention, and management, Boosting of appetite and general wellbeing, Strengthens natural body defences against diseases.

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