Managing and preventing diabetes

November is world diabetes awareness month and with 366 million people living with diabetes, this figure is set to rise to over 550 million by 2030.

Diabetes is among the top ten causes of disability, resulting in life-threatening complications such as heart disease, strokes, lower limb amputations and blindness.  
 
But while half of people with diabetes remain undiagnosed, new treatments are changing the way the disease is managed.
 
It is estimated that about 6,5% of South Africans have diabetes, mostly as a result of lifestyle eating too much and exercising too little, says Endocrinologist and specialist Physician, Dr Aslam Amod.

But by making the necessary lifestyle adjustments and complying with prescribed medication, patients are able to lessen the chance of complications related to this disease.
 
Diabetes is a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces.

Insulin is a hormone made by the pancreas that enables cells to take in glucose from the blood and use it for energy. Failure to produce insulin, or of insulin to act properly, leads to raised glucose (sugar) levels in the blood (hyperglycaemia).

This is associated with long-term damage to the body and failure of various organs and tissues.

Type 2 Diabetes
 
The most common form of diabetes is type 2 diabetes which is caused when the insulin, which the pancreas produces, is either not enough or does not work properly. Approximately 85 - 90% of all people with diabetes are type 2, and many people who have this condition are undiagnosed.

Most people with type 2 diabetes are over 40 and usually overweight and tend not to exercise, says Dr Amod. Often loss of weight alone will reduce glucose levels in patients to appropriate levels.


Scientists believe that lifestyle and type 2 diabetes are closely linked, so lifestyle is one area which individuals can focus on to help prevent or delay the onset of the disease.
 
A healthy diet, weight control, exercise, reduction in stress and no smoking are important preventative steps.

Type 1 Diabetes

 
The less common type 1 diabetes occurs when the pancreas stops producing insulin.It usually starts in young people under the age of 30, including very young children and infants, and the onset is sudden and dramatic.

People who have type 1 diabetes must inject insulin to survive. Insulin dosages are carefully balanced with food intake and exercise programmes.
 
It’s not about fad diets which exclude certain food groups, it’s more about reducing your portion size and keeping the weight off.
 
Those most at risk of developing diabetes include:

Those over 35 years; who are overweight; are members of a high-risk group (in South Africa those of Indian descent are at particular risk); have a family history of diabetes; have high cholesterol or other fats in the blood; have high blood pressure or heart disease; or have had gestational diabetes during pregnancy.  
 
Although type 2 diabetes is, in itself, not life threatening, in many ways it is more dangerous than type 1, as its onset is gradual and difficult to detect.

If it is left untreated or is not well managed, high blood glucose levels over a long period of time can cause serious damage to the delicate parts of the body.

The disease cam lead to: blindness, heart attacks, strokes, kidney failure, impotence and amputation
 
The good news is that with careful management, these complications can be delayed and even prevented, but early diagnosis is very important.  
 
New generation drugs are also able to improve patients™ sugar levels with a low risk of weight gain or hypoglycaemia (low blood sugar).   
 
But because many diabetic patients also suffer from high blood pressure, in the past they have had to take multiple pills each day to manage their condition. Now new single pill combinations are helping to improve compliance, says Dr Amod.
 
By combining different treatments into a single pill, non-compliance has been shown to reduce by 24%-26% with, translating into better clinical outcomes3.  
 
New 2-in-1treatments for diabetes are an important and exciting new treatment option, adds Dr Amod.
 
All people with diabetes should also visit a health care professional for an annual foot examination to identify high-risk foot conditions.
 
For more info on Diabetes visit The International Diabetes Foundation site on www.idf.org

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