It's “Complicated"

Since I’ve spent the last few years focused on clinical research in diabetes, I thought it would be fitting to start my blog off with that topic. Diabetes mellitus (commonly referred simply as diabetes) has become an epidemic afflicting many people all over the globe. According to the International Diabetes Federation (IDF 2017) “Approximately 425 million adults have diabetes; by 2045 this will rise to 629 million.” As a matter of fact, I’m pretty sure you know someone or somebody who knows someone with diabetes.

In the human body, there are many hormones and physiological reactions that help balance blood glucose (sugar) levels within a normal range. One of the main hormones responsible for regulating blood glucose levels is insulin. Insulin is produced by the pancreas and released into the blood stream to help the sugar molecules enter the cells and be used for energy. Diabetes is a lifelong disease in which blood sugar levels are raised basically because of a defect in this regulation process.

There are many types of diabetes mellitus. The three main ones are type 1, type 2, and gestational (during pregnancy) diabetes. Type 1 is an autoimmune disease in which the body’s own immune cells fight and destroy the pancreatic cells responsible for the production of insulin. Therefore, the damaged cells of the pancreas do not produce insulin and blood sugar levels are elevated. In type 2, the pancreas does produce insulin – but not enough, and the body resists the effects of insulin (known as insulin resistance).

Some signs and symptoms of diabetes are: 

·      Increased thirst

·      Frequent urination

·      Extreme hunger

·      Unexplained weight loss

·      Fatigue

·      Blurred vision

·      Slow-healing sores

·      Frequent infections (such as gums/skin & vaginal infections)

However, did you know that the most common symptom is no symptom at all?! Yes, in fact the majority of people are “accidentally” diagnosed at a routine checkup at the doctor’s office or while being investigated for concerns unrelated to diabetes.

As diabetes does not have a cure and is lifelong, treatment is aimed at maintaining normal levels of blood sugar. Since people with type 1 diabetes do NOT produce insulin, it needs to be replaced exogenously (ie. from outside the body) through insulin injections. In type 2, if diagnosed early, it may be managed through simply healthy eating and regular exercise. However, if the condition worsens (and in most cases even at the time of diagnosis), diabetes medications and/or insulin injections are necessary to control the blood sugar levels.

Why is it so important for people with diabetes to control their blood sugar levels you ask? Because of the COMPLICATIONS. Abnormally high levels of sugar in the blood over a long period of time have extremely damaging effects to practically every organ in the body. In fact, every individual with diabetes is at risk of going blind. People with diabetes are 2-3 times more likely to have cardiovascular disease (heart attacks, strokes, etc…). End-stage kidney disease, in which dialysis or a kidney transplant is needed to survive, is up to 10 times more prevalent in people with diabetes. In addition, persistently high blood sugar causes damage to nerves in the body.  This nerve damage can be significant enough that minor injuries (eg. on the foot) can go unnoticed and lead to ulcerations, infections and even amputations! It’s estimated that every 30 seconds someone loses a lower limb or part of a lower limb due to diabetes. This is serious stuff. If you know someone with uncontrolled diabetes who is taking it lightly, urge them to start taking it seriously immediately. The damage to the various organs over time will reduce their quality of life tremendously and can even lead to premature death.

Complications of Diabetes

Recommendations for people with diabetes:

·      Take the diabetes medication as prescribed by your physician. Compliance is vital to having your blood sugar levels under control and preventing complications.

·      Attend regular checkups with your physician (ideally 2-4 times a year).

·      Get your eyes checked by an ophthalmologist once every year.

·      Do not smoke.

·      Control your blood pressure and cholesterol.

·      Be up to date on your vaccines (like the flu (yearly), pneumonia, & hepatitis B)

·      Educate yourself about your condition. Talk to your doctor about any concerns. 

At the end of the day, your doctor can advise and guide you, but ultimately it all comes down to YOU. You only have one body for a lifetime, so take care of it. Take control of your health by eating healthy, exercising regularly, monitoring your blood sugar, and taking your medications correctly and consistently. :)