DIABETES

Understanding Diabetes Mellitus

Our body’s cells need fuel/energy to function, survive and thrive. Our fuel comes from the food we eat, which is digested in the stomach and flows into the blood stream as glucose, a form of sugar. To get into the body’s cells, the glucose needs the assistance of a hormone called Insulin, produced by the pancreas.^1,2

Diabetes is a condition in which your body is unable to use the glucose from the food you eat, which then builds up in the blood. The reason could either be that the body does not produce enough insulin, or that there is enough insulin, but the body does not respond to the insulin the way it should. When there is too much sugar in the blood, it can cause short-term and long-term health issues and damage to organs.^1,2

How common is Diabetes?

Globally, 1 in 10 adults are living with diabetes.³

Over 1.2 million children and adolescents around the world have type 1 diabetes, with more than half of them being younger than 15 years.³

1 in 2 adults with diabetes are unaware of the fact that they have the condition.³

16 % of pregnant women world-wide struggle with high blood glucose (hyperglycaemia/ gestational diabetes) during pregnancy.³

Diabetes Risk Checker

Do you know your Diabetes may be putting your heart and kidneys at risk?

Types & Stages of Diabetes

People can be classified in 3 stages of glucose control:^3-5

Normoglycaemia – where your body naturally controls your glucose levels without help.
Impaired glucose tolerance – also called “pre-diabetes”, where your blood glucose is somewhat elevated, but you are still only at high risk of developing diabetes. You are however already showing signs of other related conditions such as obesity, high cholesterol and hypertension. You can still prevent diabetes at this stage.
Diabetes Mellitus – where your blood glucose levels remain high, and you require treatment to reduce and keep it at safe levels.

There are a few identified types of diabetes ^3-5

Type 1

The body does not produce insulin as the body destroys its own cells in the pancreas (autoimmune disorder); you are dependent on insulin to survive.

This form of diabetes usually develops in children or young adults but can occur at any age. It is often called insulin-dependent diabetes or juvenile-onset diabetes. Only 5-10 % of people with diabetes have this type.

Type 2

Non-insulin dependent diabetes (or adult-onset diabetes); you might not need insulin at first but will need to take medication to reduce your blood sugar levels. More than 90 % of people with diabetes have this type.

Gestational Diabetes

When high blood sugar levels are first diagnosed during pregnancy, usually during the 2^nd or 3^rd trimester.

Diabetes due to other causes

Medical conditions like inflammation of the pancreas or cystic fibrosis can trigger diabetes, or certain medication or chemicals can damage the pancreas and cause diabetes.

Complications of Diabetes

High levels of glucose in the blood causes damage over time, leading to many health complications. Complications of diabetes are often called macrovascular damage (damage to the large blood vessels) or microvascular damage (damage to the smaller blood vessels).⁶

Macrovascular complications include:

Cardiovascular (heart) disease
Men with diabetes are 2-3 times more at risk to develop heart disease than those without diabetes, and women 3-5 times more at risk.⁴Up to 1 in 5 people with diabetes develop Heart Failure.^⁷
Affects the heart and blood vessels and may cause fatal complications such as heart attack, stroke, angina (heart cramps).⁶
High blood pressure, high cholesterol, high blood glucose and other risk factors contribute to increasing the risk of cardiovascular complications.^4,6

Peripheral arterial disease
A condition where the arteries to the lower legs and feet are obstructed and increases the risk of wounds, which is difficult to treat as healing is delayed. If uncontrolled, it can lead to amputation.⁴

Microvascular complications include:

Kidney disease (diabetic nephropathy)
More than 1 in 5 people with diabetes live with Chronic Kidney Disease.^⁷Caused by damage to small blood vessels in the kidneys leading to the kidneys becoming less efficient or to fail altogether.⁷ High blood pressure can worsen the condition.⁶

Nerve damage (diabetic neuropathy)
As the small blood vessels cannot deliver oxygen and nutrients to the nerves, it becomes damaged.⁶ This can lead to problems with loss of sense of touch, temperature perception, pain or weakness in the legs, digestion, erectile dysfunction and decreased vaginal lubrication, and many other functions.⁶

Eye disease (diabetic retinopathy)
Most people with diabetes will develop some form of eye disease (retinopathy) causing reduced vision or blindness. Consistently high levels of blood glucose, together with high blood pressure, are the main causes of retinopathy. It can be managed through regular eye checks and keeping glucose and blood pressure at, or close to, normal range.⁶

Other complications:

Infections
When diabetes is not controlled, you are prone to bacterial and fungal infections of the mouth, vagina and skin because of effect on the immune cells of the body.⁶

Pregnancy complications
Women with diabetes during pregnancy risk a number of complications if they do not carefully monitor and manage their condition. These can include, amongst others, pre-eclampsia, pre-term labour, miscarriage, stillbirth, or respiratory distress in the newborn.⁴

Can I prevent Diabetes?

At present, type 1 diabetes cannot be prevented. Investigations on the triggers that are thought to generate the process that results in the destruction of the body’s insulin-producing cells are still under investigation.

There is a lot of evidence that lifestyle changes (achieving a healthy body weight and moderate physical activity) can help prevent the development of type 2 diabetes, and some evidence has also proven that remission of the condition is even possible.³ Changing your lifestyle could be a big step toward diabetes prevention – and it’s never too late to start.

Here are some basic principles to prevent Type 2 Diabetes:⁴

Achieve and maintain weight loss >5 % (if overweight).
Eat a healthy diet, especially with less fat and more fiber.
Exercise regularly, at least 150 minutes per week.
Keep all existing medical conditions well controlled.