Diabetes is one of the human diseases known from ancient times. If untreated, it damages the body in various ways and hence is aptly called a silent killer. Every 14th of November, the world marks Diabetes Day in a bid to create more awareness about the condition.

Diabetes, which is characterised by increased blood sugar levels in the blood, was initially prevalent in the developed world and was thought to occur in mainly affluent people. Of late, however, diabetes has emerged as a major disease also in the underdeveloped countries affecting the poor as well.

Increase in affluence, migration from rural to urban areas and changing lifestyles, are some of the reasons for increasing prevalence of diabetes. The associated morbidity from long-term complications, decrease in work efficiency, abstinence from work and increased mortality affects the overall productivity of the society.

Diabetes can be due to absence of insulin, known as type I or insulin dependent diabetes. This occurs in children and young adults. In middle-aged persons, diabetes occurs due to resistance of body cells to available insulin, known as type II, diabetes.

Disease or injury to the pancreas can also cause diabetes. Viral infections cause damage to the insulin producing cells of pancreas causing diabetes. It can be due to tumors in the pancreas or drugs like corticoids and diuretics. Stress also contributes to its development while strong hereditary factors can also play a role.

Obesity is a major risk factor for development of diabetes in middle-aged individuals. This is mostly associated with over eating and under exercise. One can develop diabetes, if there are other risk factors, along with genetic susceptibility.

The classic symptoms of diabetes are excess of thirst, appetite and urination. But these may not be present all the time. One may have an infectious illness which does not respond to antibiotics, a wound or ulcer which does not heal in spite of good care and treatment, and unexplained weight loss in spite of eating well. When tested for diabetes in such situations, it is positive.

Uncontrolled diabetes leads to damage to various body parts. Eyes, heart, kidneys, peripheral nerves and blood vessels all are damaged. Therefore once detected, it is important to keep the blood sugar well controlled within normal limits.

Diet is a very important factor for management of diabetes. In fact in the early stages it can be managed only with control of diet. The diet is according to the patient’s working schedules, level of physical activity and ideal body weight. In an underweight patient, it is desirable to increase the amount of food consumed. While an overweight person would require to restrict the total calories, sugar should be shunned as it raises the blood sugar levels and has no nutritional value. Starch containing food like rice and potatoes can be eaten sparingly. In fact total calorie intake should be optimum to provide energy to the body. Saturated fats like cheese, butter and margarine, should be avoided. Eggs need to be restricted as they are rich in cholesterol. Fish, whole grains, vegetables, low sugar fruits like orange and apples are good for diabetic patients. Alcohol raises blood sugar and lipids hence should be avoided. The food taken should be in the form of small frequent meals to avoid hypoglycemia, i.e. low blood sugar.

Regular exercise (at least thrice a week) is as such good for all persons but a diabetic person needs it more to keep himself healthy and avoid obesity. Brisk walking, light jogging, yoga, aerobics or light swimming are some of the exercises which are useful. In no way should the exercise be beyond the effort tolerance of the individual.

It is important to adhere to prescribed insulin or drugs to avoid high blood sugar levels and related complications.

An individual with diabetes needs to keep a very healthy, regular and disciplined life to remain healthy.

The writer is a specialist in Internal Medicine at Ruhengeri Hospital