Diabetes mellitus, more commonly referred to as diabetes, experts say, is a chronic disease associated with abnormally high levels of the sugar glucose in the blood. In other words, it means inadequate production of insulin (which is made by the pancreas and lowers blood glucose). Gerald Luzindana, a health consultant at Amazon Nutrition Cabinet in Kigali, says diabetes mellitus is a chronic health condition that involves elevated blood sugar levels and that the metabolism of carbohydrates, proteins and fats directly lead to the production of a substance called glucose, also known as blood sugar. “Glucose acts as “fuel for our body” because it supplies energy to every cell in the body in a highly calibrated manner (moderation), in some circumstances levels are too elevated, and then they become toxic to the brain and other vital body organs,” he explains. He says that in diabetes mellitus, two main things occur which are; deficiency of insulin, a hormone produced by the pancreas that transports glucose into the cell, and resistance of the cell to insulin so that blood sugar cannot enter the cell. Luzindana says, diabetes is categorised under non-communicable diseases (NCDs) which account for 3.7 per cent in Rwanda. According to World Health Organization (WHO), it is estimated that the global NCD burden will increase by 17 per cent in the next 10 years, and in the African region by 27 per cent. Based on Rwanda’s Health Management Information Systems (HMIS) data, over the period of January to December 2013 concerning the top eight causes of morbidity in district hospitals, NCDs accounted for at least 51.86 per cent of all district hospital outpatients’ consultation and 22.3 per cent of district infirmary hospitalisation. Categories of diabetes Erick Musengimana, a nutritionist at Rwanda Diabetes Association, Kigali, says there is type 1 diabetes also known as insulin-dependent diabetes (secretion of insulin is severely deficient). Another category, he says, is gestation diabetes and type 2 diabetes also known as diabetes mellitus, which involves either resistance of cells to insulin or low levels of insulin production. “Type 2 diabetes used to be known as adult-onset diabetes, but today more children are being diagnosed with the disorder, probably due to the rise in childhood obesity,” he says. He goes on to add that unfortunately, there’s no cure for type 2 diabetes, however, losing weight, eating well and exercising can help manage the disease. Alternatively, Musengimana says that if diet and exercise aren’t enough to manage your blood sugar well, you may also need diabetes medication or insulin therapy. What to avoid When one has this condition, Luzindana says it’s vital that they avoid certain diets and embrace a healthy lifestyle. For instance, he notes that it’s essential to stay away from sugars like cookies, sodas and other sweets. Other foods to avoid, he says, are white, refined foods like bread as they too spike blood sugar levels. “Eating simple or refined carbohydrates with a high glycaemic index like white bread and rice raise the risk of type 2 diabetes,” Luzindana says. However, he notes that eating whole grains like bran cereal and oatmeal can lower that risk, adding that the glycaemic index measures the effect of carbohydrates on blood sugar levels. Dr Francis Kazungu, a general practitioner in Kigali, says eliminating alcohol and caffeine from one’s diet is important. He explains that this is so because while moderate amounts of alcohol may cause blood sugar to rise, excess alcohol can actually decrease one’s blood sugar level. And that sometimes, causes it to drop into dangerous levels, especially for people with type 1 diabetes. “The beer and sweet wine contain carbohydrates and may raise blood sugar, therefore avoiding them is essential,” he notes. Kazungu goes on to add that cutting back on consumption of saturated fat is important. It is found in red meat and dairy products and has been shown to increase the risk of diabetes and heart disease. Signs In most cases, Kazungu says there are no symptoms; but when symptoms do occur, they include excessive thirst or urination, fatigue, weight loss, or blurred vision. In addition to that, Kazungu notes that if one experiences signs such as increased hunger, unintended weight, these are also clear indicators that the person is suffering from diabetes mellitus. However, he says that diabetes symptoms vary depending on how much your blood sugar is elevated. Luzindana says that the best way to go about it is to visit a specialist for check-ups. On the other hand, Musengimana says eating the right types of foods can control one’s blood sugar and help them lose any excess weight. “Carb counting is an important part of eating for type 2 diabetes. A dietitian can help you figure out how many grams of carbohydrates to eat at each meal,” he adds. In order to keep the blood sugar levels steady, he says one should try eating small meals throughout the day. Emphasise healthy foods such as fruits, vegetables, whole grains, and lean protein among others.
