Type 2 diabetes – the most common type of the disease that can develop at any age – can be prevented by adopting a healthy diet, exercising regularly and maintaining a normal body weight, said experts while speaking at a public health awareness programme held at the Aga Khan University on Monday to commemorate the World Diabetes Day. “Diabetes is a chronic disease that affects how the body utilises blood glucose,” said Dr Najmul Islam, professor and consultant endocrinologist at the Aga Khan University Hospital (AKUH), while defining the disease and its effect on the body. The two most common types of diabetes are type 1 and type 2. “In type 1 diabetes, the body’s own immune system attacks and destroys the insulin-producing cells in the pancreas; insulin is a hormone that regulates blood sugar,” said Dr Islam. “It is unclear why this type of diabetes occurs though a person’s family history and environmental factors may play a role. Its symptoms include excessive urination, thirst, constant hunger, weight loss, blurred vision and fatigue.”
Type 2 diabetes is when the body cannot effectively use insulin or the pancreas cannot produce sufficient insulin to cover this inability. “Approximately 90 percent of people with diabetes around the world suffer from type 2 and the risk factors, besides being overweight and physically inactive, include race – Asians, Hispanics, American Indians and blacks are at a higher risk – and age. Its symptoms may be similar to those of type 1, but are often less marked; this means that the disease may be diagnosed several years after its onset.”
Gestational diabetes is first recognised during pregnancy, and its symptoms are similar to type 2. “The number of people suffering from diabetes in Pakistan is increasing at an alarming rate and it is imperative that we adopt preventive measures if we are to stop the rapid spread of this disease,” warned Dr Islam. Sumaira Naseem, clinical nutritionist at the AKUH, spoke at length about the importance of a balanced diet as perhaps the most effective preventive tool available. “We are beginning to see unhealthy lifestyles develop in Pakistan, as we are consuming more fatty foods and becoming less mobile,” she said. “The whole family needs to eat a more balanced diet not only to prevent future cases of diabetes, but also to help diabetics feel less isolated.”
Stressing the need for diabetics to be vigilant about their feet, Farzana Rafiq, a diabetes education nurse, said that foot problems are common and can become serious. “This makes it essential for diabetics to get their feet checked by their health care provider at least once a year and learn whether they have nerve damage. Patients with known nerve or blood vessel damage should check and care for their feet every single day. This can be done by examining the feet thoroughly and washing them in lukewarm water using a mild soap.”
Rafiq stressed the need for diabetics to dry their feet thoroughly as wet areas are more prone to infection.
How does type 2 diabetes develop?
Type 2 diabetes does not develop overnight. It usually begins with insulin resistance, where the body’s cells cannot use insulin properly. Glucose builds up in the bloodstream. The pancreas keeps on producing insulin to try and get the blood glucose level down. Over time the pancreas loses its ability to secrete enough insulin. This can sometimes result in the person with type 2 diabetes having to inject insulin every day.
The good news is that because it doesn’t develop overnight, if people at risk of developing type 2 diabetes are identified early enough, they may be able to take measures to avoid it.
This is why having your blood glucose level tested is a good idea. A slightly raised blood glucose level that is above normal, but below the cut off point for a diabetes diagnosis, may be a sign of glucose intolerance or what doctors have named ‘pre-diabetes’. This puts you at risk of developing not only diabetes, but also heart disease.
How insulin works and what goes wrong in type 2 diabetes
Insulin is produced in the pancreas, a large, long gland that sits behind your stomach. After you eat a meal, carbohydrates are broken down into glucose and passed into the bloodstream. The pancreas detects the rising level of glucose in your blood (called blood glucose or blood sugar level) and releases insulin. Insulin helps to take glucose out of the bloodstream by promoting its uptake into fat and muscle cells. Once in the cells, the glucose is used as the energy to fuel the cells doing their different jobs, for instance the muscles working, or is stored in the liver or muscles for use later. In people with type 2 diabetes one of 2 things goes wrong: either the pancreas doesn’t make enough insulin; or the body’s cells are resistant to the effects of insulin.
Both of these faults lead to glucose accumulating in the bloodstream. Doctors call this hyperglycaemia. If left untreated, high blood glucose can lead to complications caused by nerve and blood vessel damage, or even death.
