Beyond drugs: Diabetes mellitus 102

As early as 1552 BC, a disease was recorded that caused people to pass too much urine. To diagnose this disease in the late 1600s, doctors tasted the urine to find out if it was "sweet". Urine was later evaporated and the residue was granulated and found to smell and taste like sugar. Diabetes mellitus literally means "honey sweet diabetes."

Diabetes mellitus, which is often simply called diabetes, is a disease in which the body does not produce or properly use insulin. Insulin is a hormone produced by the pancreas, an organ near the stomach, which is needed to turn sugar and other food into energy. In diabetes, the body either does not make enough insulin or cannot use its own insulin properly, or both, making sugars in the body build up to concentrations which are too high.

Diabetes is diagnosed when the fasting blood sugar is 126mg/dl or more. In "pre-diabetes", the blood sugar is higher than normal but not yet at diabetic levels. Pre-diabetes occurs when there is an impaired fasting glucose (of 100 to 125mg/dl) and an impaired glucose tolerance.

There are 2 types of Diabetes Mellitus: Type 1 diabetes (insulin dependent) in which the pancreas makes little or no insulin. This usually occurs in children and requires daily injections of insulin for survival. Type 2 diabetes develops when the body does not make enough insulin and does not effectively use the insulin it makes. This is the most common form of diabetes and appears most often in middle age.

However, younger patients and children are now developing this type of diabetes at an alarming rate.

Diabetes is important because if untreated it can lead to wasting of the muscles and serious medical problems like blindness, kidney disease, nerve disease, limb amputation, cardiovascular disease, stroke and an early death. When insulin resistance or diabetes occur together with other risk factors like obesity, hypertension and high cholesterol, there is a high risk of heart disease and stroke. Obesity and physical inactivity are an important risk factor for insulin resistance, diabetes and cardiovascular disease.

How are diabetes and pre-diabetes managed?

A change in eating habits, weight control, exercise programs and drugs are used to control diabetes. Diet and exercise have been recommended for years as a way to stave off and even control diabetes.

People with diabetes must have regular checkups. They must work closely with their healthcare providers to manage their diabetes and control other risk factors. For example, blood pressure for people with diabetes should be lower than 130/80 mmHg (compared to 140/90 for non diabetic patients).

A change in eating habits as well as weight control can lower the risk of contracting diabetes. This is important in our modern society where obesity now occurs in younger patients. A diet low in fat, cholesterol and preservatives and high in fruits and vegetables helps the body work more efficiently and, along with regular aerobic physical exercise, helps in weight control.

It is also important not to smoke as this also increases the risk of cardiovascular disease especially in diabetics.

Preventing diabetes

Type 2 diabetes is now occurring in near epidemic proportions. Younger and younger people now regularly contract this disease that used to be a disease of middle and old age. Healthy lifestyle changes like eating right and regular exercise might help prevent this disease.

Young children, especially, have to be taught healthy lifestyle habits early on to help avoid contracting diabetes and all its associated complications.

Even better is the news that you do not need to reach your ideal bodyweight to benefit from a healthy lifestyle. Eating right does not mean starvation and exercise does not mean running on the treadmill for hours at a time. Studies have revealed that small changes like eating healthier and walking for half an hour, five times a week can make a significant difference to your health and lower your risk of contracting Diabetes by up to fifty-eight percent. Older people in the studies actually cut their risk the most, bringing it down to around seventy percent.

For exercise, try taking up a fun sport like biking with friends, going on walks or swimming. Walk the neighbourhood or to a local park (and parks are coming up all over the place in Nigeria) with your spouse or children after dinner.

The diet changes do not have to be big either. Try eating 2 types of fruit a day. Eat more raw vegetables as part of your regular diet. Use lemon instead of oils to add flavor to cooked veggies and salads. Use low fat/skimmed milk and eat lower fat products. Have grilled chicken instead of fried food.

More water, less soft drinks, a little walk every day, and you could find yourself and your whole family on a path to a healthier and longer life.

Live strong, live well, live happy.

Dr. Stella Ejiofoh-Alli is the medical director of Art of Living Nigeria, a health and wellness company which specialises in helping its clients plan and live healthy lifestyles, and provides stress management courses and training on first aid and basic life support.