• What is Diabetes
  • Gestational Diabetes
  • Diabetes & Heart Diseses
  • Diabetes Nephrology

What is Diabetes?

Over
37.1%
Dubai residents are diabetic or
pre-diabetic

&

Nearly
31.1%
Expatriate people of Emirate are diabetic or pre-diabetic

“The prevalence of diabetes among nationals was 19 per cent. Of these, 50 per cent were cases of people previously diagnosed with the disease while 50 per cent were nationals who were not aware that they had diabetes and only knew about it after they were diagnosed during the survey.”

17.3% of people, aged between
20 yrs-79 yrs have Type 2 Diabetes. There are total 1 Million+ diabetes patients in entire UAE

The increase in the number of cases can be attributed to a sedentary lifestyle, poor eating habits and decreased physical activity. On the other hand, diabetes awareness has resulted in more people getting diagnosed and starting treatment than before.

Diabetes is a chronic ‘lifestyle disorder’ in which a person has high blood sugar caused by discrepancies in the production and action of insulin. The pancreas either does not produce enough insulin or the body is unable to effectively use the insulin it produces. Insulin hormone is produced by the pancreas which regulates and maintains our blood sugar levels in the normal range. Its deficiency causes an imbalance in the blood sugar levels. High insulin level leads to diabetes.

There are majorly 3 types of diabetes:
  • Type 1 diabetes occurs when the body’s immune system attacks the pancreas considering it to be a foreign body. The pancreas stops functioning and there is no insulin production, hence causing the buildup on sugar levels in the blood.
  • Type 2 diabetes generally develops after the age of 35 though it can appear at any age including in children.
  • Gestational Diabetes – Women also suffer from a condition called as Gestational Diabetes which manifests itself during the course of pregnancy.
Early signs of possible diabetes:

Diabetes is a silent killer and may be total without symptoms (asymptomatic). Some of the early signs and symptoms of diabetes include, but are not restricted to:

  • Increase in thirst
  • Increase in hunger
  • Frequent urination
  • Weakness and tiredness
  • Unexplained weight loss
  • Numbness or tingling in the hands and feet
  • Blurring of Vision
  • Delayed healing of wounds

If any of these symptoms persist over a period of time, then it is best that you visit a specialist in order to ascertain the cause of these symptoms.

What health problems can people with diabetes develop?

The resulting high blood sugar levels due to diabetes can bring about serious harm to the entire body. There are two category of complications that occur in patients with diabetes – chronic and acute.

Chronic conditions are long-term health complications that worsen over time and can cause serious damage if left unchecked. Some of the more common chronic conditions in diabetes patients include:

  • Diabetic retinopathy: High blood sugar levels damage the small blood vessels in the eyes, leading to a loss in eyesight, if the control of sugars remains poor.
  • Foot problems: Higher risk of developing serious foot problems that if ignored result in amputation.
  • Heart attack and Stroke: High blood sugar along with high blood pressure and cholesterol lead to blockages in arteries thereby increasing the patient’s risk for cardiovascular diseases (by 2 – 3 fold) and stroke.
  • Kidney disease (nephropathy): It is a slowly developing condition that occurs in those patients who have had diabetes of long duration. Leakage of proteins in urine happen in this which leads to kidney failure.
  • Neuropathy: Nerve damage occurs because of high blood sugar levels. Neuropathy is of 3 types – sensory, autonomic and motor and may be responsible for non-healing foot ulcers leading to amputations.

What Is Gestational Diabetes?

Almost
9.2%
Pregnant Ladies have chances of having Gestational Diabetes.

Gestational diabetes is a form of diabetes commonly seen in pregnant women whose blood glucose levels increases during pregnancy. Gestational diabetes isn’t permanent. Once the baby is born, the blood sugar return to normal level most of the times.
Gestational diabetes is seen at later stages of pregnancy, i.e. after the baby’s body has been formed. It does not cause any birth defects but may interfere with the normal growth pattern of babies.

Effect on the baby
  • If your blood glucose levels are high, your baby will also have high blood glucose.
  • Baby’s pancreas will have to make extra insulin to control high blood glucose.
  • The extra glucose in baby’s blood is stored as fat if untreated or uncontrolled.
  • Baby born larger than normally called macrosomia, which can lead to difficult delivery.
  • Can have breathing problems called respiratory distress syndrome.
  • More likely for baby as it grows to become overweight and develop type 2 diabetes.
Effect on the woman
  • Preeclampsia (high blood pressure, sometimes with fluid retention and proteinuria)
  • Polyhydramnios (excessive accumulation of amniotic fluid )
  • Maternal birth trauma
  • Higher chances for C-Section
  • Developing Type 2 Diabetes
  • Reoccurrence in next pregnancy
Who is at a risk of Developing Gestational Diabetes?

About 5 to 18 percent of all pregnant women are likely to get gestational diabetes during pregnancy.

  • Age of 25 or older
  • Family history of Diabetes
  • Overweight as suggested by the Body mass index
  • Have Polycystic Ovarian Syndrome (PCOS)
  • Have a medical condition that makes diabetes more likely such as Glucose intolerance
  • Have had Gestational diabetes before
  • Certain ethnic subgroups such as African American, Native American, Hispanic or Pacific Islander
Prevention of Gestational Diabetes

Unfortunately, there is no way to guarantee that you won’t get Gestational diabetes. But there are ways to reduce its risk of development:

  • Eat a balanced diet: chose food high in fiber and low in fat and calories. Focus on eating fruits, vegetables, and whole grains.
  • Control on portion sizes
  • Regular exercise: Try and exercise for 30 minutes daily with some moderate form of exercises such as swimming or a brisk walk
  • Lose excess weight before pregnancy: If you are planning a baby, losing a few extra kilos may help you have a healthier pregnancy. Doctors do not recommend losing weight during pregnancy so plan the weight loss before you conceive.

Relation Between Diabetes And Heart Diseases

Diabetes mellitus is a chronic condition that can lead to complications over time. The complications are:

  • Coronary heart diseases or Cardiovascular disease which can lead to a heart attack
  • Cerebrovascular diseases which can lead to a stroke
  • Retinoplasty (disease of the eye) which can lead to blindness
  • Nephropathy (disease of the kidney) which can lead to kidney failure and the need for dialysis
  • Neuropathy (disease of the nerves) which can lead to, among other things, ulceration of the foot requiring amputation.

Heart diseases, particularly coronary heart diseases (CHD) are a major cause of morbidity and mortality among patients with diabetes mellitus.

At least 68% of people aged 65 or older with diabetes die from some form of heart disease and 16% of people die of stroke.

Individuals having diabetes are more prone to have a coronary heart disease (CHD), coronary ischemia, Heart Attack (MI) or a silent heart attack.

Myocardial infraction – Diabetes increases risk of Myocardial Infarction (MI). In the worldwide Inter heart study of patients from 52 countries, diabetes accounted for 10% of the population attributable risk of a first MI.

Silent ischemia and infarction – Some diabetic patients have blunted appreciation of ischemic pain, which may result in non-classical angina symptoms, silent ischemia or even silent infarction.

Why are people with Diabetes at increased risk for CVD?

Diabetes is treatable. But people maintaining their glucose levels still have the risk of heart diseases and stroke. People, particularly having type 2 diabetes, face such conditions that leads to development of cardiovascular diseases.

  • High blood pressure is a major risk factor for cardiovascular disease. When patients have both hypertension and diabetes, their risk for cardiovascular diseases doubles.
  • Patients with diabetes have unhealthy cholesterol levels i.e. high LDL (bad cholesterol), low HDL (good cholesterol) and high triglycerides. It is a characteristic of lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in diabetes patients.
  • Obesity is a major risk factor for cardiovascular disease, strongly associated with insulin resistance. Weight loss can decrease cardiovascular risk, decrease insulin concentration and increase insulin sensitivity.
  • Physical inactivity also affects the insulin resistance and cardiovascular disease. Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure leading to lesser risk of heart attack and stroke.

All those people who have a family history or other risk factors of diabetes or have been diagnosed with prediabetes, there are many healthy living tips to prevent or delay the onset of diabetes. Also if you are already a diabetic patient, these tips can slow the progression of the disease.

  • Lose weight, eat healthy and increase your physical activity to reduce the progression of type 2 diabetes and controlling type 1 diabetes. These changes minimize the risk factors like high blood pressure and blood cholesterol.
  • Also, lifestyle changes must be complemented by right medications to control blood glucose levels, high blood pressure, and cholesterol.

About Diabetic Nephrology

1. What is diabetic nephrology and other complications?

Diabetic Nephropathy is a complication that occurs in diabetic patients which leads to permanent damage of blood vessels and cells of the kidney. This can occur for both Type 1 and Type 2 Diabetes mellitus.

A Worldwide study of heart patients of 52 nations say, around 10% of population attribute the risk of first MI

Persistent itching over the body, disturbed sleep, reduced urine volume, lack of appetite with vomiting suggest retention of toxic chemicals in the body due to kidney damage.

2. What are the common mistakes a diabetes patient makes while dealing with kidney complications?

There is an increase thirst with good urine volume in the initial stage of kidney complication. A diabetic kidney tends to retain water and salt due to its faulty regulation. People with diabetic kidney disease are prone to develop high blood pressure.

The diet also need to be modified with additional protein restriction once kidney disease is established. Fruits and juices are also restricted to maintain the potassium levels.

3. What are the different treatments for such kidney complications/diseases?

The treatment begins with prevention of progression – this includes diligent sugar control, regular blood pressure checkup and adherence to prescribed diet plan.

If an individual reaches stage 5 kidney disease then he has to go for dialysis or kidney transplantation. Dialysis modalities include hemodialysis or peritoneal dialysis. In hemodialysis the blood is filtered with the help of a tube called dialyzer. Whereas, in peritoneal dialysis, the patient’s own abdomen cavity is utilized as a filtration tool.

Kidney transplantation can only happen, if a suitable donor is available. Medications are continued lifelong to prevent kidney rejection after the transplant.