India is now known as the diabetes capital of the world, it is the not an aspect we as one of the fastest growing economies in the world would like to be leading in. There is a high burden of diabetes in India with approximately 50 million people suffering from type 2 diabetes. But the problem doesn’t end here, according to estimates by the WHO the burden is expected to rise to 58% this means that the 50 million people suffering from type 2 diabetes will increase to 87 million by the year 2030. The mortality rate due to diabetes has also been increasing at an alarming rate. The Global Burden of Disease Report 2015, stated that the number of deaths due to diabetes increased from 2,24 lakhs in 2005 to 3.46 lakhs in 2015. Early diagnosis and treatment are crucial in the management of this condition. To manage and treat diabetes effectively it is important to understand completely what the condition is all about.
What is Diabetes?
To put it simply, diabetes is a chronic disorder of metabolism due to insufficiency in insulin secretion or defective response to it. Insulin a hormone secreted by the pancreas regulates the levels of blood sugar in the body. There are numerous kinds of diabetes the most common being diabetes mellitus, which is further classified as:
Type-1 diabetes: Also known as juvenile diabetes or insulin-dependent diabetes it is a condition in which an individual’s pancreas does not produce insulin and therefore high concentrations of sugar remain in the blood which has the potential to cause cardiac, renal, nervous, visual, and dental disorders.
Type-2 diabetes: This is the most common type of diabetes presented by the population. It caused due to inherited and/or acquired deficiency in the production of insulin by the pancreas, or by the ineffectiveness of the produced insulin. This, in turn, leads to increased glucose concentrations in the blood with various potential complications including cardiac diseases and stroke.
Diabetes is primarily managed with insulin therapy and oral medications. The insulin injections are the main mode of treatment for type-1 diabetes mellitus while insulin along with oral medicines is utilized in the therapy of type-2 diabetes mellitus. Physical activity and dietary restrictions are crucial in managing the condition.
Let us now delve a little deeper and understand slightly better the history of this condition:
The occurrence of diabetes dates back to the 1550 B.C. Egyptian manuscripts. Our ancestors were well versed with the condition and its two types. They tested an individual’s urine based on whether ants were attracted to it to detect the presence of sugar in the urine. This test was called ‘honey-urine’.
The term ‘diabetes’ was coined by a Greek physician called Apollonius of Memphis and means to ‘to pass through’ which signifies the main symptom of the diabetes frequent urination. There was an awareness regarding the condition in the Indian, Arab, Greek, and Chinese but they were unable to determine the cause and therefore having diabetes in ancient times was proportional to a death sentence.
It was at the beginning of the 20th century that Edward Albert Sharpey-Schafer stated that inability to produce insulin was the cause of diabetes.
The first treatment option for diabetes was discovered in 1921 by Frederick Grant Banting and Charles Herbert Best who successfully extracted insulin and treated dogs suffering from diabetes with it. The management of the condition improved drastically with the advent of urine strips and single-use syringe for the delivery of insulin. By 1970 we had insulin pumps. Oral medications have greatly improved the quality of treatment for type-2 diabetes. Recently, the FDA also began reviewing the first antidiabetic oral drug for type-1 diabetes. The scope for treatment advances looks very bright for diabetes.
An important aspect in managing and treating diabetes is the role doctor’s play in the same. Doctor’s play a crucial role in ensuring timely diagnosis, managing, treating, and preventing diabetes.
Carefully evaluating the patient’s medical and family history is vital in quick detection of diabetes. Knowing the family history well helps the doctor understand whether or not the patient is at risk for developing diabetes in the future as type-2 diabetes is an inheritable condition.
After a timely diagnosis, it is important that a doctor manages the patient’s condition efficiently so that the patient is at less risk of diabetes-related complications. This includes prescribing a strict diet plan which involves cutting down on sugars as much as possible and advising incorporation of several lifestyle changes.
Understanding the patient’s condition and disease pathophysiology correctly is of profound importance to the treatment. Whether the patient requires just oral medication or oral medications in combination with insulin injections are important aspects of treatment decisions.
Prevention of potential complications is vital. Ensuring the patient does not lead a sedentary lifestyle, is fit, and takes his medications timely helps safeguard the patient from adverse complications like cardiac diseases, renal diseases or failure, stroke, etc.
Family and Diabetes
The World Diabetes Day which is observed every year on the 14th of November aims to this year spread awareness about the impact diabetes has on a family and to encourage the part a family plays in management, care, prevention, and education about the condition.
Having a diabetic in the family has a direct impact on all the members. It is just like any other chronic illness but it has its own quirks. It is the only chronic disease which involves primarily the family in daily disease management. In the case of adolescent and childhood diabetes, the role a family plays in its management is incomparable. Understanding the child’s mindset and explaining to him/her in the simplest way possible what they are going through all rests in the hands of the family.
The International Diabetes Federation believes the family plays an important role in three major areas:
- Detection of diabetes
- Prevention of diabetes
- Management of diabetes
Detection of diabetes:
Statistics state that everyone in two people suffering from diabetes stays undiagnosed. A doctor can only make a diagnosis of diabetes if the person suffering makes a visit to the clinic or hospital. Awareness in the family regarding the condition is extremely helpful as they recognize the symptoms and recommend medical advice to the patient. This is profoundly helpful if parents of children suffering from type-1 diabetes are well informed. Delay in diagnosing type-1 diabetes can cause serious disability or death. Knowing the common symptoms of diabetes is a must for all. They include:
- Frequent urination
- Excessive hunger
- Increased thirst
- Blurred vision
Prevention of diabetes:
It is well known that type-2 diabetes is inheritable and therefore persons with a family history of diabetes must take the necessary precautions to prevent the condition as much as possible. Those who do not have a family history but are leading a sedentary lifestyle must make the necessary changes in their habits, cut down on sugars, and exercise regularly. Maintaining a healthy diet and exercising regularly with your family is a great way of communication as well as prevention of diabetes.
- Some steps to prevent diabetes include:
- Avoiding excess weight gain
- Maintaining a balanced diet
- Exercising regularly
- Regular check-ups
Management of diabetes:
If a member of your family is suffering from diabetes it is essential that the entire family is empathetic to him/her and supportive to their fight against the condition. It is essential that every member of the family is well informed about the do’s and don’ts. The family also needs to ensure that the diabetic leads a healthy lifestyle and not give in to his/her whims when it comes to dietary restrictions.
Monitoring the blood sugar on a regular basis and ensuring the diabetic takes medications or injections time-to-time is also an important responsibility of the family members.
Effective communication plays a very important role while dealing with a child or an adolescent suffering from diabetes as they do not understand the seriousness of the condition completely. It is essential that family members engage in active communication with them to know their thoughts, insecurities, and beliefs about the condition to help them deal with the disorder in a positive way.
Good communication and relationships in the family ensure the person does not suffer from diabetes distress and other psychological issues pertaining to diabetes. Having healthy relationships with family members is of profound importance in managing diabetes in both adults and children.