Early signs that can save lives
By Smriti Daniel
In recent years, diabetes has taken on the proportions
of a national epidemic. Earlier, Type 2 diabetes appeared only in
adults, but increasingly very young people are also falling victim
to it (statistics place the number as high as 14% of young adults
in urban areas) and the age of onset is rapidly becoming within
the first or second decade of life.
However, recent research offers us hope that we
might be able to nip this disease in the bud with a condition called
pre-diabetes sounding the alarm for us. Doctors are recognizing
the importance of diagnosing pre-diabetes; as treatment of the condition
may prevent Type 2 diabetes as well as its associated complications
such as heart and blood vessel disease and eye and kidney disease.
Here, Mediscene speaks to Dr. Mahen Wijesuriya,
President of the Diabetic Association of Sri Lanka about pre-diabetes
and how early identification can literally be a lifesaver.
What is Pre-diabetes and what causes it?
Before a person develops Type 2 diabetes, they almost always have
"pre-diabetes," a condition in which blood glucose levels
are higher than normal but not yet high enough to be diagnosed as
diabetes. Those with pre-diabetes represent a high risk group, balanced
on the edge. If they ignore their health, then it will only get
worse. Recent research has shown that some long-term damage to the
body, especially the heart and circulatory system, may already be
occurring during pre-diabetes.
What causes it?
The primary cause is nutritional - fluctuations between intrauterine
under-nutrition and post natal over-nutrition. Thanks to the former,
pre-diabetic markers are already in place even before birth, though
they may or may not be identifiable. The latter which is rooted
in increased intake of refined foods and unhealthy diets is also
a matter for some concern. Uncontrolled weight gain, sedentary lifestyles,
genetics and ultimately stress also combine with such nutritional
issues to create the condition. Unfortunately, most people with
pre-diabetes aren't aware they have it and so within a few years
find themselves having to cope with full blown Type 2 diabetes.
People with Type 2 diabetes either lose the ability
to respond to insulin, or their bodies no longer make enough of
the hormone. Insulin helps the body use glucose as fuel, so without
it sugar builds up in the bloodstream. Over time, especially if
blood sugar levels are not kept in check, diabetes can increase
one's risk of heart disease and cause damage to the eyes, kidneys,
nerves and other body tissues.
So if you have pre-diabetes, you know there's
danger ahead - but it's in your power to do something about it.
What are the symptoms of pre-diabetes?
Most people with pre-diabetes have no symptoms at all. Symptoms
of diabetes may include unusual thirst, a frequent desire to urinate,
blurred vision, or extreme fatigue. However, warning signs may take
the form of problems such as high blood pressure, increased levels
of abdominal fat or central obesity, high cholesterol and triglycerides,
heart disease, hypertension, and insulin resistance.
What are the tests you need to take?
The fasting glucose test (taken after 8 hour abstinence) is one
of the most reliable tests. If your fasting glucose results fall
between 110 - 125mg/dl or your 2-hour post glucose load/meal test
is between 140 - 199 mg/dl, a diagnosis of pre-diabetes can be made.
Why is it important to recognize and treat
pre-diabetes?
By identifying the signs of diabetes before diabetes occurs, you
can prevent Type 2 diabetes altogether and lower your risk of complications
associated with the condition, such as cardiovascular disease.
It must be emphasized that prevention is much
better than cure. The best case scenario is that one does not even
stumble into the high risk zone.
For some people with pre-diabetes, intervening
early can actually return elevated blood glucose levels to the normal
range.
Should you be evaluated for pre-diabetes?
If you answer yes to any of the questions below, particularly to
more than one, you may very well be at risk.
1. Do you have a relative with Type 2 diabetes
or heart disease?
2. Are you overweight or obese?
3. Are you 45 or older?
4. Do you have high blood pressure?
5. For women who've had children, did you develop diabetes during
pregnancy or have a baby who weighed more than nine pounds at birth?
If you have polycystic ovary syndrome (PCOS) you are also at risk.
6. Do you have high cholesterol, high triglycerides, low good 'HDL'
cholesterol combined with a high bad 'LDL' cholesterol?
7. Do you live a sedentary lifestyle?
8. Do you have "apple-shaped" rather than "pear-shaped"
weight distribution, meaning your excess weight collects around
your belly rather than your hips?
Those who wish to know more or get themselves
tested may contact the National Diabetes Centre, phone no: 011 -
2883318
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