Diabetes: Lifestyle changes can help keep it at bay

By Prof. Upali Illangasekera

Diabetes is a chronic debilitating disease, the complications of which affect important organs in the body such as the heart, brain, kidneys and the eyes. It is also the leading cause of amputation of limbs worldwide.

It has been stated that every one second a new patient with diabetes is discovered somewhere in the world and every one minute a death occurs due to this condition. There has been an exponential rise in the occurrence of this illness particularly in Asia and Africa, where countries do not have sufficient resources to tackle this huge problem. In Sri Lanka too research has shown that nearly one in ten of all adults (more than 40 years old) has already been diagnosed with diabetes or remains undiagnosed. However there is a dangerous trend in the rise in the incidence of diabetes even among children in our country.

When one talks about prevention, it could be in those who are prone to develop the illness as well as identifying and treating complications. Those who are prone to develop diabetes include those with a family history of diabetes, who are overweight, have sedentary occupations, who already have high blood pressure and high cholesterol values. In fact some of them may already be suffering from a condition called “prediabetes” determined by a blood sugar estimation.

It has been stated Asians being genetically prone to develop the illness, should be screened for diabetes at least once a year, especially those who are more than 40 years of age even in the absence of above conditions. It is possible that those at high risk could be already harbouring the illness and therefore should be tested. It has also been shown that at the time of diagnosis, many have already developed complications, again highlighting the importance of early diagnosis.

How can diabetes be prevented in those who are prone to develop the illness?

Diabetes is considered to arise from an interaction between genes and the adverse environment. Since nothing can be done about a person’s genetic make-up, the most effective method would be to attend to the environmental factors. The environment mainly consists of life style factors such as diet, lack of exercise and mental stress. All these are components of the modern competitive way of life adopted by most Sri Lankans.

“Instead of a healthy diet which consists mainly of carbohydrates such as rice, plus fruits, vegetables and moderate amounts of fat and protein, most are prone to consume a diet rich in sugar, animal proteins and fats. This “fast food culture” is rapidly spreading among the younger generations accounting for a large number of children with diabetes. It has also been convincingly shown that a vegetarian diet not only prevents diabetes but also consequent kidney disease.

Lack of exercise too is an important contributory factor for the development of diabetes. Regular physical exercise is not only beneficial in preventing diabetes but also other diseases such as high blood pressure, heart disease and even cancer. Regular moderate exercise such as walking should be done at least 5 times a week for half an hour or more. More vigorous exercise such as jogging, swimming or other active sports should be done at least three times a week.

Mental stress too has become a social problem. Stress is a reaction of the body to an external stimulus such as worry, anxiety or overwork. Methods of avoiding mental stress include relaxation, listening to music, reading, meditation or yoga.

Once a person is diagnosed as having diabetes it is in the interest of all to prevent the development of complications. In addition to adopting a proper diabetic diet, drugs as well as education of the patient about the illness have been shown to arrest or prevent progress of these complications. The prescribed diet and drugs should be taken regularly. As some may already be suffering from complications it is crucial to examine their eyes, measure the blood pressure, check cholesterol levels and the presence of proteins in the urine which may indicate early kidney involvement. Effective treatment options are available for all these conditions if diagnosed early.

Once a complication such as a heart attack, stroke, eye problems and kidney issues is evident, great precautions should be taken to prevent their progress. In addition, new classes of drugs and procedures are now available to achieve good results.

Recently it has been found that low birth weight, atmospheric pollution, gum diseases and even climatic changes too could be risk factors for future development of diabetes. Thus maintaining proper maternal hygiene as well as paying attention to pollution and regular examination of teeth and gums can be beneficial.

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