Diabetes Mellitus, more simply called diabetes, continues to be a major public health problem. According to the 2021 Diabetes Atlas of the International Diabetes Federation (IDF), 6.5% of the adult population in the Philippines, or around 7.2 million Filipinos, are diagnosed with the disease in the past year.
High blood sugar is the hallmark of diabetes, and it is more serious than it sounds. Left unchecked and untreated, high levels of sugar in the blood can lead to complications such as cardiovascular diseases (CVD), nerve damage, kidney damage, lower-limb amputation, and even vision problems. Not only these complications are serious but also costly if not prevented.
The good news is, with a proper understanding of the disease, timely diagnosis, and careful management, the long-term consequences of diabetes can be prevented or delayed, and people diagnosed with the disease can still live a normal life.
Diabetes Mellitus is a chronic (long-lasting) condition in which the body cannot produce enough insulin or does not effectively use the insulin it produces, causing your blood sugar to rise.
Role of insulin
Normally, after eating a meal, the body breaks down the carbohydrates present in food into sugar (glucose). This sugar is released into the bloodstream (causing a temporary rise in blood sugar after eating) and then enters the cells to be used as energy (or stored for later use). Insulin acts as a key that allows the sugar to enter the cells where it will be converted to energy or stored.
In people with diabetes, sugar cannot enter the cells either because no insulin helps move the sugar from the bloodstream into the cells or the cells just don't respond well to the insulin. This causes the sugar to accumulate in the bloodstream and continue to rise after eating.
Types of Diabetes
There are several types of Diabetes, but the most common ones are Type 1 and Type 2.
Type 1 Diabetes occurs when the body does not produce any insulin at all due to an autoimmune reaction. Neither its cause nor the ways to prevent it are known, but experts agree that genetics and environmental triggers (such as a viral infection) play a role in its development. Having a family member with type 1 Diabetes is also believed to increase one's chance of developing the disease.
Symptoms of Type 1 diabetes include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly and begin at an early age – child, teen, or young adult.
People affected with Type 1 diabetes need to administer insulin, either via injections or insulin pump, to control their blood glucose and survive.
Type 2 Diabetes is the most common type of diabetes, accounting for 90 % of Diabetes cases worldwide according to the IDF. In type 2 Diabetes, the body either doesn't make enough insulin or the body's cells don't respond normally to the insulin. Several risk factors contribute to the development of Type 2 diabetes, but the majority of cases are linked to excess body weight and a family history of the disease.
Symptoms may be similar to those of Type 1 diabetes but are often mild and develop slowly. As a result, the disease may be left undiagnosed for several years until complications have already arisen.
The cornerstone of treatment of Type 2 diabetes includes healthy eating and regular exercise. If healthy lifestyle changes are not sufficient to control blood glucose levels, oral medication may be prescribed to control blood sugar. People with type 2 diabetes may also require insulin injections when the doctor finds that oral non-insulin treatments are not sufficient to control blood glucose levels.
Effective and successful management of diabetes will require teamwork between you and your doctor/s. As part of the team, you must also do your part to manage your condition and avoid complications.
The following are the things that you can do to take an active role in your diabetes care:
Make healthy food choices. Eat more foods high in fiber such as fruits, vegetables, and whole grains (instead of refined ones). These foods are not only high in fiber but also low in carbohydrates which can help keep your blood sugar levels more stable.
In addition to including healthier options in your diet, you must also work on limiting your intake of saturated fat, trans fat, salt, and added sugar by doing the following: choosing lean cuts of white meat, poultry, or seafood instead of red or processed meat; choosing unsaturated fats (olive oil, canola oil, corn oil, or sunflower oil) instead of saturated fats (butter, animal fat, coconut oil or palm oil); and drinking water instead of sugar-sweetened beverages (i.e., juice or soda).
Control your food portions. Aside from the type of food, you must also be extra conscious of the amount of food you are eating. One way to control your portion is to follow the Pinggang Pinoy model of the Food and Nutrition Research Institute. Just fill half your plate with vegetables and fruits and the remaining half of your plate should be evenly divided between lean proteins (i.e., tofu or chicken) and whole grains/starches.
If you drink alcohol, do so responsibly. Alcohol can either cause high or low blood sugar depending on the amount consumed and whether you consumed it with food. If you are to drink alcohol, limit to one drink a day if you are a woman and or a man over 65 years old or 2 drinks a day if you are a man under 65 years old. For reference, one drink is equivalent to a 12-ounce beer, 5 ounces of wine, or 1.5 ounces of distilled spirits.
If you take insulin or other diabetes medications, be sure to eat before you drink, or drink with a meal to prevent low blood sugar. On the other hand, if you already have existing complications, be sure to check with your doctor whether it is ok to drink alcohol.
Increase physical activity. Exercise is an important part of diabetes management because muscles use sugar for energy, thereby reducing sugar in the blood. If you do it regularly, it could also help your body use insulin efficiently in the long run. Exercising can also help manage your weight.
You should include a combination of aerobic (i.e., jogging, swimming, cycling) exercises and strength training (i.e., hand-held weights, resistance bands, and bodyweight exercises) each week. However, you must ask your doctor about the specific exercises that are right for you and the best time of the day to do them. This is important especially if you have been inactive for a long time, have other health conditions, or are taking medications/insulin.
Control your diabetes "ABCs". If you have diabetes, you should control all your "ABCs" namely A1C (a test that shows blood glucose over the last 2-3 months), blood pressure, and cholesterol with the help of your doctor to prevent or delay the health complications.
These 3 things must be controlled because when high blood sugar, high blood pressure, and high cholesterol team up, they can lead to a heart attack, stroke, or other serious complications. Below are the things to consider:
Follow all the advice of your diabetes treatment team. Take all your medications, both for diabetes and for any risk factors (high blood pressure, high cholesterol, etc.), as directed. Keep regular appointments with your doctor so that your diabetes can be closely monitored, and complications can be carefully watched. If laboratory tests are required, complete all tests as ordered. You must also monitor your blood sugar as instructed by your doctor.
Find ways to manage your stress. Having a chronic condition like diabetes can be overwhelming and stressful. But when you are stressed, your body makes hormones that increase blood sugar levels, making diabetes even harder to manage. You are also less likely to follow your diabetes care routine which can aggravate your condition.
Learn relaxation techniques, deep breathing exercises, meditation, or yoga to help you cope with stress. Avoid common stressors in your daily life as well, if possible. For other helpful stress management tips, check out CDC's 10 Tips for Coping with Diabetes Distress.