-Dr.Shantanu Sheshgir

Diabetes is emerging as a major public health issue the world over and India is no exception.    In fact, it has the maximum number of diabetics in the world (40.9 million - 2007). Each year 7 million new individuals are added to the global diabetic populace.

 Some facts about Diabetes:

•          Each year, 3.8 million deaths are attributable to this disease.
•          It is the fourth leading cause of death the world over by disease.
•          Diabetic retinopathy is the leading cause of vision loss in adults in industrialized nations.
•         At least 50% of diabetics are unaware of their condition, in some nations this figure may reach up to 80%. As a result it can be called the “Silent Killer.”

          So, what exactly is this disease?

            Diabetes is what is called a non-communicable disease, i.e. it does NOT spread from person to        person like for instance the common cold, conjunctivitis, AIDS, and neither does it spread through any insect (malaria). The reason for this is that the cause is not any micro-organism that can be transmitted.

            This disease is characterized mainly by the body’s inability to maintain the glucose levels in the body within permissible limits. Glucose is required by the body to generate energy to power our day to day activities; walking, using a workstation, jogging, even reading this article. Common sense or simple logic would then suggest that the more fuel in our blood, the better, but this can’t be farther from the truth.

            The Pancreas, a large gland secretes Insulin, a hormone that regulates sugar levels in the blood to a very delicate balance. Too much of it, and you’ll feel weak and giddy, and too little, is harmful, as seen in diabetics. In these people, this mechanism fails for certain reasons, leading to a whole plethora of complaints of which the most basic one is Hyperglycemia (high blood sugar), which leads to other complications.

            Causes:

            The basic cause of Diabetes is a deficiency of insulin, which in turn has a whole range of causes and predisposing factors:

•       Disorders of the Pancreas itself, cancers, congenital or birth defects, etc.
•       Inability of the body to make the right kind of Insulin. The body has processes which are very delicately balanced. Think of it as a lock-key mechanism. All keys to the lock must be precisely similar each time.
•       Decreased insulin sensitivity
•       Auto-immunity, the immune system fails to recognize its own cells and destroys them. “Friendly Fire?”
•       Genetic defects, both in the person’s overall make-up making him more susceptible to Diabetes than others, which is why it is often seen to run in families. Also, in the specific gene responsible for Insulin production.
•       Obesity: This is one of the biggest predisposing factors for Diabetes. Especially, truncal obesity or a very large paunch/pot-belly is a serious matter. A BMI (Body Mass Index) of more than 25 is overweight, and above 30 is obese. BMI= (Body wt.)/(height in meters)²
•       Unhealthy lifestyles lead to Obesity, which can trigger the disease in susceptible people.
•       Lack of exercise and a sedentary lifestyle.
•       Unhealthy Food Habits. Too much Fatty or sweet food is harmful.
•       Alcoholism
•      Stress, both severe physical and mental, can cause latent disease to flare up.

          A Ready Reckoner of Signs which are indicative of diabetes and should cause concern:

•      Increased rate and amount of urination to the point when sleep is disturbed. Often accompanied with burning.
•       Excessive thirst and a dry mouth or persistent thirst even after drinking plenty of water.
•      Weight loss due to loss of excess calories in urine.
•       Increased hunger as patient tries to compensate this loss.
•      Vision disturbances, narrowing of the field of vision.
•      Drowsiness, lack of “spunk” or energy as it is often expressed. Poor effort tolerance.
•      Loss or diminished sensation in fingers and toes. In severe cases, the patient may fail to notice wounds or injuries.
•      Delayed healing of wounds, tendency to their infection. Ugly, deep, long-standing ulcers which do not heal.
•       Kidney failure.
•      Frequent fainting spells, along with more than one of the above mentioned signs.
•      Weird smell to the breath, best described as of nail-polish, which is an alarming sign of a complication.
•      Confusion, delirium, loss of consciousness; an alarming development.
•      Abnormal sensations (tingling, pricking, etc) or loss of sensation along a particular limb.
• If you or any of your friends, family, have any of these signs and symptoms, please consult your doctor for appropriate advice. Regular health check-ups and blood sugar level assessments greatly enhance the chances of effective and complication free management of Diabetes. Remember if you detect this Silent Killer, you can defeat it.

(In the next article: Tests to diagnose Diabetes and its Complications: What a Diabetic should know, and Treatment options from Allopathic and homoeopathic points of view including General Treatment)

Regards,

Dr. Shantanu

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