Diabetes mellitus since antiquityhas been known and ddescriptions have been found in the Egyptian papyri, in ancient Indian and Chinese medical literature, as well as, in the work of ancient Greek and Arab physicians. The term “diabetes” was first coined by Araetus of Cappodocia (81-133AD). Later, the word mellitus (honey sweet) was added by Thomas Willis (Britain) in 1675 after rediscovering the sweetness of urine and blood of patients (first noticed by the ancient Indians).Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn’t make enough insulin. In the past three decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025. The studies show that Diabetes is now a disease of major concern both globally and regionally and is a leading cause of death in most countries. In 2013, the International Diabetes Federation (IDF) estimated that ~382 million people had diabetes worldwide, and by 2035, this was predicted to rise to 592 million. Eighty percent live in low- and middle-income countries, and of the total, more than 60% live in Asia, with almost one-third in China. Major increases in the prevalence of diabetes have occurred in developing countries due to rapid and ongoing socioeconomic transition and will likely lead to further rises. The prevalence of both type 1 and type 2 diabetes (T2DM) has increased significantly during recent decades. T2DM, being much more common, has been the main driver for the increase in global diabetes prevalence.The rise of type 2 diabetes in South Asia is estimated to be more. Although aging, urbanization, and associated lifestyle changes are the major determinants for the rapid increase, an adverse intrauterine environment and the resulting epigenetic changes could also contribute in many developing countries. More than 60% of the people with diabetes live in Asia, with almost one-half in China and India combined. The Western Pacific, the world’s most populous region, has more than 138.2 million people with diabetes, and the number may rise to 201.8 million by 2035. The scenario poses huge social and economic problems to most nations in the region and could impede national and, indeed, global development. Today we celebrate World Diabetes Day to raise global consciousness of a disease that affects people worldwide. World Diabetes Day (WDD) was established by the International Diabetes Federation in 1991 to call attention to this worldwide epidemic. The date of November 14 was chosen to honor Dr. Frederick Banting, co-discoverer of insulin back in 1921 along with Dr. Charles Best. While it did officially exist through the 90s and early 2000s, WDD day was largely off the radar until 2006, when the IDF successfully advocated for the United Nations to issue a resolution on it and it was officially recognized for the first time the next year. The mission of the WHO Diabetes Programme is to prevent type 2 diabetes and to minimize complications and maximize quality of life for all people with diabetes. Our core functions are to set norms and standards, promote surveillance, encourage prevention, raise awareness and strengthen prevention and control. Can lifestyle changes affect diabetes?The studies show that lifestyle changes affect diabetes. The healthcare provideroften recommend patients to increase their physical activity and eat a balanced diet of fruit, vegetables, legumes, whole grains, protein-rich foods and dairy to help prevent prediabetes and type 2 diabetes and to control all types of diabetes. Along with any medication prescribed by a healthcare provider, lifestyle changes like reducing intakes of added sugars and excess calories, increasing physical activity, and losing excess weight all help people with diabetes live a healthy and happy life. What role do low-calorie sweeteners play in diabetes management?
”World Diabetes Day provides an opportunity to raise awareness of diabetes as a global public health issue and what needs to be done, collectively and individually, for better prevention, diagnosis and management of the condition. This World Diabetes Day, WHO will highlight the need for equitable access to essential care, including raising awareness of ways people with diabetes can minimize their risk of complications. Activities will also celebrate the experiences of people with all forms of diabetes to help those impacted to take action, including seeking and obtaining essential care.”
The patients with diabetes are amazed by the difference in their blood sugar levels when they switch from sugary drinks to water or beverages sweetened with low or no calorie sweeteners. They get better control and feel so much better! A research study conducted in 2013 found replacing added sugars with low-calorie sweeteners can reduce the rise in blood glucose levels and aid in controlling weight too. Overall, it’s a big win to switch from added sugars to no calorie and low-calorie sweeteners. Top Tips for People Newly Diagnosed with Type 2 Diabetes :(a). Know that developing type 2 diabetes does not represent a personal failing: Type 2 diabetes develops through a combination of factors that are still being uncovered and better understood. Lifestyle (food, exercise, stress, sleep) certainly plays a major role, but genetics play a significant role as well. It is often described in the media as a result of being overweight, but the relationship is not that simple. Many overweight individuals never get type 2 diabetes, and some people with type 2 diabetes were never overweight. At its core, type 2 involves two physiological issues: resistance to the insulin made by the person’s beta cells and too little insulin production relative to the amount one needs. These problems can lead to high blood sugar, which over time can cause various complications like heart disease and stroke, retinopathy, and neuropathy (you can read more about diabetes complications here). Treatments for type 2 diabetes – a healthy eating plan, regular exercise, and blood glucose lowering drugs – involve addressing both insulin resistance and the relative lack of insulin to control blood glucose levels. The progression from normal glucose levels through prediabetes, and then to type 2 diabetes, can often take five to 10 years.(b). Taking care of your diabetes soon after diagnosis (and before) will pay off now and in the long term: Type 2 diabetes is not a death sentence by any stretch, but it is a serious disease that demands your attention immediately. Ignoring it may not seem to have significant short-term consequences (chronic high blood glucose levels are not painful), but over time, the elevated glucose levels can damage nervous system, blood vessels, eyes, heart, and kidneys of a patient. In the landmark Diabetes Prevention Program study, even a small percent of people with prediabetes were found to have evidence of eye disease (retinopathy). Managing blood glucose levels, along with other health risk factors (e.g., cholesterol, blood pressure, weight), is necessary for preventing these complications. Losing even a small amount of weight and keeping it off can also improve glucose control as well as have other clinical benefits (read more tips on managing diet and exercise below for more on weight loss). Keep in mind that better diabetes management will also benefit now, mood and energy levels are adversely affected when our glucose levels are high.(c). Recognize that type 2 diabetes is a progressive disease: When people are diagnosed with type 2 diabetes, they have already lost up to 50% or more of their beta cell function (the cells in the pancreas that make insulin) and are typically also insulin resistant, meaning they can’t use the insulin they make effectively. A few patients can initially manage their diabetes with a healthy eating plan and exercise. But over time, beta cell function decreases, which makes blood glucose harder to manage. To continue achieving blood glucose control, people typically need to add one or more different types of medications. The good news today is that there are many more choices available, and a number of these medications don’t cause as much hypoglycemia, hunger and/or weight gain as in the past (e.g., metformin, pioglitazone, DPP-4 inhibitors, GLP-1 agonists, SGLT-2 inhibitors, and better insulin). The need to use more and different types of medications does not mean that you have failed. Diligent management early on can help preserve remaining beta cell function and slow progression , another reason why acting early and aggressively is so important.(d). Food has a major impact on blood glucose – optimizing your mealtime choices, especially carbohydrates, can improve your diabetes management and overall health: It is noticed that, carbohydrates can raise blood sugar much more than protein and fat and thus, require extra monitoring and management with available insulin. Here are a few tips that may help to manage blood sugars: (i) try to reduce the amount of carbohydrates by eating at one time (ii) lower on the glycemic index (iii) Avoid drinks with lots of added sugars and carbohydrates (unless you have low blood sugar, also called hypoglycemia). Staying away from regular soda and large amounts of fruit juice is usually wise (iv) Impose portion control. For instance, use the “½ plate rule” – fill half your plate with veggies or salad. Also, avoid directly eating out of food packages, a convenience trap that encourages overeating. (v) As a general rule, try to eat foods that are as natural and minimally processed as possible – the fewer ingredients on the label, the better. Fruits and vegetables are always a good way to go. By contrast, try to avoid highly processed foods (e.g., chips, candy) that I find can be less filling and raise my blood glucose more substantially (vi) Try substituting almond and coconut flour in recipes as these have a significantly smaller impact on blood glucose, contain lots of healthy fat and fiber, and help make baked goods much more diabetes-friendly. (e). Exercise is a free drug – use it as much as possible: Regular physical activity done for about 30 minutes most days each week can lower blood glucose. (f). Use blood glucose testing to identify patterns: When it comes to managing blood sugar, think of your glucose meter as a compass. By testing before and after certain events like meals and exercise, these data can point the way toward factors that affect your blood glucose. (g). Needing to take insulin is NOT YOUR failure: Type 2 diabetes is a progressive disease, and your body’s ability to make insulin is likely to decline over time. Indeed, about 30-40% of type 2 patients end up needing to take insulin to manage their blood glucose, particularly those who have had diabetes for a long time. To take insulin there are now devices designed to ease the burden like insulin pens, Valeritas’ V-Go insulin delivery device, Medtronic’s i-Port Advance, and full-featured insulin pumps. (h). Keep learning and find support: The more you learn about type 2 diabetes, from organizations and other people, the more you will realize how much there is to know. (i). Seek out a Diabetes Educator: Diabetes educators are certified health care professionals with specialized knowledge in diabetes self-management and education. They provide real-life guidance, coaching, and support. To receive diabetes education, you can ask for a referral from your primary health care provider. To conclude, this World Diabetes Day, we need to raise awareness of a condition that millions of people all around the world live with every day.In brief, World Diabetes Day provides an opportunity to raise awareness of diabetes as a global public health issue and what needs to be done, collectively and individually, for better prevention, diagnosis and management of the condition. This World Diabetes Day, WHO will highlight the need for equitable access to essential care, including raising awareness of ways people with diabetes, can minimize their risk of complications. Activities will also celebrate the experiences of people with all forms of diabetes to help those impacted to take action, including seeking and obtaining essential care.
(While Dr. Syed Sabahat Ashraf is a freelancer, Dr Bilal A Bhat is Professor Statistics at S K University Of Agriculture Sciences & Technology-SKUAST Kashmir . The views, opinions and conclusions expressed in this article are those of the authors and aren’t necessarily in accord with the views of “Kashmir Horizon”.)