Dr. Declan Nwaigwe is the senior medical officer at Avon Medical Services Limited, Surulere, Lagos. In this interview with GERALDINE AKUTU, he discusses diabetes and how it can be properly managed and prevented.
What is diabetes?
Diabetes is a complex group of diseases with a variety of causes. People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia. Diabetes is a disorder of metabolism—the way the body uses digested food for energy. The digestive tract breaks down carbohydrates—sugars and starches found in many foods—into glucose, a form of sugar that enters the bloodstream. With the help of the hormone, insulin, cells throughout the body absorb glucose and use it for energy.
Diabetes develops when the body doesn’t make enough insulin or is not able to use insulin effectively, or both. Insulin is made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.
If beta cells don’t produce enough insulin, or the body doesn’t respond to the insulin that is present, glucose builds up in the blood instead of being absorbed by cells in the body, leading to prediabetes or diabetes. Prediabetes is a condition in which blood glucose levels or A1C levels—which reflect average blood glucose levels—are higher than normal, but not high enough to be diagnosed as diabetes. In diabetes, the body’s cells are starved of energy despite high blood glucose levels.
Over time, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Other complications of diabetes may include, increased susceptibility to other diseases, loss of mobility with aging, depression, and pregnancy problems. No one is certain what starts the processes that cause diabetes, but scientists believe genes and environmental factors interact to cause diabetes in most cases.
What are the types of diabetes?
The two main types of diabetes are Type 1 diabetes and Type 2 diabetes. A third type, gestational diabetes, develops only during pregnancy. Other types of diabetes are caused by defects in specific genes, diseases of the pancreas, certain drugs or chemicals, infections, and other conditions. Some people show signs of both Type 1 and Type 2 diabetes. Type 1 diabetes is caused by a lack of insulin due to the destruction of insulin-producing beta cells in the pancreas. In type 1 diabetes—an autoimmune disease—the body’s immune system attacks and destroys the beta cells.
Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. Type 1 diabetes typically occurs in children and young adults, though it can appear at any age. In the past, type 1 diabetes was called juvenile diabetes or insulin-dependent diabetes mellitus.
Type 2 diabetes—the most common form of diabetes is caused by a combination of factors, including insulin resistance, a condition in which the body’s muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin. Symptoms of type 2 diabetes may develop gradually and can be subtle; some people with type 2 diabetes remain undiagnosed for years.
Type 2 diabetes develops most often in middle-aged and older people who are also overweight or obese. The disease, once rare in youth, is becoming more common in overweight and obese children and adolescents. Scientists think genetic susceptibility and environmental factors are the most likely triggers of type 2 diabetes.
Gestational diabetes affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose. Diagnosis of gestational diabetes is made during pregnancy. The majority of gestational diabetes patients can control their diabetes with exercise and diet.
Is there a cure for diabetes and what are the treatment options available?
There is no cure for diabetes, but it can be managed and controlled. Treatment for diabetes depends on the type of diabetes. Insulin injections, controlling blood sugar levels, controlling cholesterol, taking prescribes diabetic medicines and making healthy food choices are the most common treatment methods. Another option is getting a pancreatic transplant, but this is possible for people with type 1 diabetes. A pancreatic transplant would help restore blood sugar control, but the patient would need to take medicine for the rest of their life to help their body accept their new pancreas.
The natural treatment and home remedy for diabetes are grape seed extract, garlic, walnut, ginger, bitter melon, aloe vera, olive oil, Vitamin C supplements, berries, apple, okra, papaya, beans, salmon, oats and so on. Diabetics should avoid fruits like pineapple, strawberries, oranges, very ripe bananas. If you are diabetic, you have to keep a close eye on the amount of carbohydrate you eat to avoid weight gain and high blood sugar level.
What lifestyle changes can be made in preventing diabetes?
There is need to manage your blood sugar levels. Check your glucose level frequently, weight loss management, avoid stress, exercise and ensure you have a good sleep. Also indulge in vegetable like lettuce, spinach and fruits like mango, apple, guava, grapefruit, oranges, blueberries and so on. Emotional stress affects your blood sugar levels. So, it is paramount to learn to relax.