What is diabetes?

Diabetes Mellitus or diabetes is a condition in which the blood sugar levels reach abnormally high levels because the body is unable to control sugar levels by producing enough insulin or responding to insulin properly. Diabetes occurs because either the pancreas produces insufficient insulin necessary for the absorption of sugar by the body cells or the body cells are resistant to the insulin that is produced and therefore unable to absorb the sugars.

Diabetes is categorized into two major classes:

Symptoms of diabetes include increased fatigue, thirst, hunger, and urge to urinate. Weight loss and blurry vision may sometimes be observed. Blood vessels are damaged and therefore simple wounds may take long to heal. There are blood tests that can yield accurate information on whether the blood glucose levels are in the appropriate range.

Causes of diabetes

• Heredity is one cause over which the prospective patient has little control. If a parent is diabetic, there is always a chance that the offspring has inherited the genetic traits that can lead to this condition.
• Autoimmune reactions are the most common cause of Type 1 diabetes; the reaction leads to a destruction of the insulin-producing pancreatic cells. It may caused by a viral attack or an abnormal secretion of hormones antagonistic to insulin.
• Age is an important factor, with more than 80% of the cases reported in people above 50 years in age.
• Type 2 diabetes has a very strong correlation to lifestyle. A healthy lifestyle that includes exercise and nutritious food goes a long way in keeping the dreaded disease at bay. Conversely, eating refined foods and leading an excessively sedentary life increase the chances of a person acquiring this condition.
• There is a direct relation between cardiovascular disease and diabetes.

Complications resulting from diabetes

• Nerve disease is an invariable outcome of long-term diabetes. The femoral nerve may also be affected. Cramps and tenderness in the muscles is felt. Muscular pain is relieved to an extent by activity but gets aggravated by cold. Symptoms of neuropathy caused by diabetes include reduced perspiration, edema, carpal tunnel syndrome, incontinence, constipation, etc.
• Diabetes can lead to loss of vision. The patient may experience narrowing and hemorrhaging of blood vessels in the eye. Loss of vision and reduced field of vision is noted in the earlier stages; retinal detachment may occur in the later stages. Diabetes can cause cataracts and glaucoma.
• Diabetes causes atherosclerosis and coronary artery disease; disease of the blood vessels is what often proves fatal to diabetics.
• Renal damage occurs with diabetes and is a leading cause of death with young diabetics.
• If the body is treated with too much insulin it leads to a drop in the blood sugar levels; low blood sugar levels or hypoglycemia deprive the body and particularly the brain of an important source of energy. Hunger, dizziness, palpitations, and loss of consciousness may occur if a person suffering from hypoglycemia over-exercises or skips a meal.
• An increased risk of infection from wounds, complications during pregnancy, problems in the gastrointestinal tract, oral disease, etc are some other complications that a diabetic may have to face.

Diabetes and weight loss

Obesity has been considered to be a very significant factor in the development of insulin resistance. A high fat diet and a lack of exercise are undeniable causes of obesity. Apart from diabetes, obese people are more susceptible to hypertension and arthritis. Thus, weight loss and weight management are important aspects of a diabetes control and management regimen.

Diet, nutrition, and exercise play an important role in losing weight, particularly around the abdominal area. Bariatric surgery is considered when a person is too obese and there is an urgent need to lose weight. Chart out a weight loss plan in consultation with your doctor as he is well-placed to factor in the effects of your medication on your weight loss activities. The basic idea is to cut calories, eat more fiber, and exercise. Quit smoking and moderate your alcohol consumption.

Diet and nutrition for the diabetic

Diet and nutrition are two very important elements in the management of this condition; with proper diet a person can slow down the progress of this disease and reduce insulin dependence. The nature of diabetes, its severity, age, weight, activity-levels, and gender are some of the factors that are considered when deciding a diet for diabetics. The diet should be such that we can control the amount of blood sugar to the extent possible. To this end, we need to eschew sugar rich foods and carbohydrates. There is no reason why a diabetic should be restricted to a bland diet; it is possible to enjoy different fruits, vegetables, and other foods provided moderation and balance are employed.

Cooking techniques make a difference – bake food items instead of frying them. Stay away from batter-cooked food. Condiments such as mustard and ketchup that are high in salt and sugar (as well as the foods on which they are typically used) should be avoided.

Following a routine is important; you may benefit from a food journal. If a journal is too difficult to maintain then you at least need to keep a schedule timing your diet, need to check blood sugar levels, and insulin administration- particularly if you take long-acting insulin.

On rare occasion you may treat yourself to less optimal diet choices. If you should cheat a bit on your diet you should not use that as a psychological block to ignore the spike in blood glucose that will inevitably follow. Always keep tabs on your blood glucose levels.

Consult your doctor on the best nutritional supplements for your condition. Increased intake of Vitamin C is important as the metabolism of this vitamin is hindered by insulin deficiency. Chromium and biotin help to metabolize carbohydrates. Magnesium helps lower the risk of heart attack by lowering blood pressure. Vitamin D and E have been suggested to improve insulin sensitivity and reduce insulin resistance.

Bariatric surgery, obesity, and diabetes

Bariatric surgery has emerged as a very effective and credible treatment option for obesity-related diabetes, particularly for patients afflicted with Type 2 diabetes. This type of surgery is usually considered for obese diabetics with a Body Mass Index of over 35.

Weight loss achieved through bariatric surgery has been associated with improvements in many chronic conditions including diabetes. After surgery, the insulin requirements of a patient reduce. This is because with weight loss, insulin sensitivity increases and the patient responds better to oral medication. Successful weight-loss surgery followed by a healthy lifestyle can cause the condition to go into remission. The biggest advantage with bariatric surgery is that the patient can achieve and sustain a significant weight loss which leads to much improved blood glucose control. The difficulty is in maintaining the post-operative lifestyle regimen.

The Roux-en-Y gastric bypass (RYGB) and the Lap-Band procedures offer good results in context of weight reduction and remission of the diabetes. The RYGB seems better for this purpose. Bariatric procedures of the bypass type also help by stimulating the secretion of gut hormones that increase insulin secretion and sensitivity. Improved blood sugar control often occurs in bariatric patients even before major weight is lost.

The surgical method has been shown to be most effective when applied to patients with a recent onset of the condition, i.e. less than five years. Proper diet, oral medication, and a substantial plus durable weight loss through surgery can lead to diabetes remission in relatively young and fit diabetics.

Bariatric surgery as an option for treating diabetes is relatively safe and very importantly cost effective when factored as an intervention for preventive medicine. Non-surgical treatments are an ongoing financial drain on the patient and do not present as high a likelihood of cure as does bariatric surgery.

People with type 2 diabetes are at risk for developing: