The numbers are scary: about 24 million adults who are 18 and older had diabetes in 2021; the number is set to increase to 55 million by 2045, and more than half of people living with diabetes do not know that they have the disease.
While diabetes is not a death sentence, it is a significant cause of life-threatening complications such as heart diseases, stroke, blindness, kidney disease, foot ulcers, urinary tract infections in women, erectile dysfunction in men, and so on. Knowing what diabetes is all about can help you make safe choices to protect yourself and perhaps manage the risks.
Diabetes is a chronic disease
Diabetes is a chronic condition that develops when the body cannot control blood sugar, either because it cannot use the insulin the pancreas makes or because the pancreas does not produce enough insulin.
Uncontrolled diabetes frequently causes hyperglycaemia, or elevated blood sugar, which over time seriously harms many bodily systems, including the nerves and blood vessels. Diabetes caused 416,000 deaths across the world in 2021.
Type 1 versus type 2 diabetes
The primary difference between type 1 and type 2 diabetes is that type 1 is a genetic illness that usually occurs in childhood. When you have type 1 diabetes, your immune system attacks and kills the cells in your pancreas that make insulin. In contrast, type 2 is primarily a result of lifestyle choices and develops over time.
Type 1 diabetes
Deficient insulin production is a hallmark of type 1 diabetes, sometimes called insulin-dependent, juvenile, or childhood-onset. This condition requires daily insulin injections.
In type 1 diabetes, the body attacks the pancreatic beta cells, impairing their capacity to make insulin. High blood sugar levels result from the cells' inability to absorb glucose in the absence of sufficient insulin. Children are most frequently affected by type 1 diabetes.
Symptoms of type 1 diabetes include:
- frequent urination (polyuria)
- excessive thirst (polydipsia)
- persistent hunger
- Weight loss
- poor vision
- exhaustion
These signs often appear suddenly and worsen over time if the high blood sugar is not well controlled.
Type 2 diabetes
Type 2 diabetes, also known as non-insulin-dependent or adult-onset diabetes, occurs when the body cannot use insulin adequately. Most people with diabetes worldwide suffer from type 2 diabetes, and the common risk factors include being overweight and physically inactive. The disease is more common in adults.
Insulin resistance, which is a complication of type 2 diabetes, affects how well your body recognizes insulin. Without a sufficient insulin response, it becomes more difficult for your cells to absorb glucose, which causes blood sugar levels to increase.
While symptoms are frequently less severe than those of type 1 diabetes, they may be comparable. As a result, the condition may not be discovered until after its onset, when complications have already developed. This particular type of diabetes was previously only observed in adults, but it is becoming increasingly seen in kids.
Is it true that black people are more likely to have diabetes?
One reason millions of Africans have diabetes is that black people are more likely to have the disease than non-blacks. This increased risk are linked to:
- Gene-dependent factors
Some researchers suggest that the “thrifty gene”, which helps certain groups to conserve energy and nutrients during scarcity, is a potential reason why black Americans had higher diabetes rates than other ethnic groups.
- Health-related factors
Obesity and reduced physical activity are linked to increased emergence of type 2 diabetes among blacks.
- Social factors
Poverty is a significant risk factor for diabetes. In a 2014 study, researchers studying the relationship between diabetes prevalence and poverty found that the rates of diabetes were greater among blacks but particularly higher in poor folks.
Diabetes during pregnancy
Gestational diabetes is a type of hyperglycemia that develops during pregnancy. It may cause the child to die before birth, and make the child grow so big that delivery may be difficult.
Prenatal screening is used to determine gestational diabetes rather than patient complaints of symptoms.
Diabetic neuropathy
Persistent increase in blood glucose levels can damage nerves, leading to diabetic neuropathy. This condition is common to both type 1 and type 2 diabetes.
Nerve damage numbs some parts of the body, especially the feet, causing loss of sensation and sometimes pain. People who lose sensation are most likely to get ulcers on their feet, which, if not detected early, can lead to foot amputation.
However, you can reduce your risk of developing nerve damage by keeping your blood sugar level at your target range or as close to normal as possible and practicing careful foot care.
How do you reduce your chances of developing diabetes?
Type 1 diabetes is not preventable. On the other hand, you can minimize your chance of having type 2 diabetes even if you have a higher risk than average for the condition by:
- Modifying your diet
Eat a well-balanced diet with less sugars, reduced fats, and more fresh fruits and vegetables. Fill your plate with whole meals, including whole grains, lean meats, and healthy fats. Avoid eating food that is heavy in calories and fat.
- Exercising regularly
Aim to get at least 30 minutes of physical exercise. Commit to taking 6,000 steps per day. Walk around the house or jog a few hundred metres. Skip a rope or do what you can to keep your heart pumping or make you break a sweat for a moment. Doing these will help you shed excess blood sugar and keep the level low.
- Going for regular medical checkups
See your doctor at least twice a year. Diabetes raises your odds of heart disease. So learn your numbers: cholesterol, blood pressure, and A1c (average blood sugar over three months). Get a complete eye exam every year. Visit a foot doctor to check for problems like foot ulcers and nerve damage.
- Managing stress
Stress causes your body to release hormones that increase blood sugar levels. Relieve that stress by seeking help where necessary, delegating your tasks, saying no to stressful commitments, or engaging in hobbies that help you relax.
Other steps that can reduce your risk include:
- Reducing your alcohol intake
- Quit smoking
- Managing your body weight
How can you tell if you have diabetes?
Symptoms of diabetes take time to appear, and by that time, complications might have set in. A safer way to know your diabetes status is to monitor your blood sugar level.
Blood sugar testing is an important part of early diabetes diagnosis and diabetes care. If you have diabetes, commit to checking your blood glucose levels. It will help you manage diabetes and prevent complications.
There is no fixed number of times you should check your blood sugar level. The frequency of testing will depend on the type of diabetes and your treatment goals.
The different types of tests that could tell if you have diabetes are:
Fasting blood glucose test
An 8–12 hour fast is required for a fasting blood glucose test, and the results could show:
- Less than 100 mg/dL shows a normal range
- From 100 to 125 mg/dL shows signs of prediabetes
- Greater than 125 mg/dL on two occasions is a sign of diabetes
Oral glucose tolerance test
An oral glucose tolerance test measures your blood sugar levels over two hours following the consumption of a sweet beverage. Test results for oral glucose tolerance may show:
- Standard range: blood glucose level less than 140 mg/dL
- Prediabetes: blood glucose level between 140 and 199 mg/dL
- Diabetes: blood glucose level greater than 200 mg/dL
A1C test
An A1C test measures your average blood sugar control over the previous two to three months. It may show:
- Standard range: less than 5.7%
- Prediabetes: 5.7% to 6.4% of the total
- Diabetes: above 6.4%
Treatment of diabetes
Diabetes is treated by a balance of healthy diet, regular exercise, and other steps to reduce blood sugar levels, and manages the risk factors for complications. Interventions that are both practical and affordable in developing nations include
- Blood glucose management with lifestyle and dietary adjustment, insulin, and oral medications
- Blood lipid management
- Screening and management of diabetes complications
Final words
Millions of people in Africa have diabetes, and many more millions are set to have the disease. Many people do not know their diabetes status because they do not check their blood sugar levels regularly and because diabetes symptoms do not appear early. You can protect yourself by adjusting your diet and lifestyle.
