Diabetes often goes undiagnosed in many people because they have only minor symptoms especially in the initial stages.
Babu, a 64-year-old farmer, had a slight burning sensation in his feet and mild fatigue for six months. He felt it was due to the hot and humid climate. But when he approached a local physician for reduced vision he was told that he had cataract, which needed surgery. After investigations, the physician informed him that he was not fit for surgery since his ECG showed some changes, and he had also developed diabetic neuropathy and diabetic retinopathy (damage involving the nerves and the retina of the eye respectively).
It is common to see such situations where people who had no indication of diabetes presenting to a physician with complications due to diabetes. This is because undetected diabetes may go on for several months leading to these complications. Undiagnosed diabetes represents about 50 per cent of the cases in the population. Since diabetes primarily affects the blood vessels, these people develop problems in the retina, kidneys, heart, brain and nerves in the feet.
How can we prevent this situation? This is where primary prevention of diabetes and early secondary prevention strategies play a very important role.
It is very necessary for people with a family history of diabetes and other risk factors like being overweight and high blood pressure and cholesterol levels to have regular blood sugar checks with a glucose tolerance test to detect the early stages of the disease. This helps in primary prevention of which helps to delay the onset of diabetes for several years with regular exercise and diet control.
For people in whom diabetes has already been detected, it is necessary to have good control of their diabetes with regular exercise, medication and diet control and also by controlling the other co-morbid conditions like hypertension and cholesterol.
Therefore people who have a risk of developing diabetes should undergo regular blood sugar checks. They can have a random blood sugar check at diabetes camps conducted by various organisations. This will bring to light many of the undetected diabetes cases. Each time such a camp is held, at least 10 per cent of people tested will be found to have diabetes for the first time.
It is very important for such people to keep their diabetes under control right from day one since it is possible that they have had diabetes for many months without their knowledge. They must consult a physician and get advice about medication, diet, lifestyle and blood sugar checks.
All medical professionals including nurses and paramedics must keep the symptoms of diabetes in mind and try to screen those who come for other ailments for diabetes also. Health promotion and early detection will help reduce the number of undetected and untreated diabetes in the community, thus decreasing the morbidity, mortality and cost burden due to diabetes and its associated complications.