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Destination diabetes

KAMALA THIAGARAJAN
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HEALTH Over the years, you may have heard much about the disease that we are so vulnerable to as a nation. And yet, misinformation abounds. KAMALA THIAGARAJAN separates fiction from fact to bust the biggest diabetes myths

According to the Indian Diabetes study, (a nation-wide study conducted by the Indian Council of Medical research), 62.4 million Indians are currently battling diabetes. It has undoubtedly become our national disease. And experts predict that these figures will soon rise. Our country is estimated to have over 100 million diabetics by 2030. When a disease takes on these epidemic proportions, it is only right that we arm ourselves with as much awareness as we can in order to fight it.

Decoding Diabetes: What is it exactly?

We require energy for all thought and action--it is the essence of life. To provide us with this life-sustaining energy, the food we eat is digested, converted into glucose and enters our blood stream. But this glucose is useless to us unless it is transferred effectively to our cells. And in order to make this transfer, the Beta cells in our pancreas must produce a substance called insulin. Normally, this process happens in our bodies without our knowledge. After every meal, the pancreas produces sufficient amounts of insulin and you feel energetic and refreshed. However, if you have Type 1 Diabetes, a genetic disease, the pancreas fails to produce insulin. Type 2 diabetes however, is induced by a bad lifestyle and is a result of constant abuse. If you're overweight and unfit, you're a prime candidate. Often, we don't eat meals on time or eat the wrong kinds of foods and soon, our bodies are producing plenty of insulin but our cells are no longer responding to it. In both cases of diabetes, glucose accumulates in the blood stream and our body is left to deal with the overload by excreting it, making you officially diabetic.

Here are some common myths that revolve around the disease.

Myth: Diabetes affects only the middle-aged or elderly:

Diabetes can affect anyone--even children. Most children have the Type 1 variety as a result of genetic factors. Experts say that the Type 2 diabetes is now prevalent among adolescents and the younger generation.

"The majority of people with diabetes mellitus have the Type 2 variety (also called T2DM). T2DM predominantly affects older individuals in developed countries, but in developing nations like India, it has affected our younger population in the prime of their working lives and thus poses an even greater threat to their health and quality of life," says Vartika Singhal, a consultant dietician at the North Delhi Diabetes Centre.

Myth: All patients with diabetes require insulin injections:

Not all diabetics require insulin injections. "Several factors should be taken into account such as type of diabetes, current blood sugar levels, whether or not the patient is able to manage blood sugar with medication along with diet and lifestyle changes. Once diagnosed, people with Type 1 diabetes need to take insulin throughout their lives, because their bodies are incapable of making it," says Dr Swati Bhardwaj, Vice Head, Center for Nutrition and Metabolic Research (C-NET) and senior Research officer (Nutrition) of the Diabetes Foundation of India (DFI).

And today, as technology advances, insulin pumps have replaced the need for periodic injections. "The insulin pump delivers rapid or short acting insulin 24 hours a day through a catheter placed under the skin. When you work closely with your diabetes care team, insulin pumps can help you keep your blood glucose levels within your target ranges," says Dr Bhardwaj.

Myth: People with diabetes must avoid sugar like the plague:

You might be surprised to learn that people with diabetes often have meal plans that include sugar. "Having diabetes doesn't mean that one can never eat sweets or cakes again,"says Dr Bhardwaj. "While processed sugar should usually be avoided, when eaten as part of a healthy meal or combined with an exercise plan, sweets and desserts (in small portions) can be taken. However for this, it is essential to monitor your blood sugar levels on a regular basis."

Regulating blood sugar is of course, the key to controlling the disease. This is because diabetics tend to lose a lot of sugar in urine and there are times when blood sugar levels fall alarmingly. When the blood sugar levels drop below 70 mg/dL (also known as hypoglycaemia), the patient experiences symptoms like weakness, extreme fatigue, shivering, sweating, nervousness, double vision, fast or pounding heartbeat, hunger and headaches. In such a situation, a diabetic needs to consume sugar in order to raise the blood glucose level. "Any simple form of sugar should be immediately consumed, such as 2 teaspoonfuls of sugar/honey, 1 cup fruit juice, 1 cup regular soft drink, 5-6 pieces of chocolate," says Dr Bhardwaj.

Myth: Only overweight people are in danger of contracting diabetes:

While being overweight is a risk factor for contracting Type 2 diabetes, thin people may be at risk too. "Even thin people can be affected if they have high blood pressure, a heart attack or stroke," says Vartika Singhal. "An inactive lifestyle and unhealthy eating habits are bad for all and lead to beta cell impairment (damaging the pancreas and it's ability to secrete insulin). Women suffering from polycystic ovarian syndrome, who have had gestational diabetes or severe mental health problems are all at risk."

Myth: All diabetics should avoid exercise

Experts recommend a daily physical activity of 60 minutes in duration, including 10-15 minutes of resistance exercise for diabetic patients. However, any exercise program must be evaluated by a physician before beginning as diabetics must be cautious of abruptly starting any activity. Exercise is best avoided only if your blood glucose level is greater than 300 mg/dL, lower than 70 mg/dL, or in the case of type 1 diabetes, your fasting glucose level is greater than 250 mg/dL and/or ketosis is present. Patients with diabetic retinopathy should avoid resistance or weight training.

Myth: Diabetics are often ill, especially affected by cold:

Diabetics are no more prone to cold than non-diabetics, but they do need to ensure that their condition doesn't aggravate other health issues. "Studies have shown that diabetes is the major risk factor for heart attacks, paralytic strokes, kidney failure leading to dialysis, foot amputations and blindness. If diabetes is not controlled, related complications like diabetic nephropathy, retinopathy, neuropathy can crop up" says Dr Bhardwaj. Even minor illness can make diabetes difficult to control, so keeping yourself healthy, taking regular flu shots, monitoring blood pressure and cholesterol should all play a vital part of leading a healthy, stress-free life after diabetes.

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