Diabetes Mellitus - a "sweet" but risky enemy
What is diabetes mellitus?
Diabetes Mellitus (DM) is a group of diseases characterized by high blood glucose levels, resulting from weakness / insufficiency of insulin production by the body, limited activity of insulin produced or a combination of both conditions (CDC 1998).
What are the risk factors for DM?
We can divide the factors into modifiable and non-modifiable ones, with the modifiable risk factors being:
- Obesity and excessive body weight, especially the accumulation of abdominal fat.
- Nutrition high in animal protein, fat and low in fiber.
- High blood pressure and high cholesterol
- History of gestational diabetes mellitus (since obesity is a risk factor for the occurrence of gestational diabetes)
- Sedentary lifestyle
Among the non-modifiable risk factors for DM are:
- Family history of diabetes
- History of gestational diabetes (as risk factors for the occurrence of gestational diabetes are also non-modifiable risk factors such as race / nationality or family life).
- For women: polycystic ovarian syndrome
What is prediabetes?
Before a patient develops type 2 diabetes, he usually suffers from a condition called prediabetes. In this case sugar levels increase, but not so much in order to diagnose diabetes mellitus, with the limits of the fasting blood glucose to be 100 - 125 mg / dl.
Is it important to identify prediabetes?
Yes, since it does not show any signs of symptoms. Therefore, people with high risk for DM should be checked for prediabetes and not ignore or underestimate its existence.
Are there ways to prevent diabetes mellitus?
There are ways to avoid or delay the onset of DM. These are:
- Achieve and maintain a healthy body weight.
- Achieve reduction of waist circumference (<102 cm for men and <88 cm for women).
- Increase physical activity - at least 30 minutes of regular, moderate intensity activity in most days, ideally every day.
- Follow a healthy diet (a Mediterranean diet) comprising three to five servings of fruits and vegetables per day as well as a reduction in sugar and saturated fat intake.
- Avoid smoking that increases the risk of cardiovascular disease.
Who should undergo medical tests and at what age does preventive testing for diabetes begin?
Anyone with symptoms of diabetes mellitus and who is at risk for diabetes mellitus should be tested. American Diabetes Association recommends that screening for type 2 diabetes should begin at the age of 45 and be carried out on an annual basis as it is estimated that from that age onwards, the chances of developing the disease are significantly increased.
Is it important to deal with diabetes quite early or can I leave it if there are no signs?
It is especially important that the onset of the treatment, the follow-up and the outcome of the therapy are CONTINUOUS and successful. If this is not the case or the treatment is imperfect or occasional, the patient is exposed to acute and mainly to chronic complications.
What are the chronic complications?
- Diabetic retinopathy: high blood sugar levels cause damage to blood vessels in the eye. If not treated properly, it can lead to blindness.
- Diabetic nephropathy: kidney damage caused by DM. It is risky and evolves gradually. It shows no signs of symptoms except for when detected via laboratory findings in the urinalysis.
- Diabetic neuropathy: with symptoms such as numbness, burning sensation, limb pain
- Complication in large vessels: with symptoms such as myocardial infarction, stroke.
What are the four pillars for the proper control of diabetes mellitus?
- Cope with obesity
- Do physical exercise
- Follow a proper diet
- Stop smoking
A few tips for increasing physical activity are the following:
- Walk while talking on the phone or when ads are displayed on TV
- Increase household chores such as gardening, car wash etc.
- Park far beyond than usual when you reach your destination (eg in the previous block)
- Take the stairs instead of the elevator
- Use a stationary exercise bike in the living room
By the Scientific Director Aristides Paraskevopoulos
1: Crawford K. Review of 2017 Diabetes Standards of Care. Nurs Clin North Am. 2017 Dec;52(4):621-663. doi: 10.1016/j.cnur.2017.07.010. Review. PubMed PMID: 29080582.
2: Dodds S. The How-To for Type 2: An Overview of Diagnosis and Management of Type 2 Diabetes Mellitus. Nurs Clin North Am. 2017 Dec;52(4):513-522. doi: 10.1016/j.cnur.2017.07.002. Epub 2017 Oct 5. Review. PubMed PMID: 29080574.
3: Appannah A, Rice T, Ogrin R. A review of current models for initiating injectable therapy for people with type 2 diabetes in primary care. J Clin Transl Endocrinol. 2017 May 22;8:54-61. doi: 10.1016/j.jcte.2017.05.003. eCollection 2017 Jun. Review. PubMed PMID: 29067260; PubMed Central PMCID: PMC5651335.
4: Bachmann KN, Wang TJ. Biomarkers of cardiovascular disease: contributions to risk prediction in individuals with diabetes. Diabetologia. 2017 Sep 28. doi: 10.1007/s00125-017-4442-9. [Epub ahead of print] Review. PubMed PMID: 28956084.
5: Chew BH, Vos RC, Metzendorf MI, Scholten RJ, Rutten GE. Psychological interventions for diabetes-related distress in adults with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2017 Sep 27;9:CD011469. doi:10.1002/14651858.CD011469.pub2. Review. PubMed PMID: 28954185.
6: Standards of medical care in diabetes – 2017, American Diabetes Association
7:Exercise and Diabetes Mellitus, Alliance for Health, 2017