By Noel Somasundaram
November 11, 2021: With a staggering 463 million adult diabetic patients present worldwide, World Diabetes Day 2021 – falling on the 14th of November- is a critical time for diabetes support communities and healthcare advocates to rally together to create awareness about this debilitating medical condition and push for progress in the standards of care and the better management of diabetic patients. In Sri Lanka alone, 1 in 10 adults are approximated to suffer from the disease, with a large number of patients succumbing to its various complications every year.
Diabetes takes root when the body isn’t able to take up sugar (glucose) into its cells and use it for energy. Insulin is a hormone made by the pancreas, an organ located behind the stomach. The pancreas releases insulin into the bloodstream. It acts as the key that unlocks the cell, allowing glucose to enter the body’s cells to provide them with the energy required to function properly. With diabetes, these insulin producing cells in the pancreas are either destroyed and obstructed or the insulin that is produced is prevented from being absorbed into the body’s cells to process glucose adequately. This results in a build up of extra sugar in the bloodstream, and gives rise to what we call ‘high blood sugar’.
Factors that cause diabetes are varied, and can be both genetic and lifestyle induced, and be classified into Type 1 and Type 2 diabetes. With Type 1 Diabetes, the immune system mistakes the body’s own healthy cells for foreign invaders. The immune system attacks and destroys the insulin-producing beta cells in the pancreas. After these beta cells are destroyed, the body is unable to produce the insulin that is critical to process glucose. Type 1 Diabetes is generally caused due to genetic and environmental factors such as a family history of diabetes and even geographical location.
With Type 2 Diabetes, with type 2 diabetes, patients are insulin resistant. This means that the liver is unable to produce enough insulin, and is unable to use it effectively, causing glucose to amass in the blood. Type 2 is most often due to physical inactivity and obesity.
Poorly controlled diabetes can lead to serious consequences, causing damage to a wide range of the body’s organs and tissues. Over a lifetime, poor glucose control inflicts widespread damage in our systems which can lead to strokes, heart attacks, kidney failure, eye disease, and limb amputations, and reduce a person’s quality of life.
A few symptoms of this silent killer includes increased thirst, lethargy, frequent urination, unexplained infections, numbness or tingling in hands or feet, slow-healing wounds, blurred vision, amongst others.
COVID-19 and diabetes
Recent studies have also shown that the COVID-19′ virus has a stronger impact on those with comorbidities such diabetes. There appears to be two primary reasons driving this predicament. Diabetes causes the linings of blood vessels throughout the body weaken to an extent where they can’t ferry necessary nutrients adequately, which together with inflammation, another byproduct of poor diabetes control, makes the body ill-prepared for the onslaught of the viral disease.
Secondly, the rich environment of elevated blood glucose present in diabetic patients, makes them prone to superadded bacterial complications during the viral infection. Many diabetics also tend to have other co-morbidities such as obesity, hypertension, and heart disease, which are all factors that aggravate complications during viral illneses. These problems are seen in any infections in the setting of diabetes and not only with COVID 19.
Simple steps, regular checks!
During this pandemic, apart from strict adherence to general COVID-19 personal safety protocols such as strict social distancing and sanitization, it is important for patients to regularly monitor their glucose levels to avoid complications caused by fluctuating blood glucose. Proper hydration is essential for good health. It is also crucial to have access to a good supply of the prescribed diabetes medications and healthy, wholesome food so that patients are able to correct the situation if blood glucose levels fluctuate. Finally, regular checkups, sticking to a comfortable daily routine, maintaining an exercise program even within the confines of home, reducing excessive work and having a good night’s sleep can go a long way in keeping a person strong.
The Nawaloka Diabetes Centre offers a wide plethora of affordable health packages carefully curated to suit diverse patient requirements. This includes initial screening packages, cardio checks, quarterly screening packages, annual screening package, and complete neuropathy assessments, under which patients are tested with a full panel of blood, liver, lipid and renal tests, neuropathy examinations, fundal photography, abdomen scans, x-rays and ECGs amongst others.
(The writer is Dr. Noel Somasundaram, Endrocinologist and Diabetologist at Nawaloka Hospitals, Colombo)
