Facing the dilemma of having diabetes

We all are fond of celebrations. Because, they carry love, laughter, happiness and food. 

December is almost over and now we are eagerly awaiting the new-year, (2020) as the starch and sugar, piled up during the celebrations are slowly trying to settle within our bodies in the best possible manner. Our bodies are a miracle and works to our favour. It always tries it’s best to let us enjoy the food without endangering our lives, but at one point, the intake becomes something more than what’s manageable. That is where we fall sick.

As we talk about starch and sugar, one miserable condition which definitely pops up in your head would be Diabetes. We have shared so much information on Diabetes from time to time hence you must have gathered all the basics facts about the disease. But the intention of today’s article is be to address some major issues related to it while focusing on common myths and beliefs existing during clinical practice. 

“High sugar levels in the blood can be fatal” warns Dr. Mrs. Kaushalya Perera, Health educator and Head of Wellness at Hemas Hospitals, Thalawatugoda, (MSc in diabetes (Hons)( USW,UK), Diploma in diabetes (USW, UK). 

Your body comprises tons of blood vessels from head to toe. These vessels are considered as the highway which circulate oxygen, glucose and nutrients to each organ and each part of your body. When the blood vessels carry a higher level of sugar, it damages the inner layer of the blood vessel (endothelium).

“High concentrations of sugar particles are considered to be toxic for the blood vessels. The damaged layer then houses LDLs and Triglycerides which get accumulated on the damaged surface. Platelets and Red Blood Cells get attracted to this location and ultimately formulates a clot. Subsequently the wall of the blood vessel becomes fragile and falls in to the risk of getting ruptured in a spur of a second”

Let’s make a quick re-cap on the basics.

Early symptoms 
“Patients would feel an unquenchable thirst, excessive hunger, a sudden weight-loss over a very short period, blurred vision, slow wound healing and genital irritation due to recurrent fungal infection.

Also sexual dysfunctions for both men and women can be a symptom which most parties refuse to accept and voice out” says Dr.Perera.

Types of Diabetes
Diabetes classification transcends even beyond the most infamous type 1 and type 2 interpretations. Apart from these, there are the Maturity Onset Diabetes of the Young (MODY), Latent Autoimmune Diabetes in Adults (LADA), Gestational diabetes (developed during pregnancy and usually disappears after giving birth) and Secondary diabetes (as a secondary effect due to Cushing syndrome and other conditions).

Target blood sugar levels
“According to 2019 guidelines, the HBA1C should be maintained at 6.5- 7%. If you are above 60 Hba1C of 7% is allowed,” the doctor said. 

‘Silent Killer’
“Nerves are considered as the signaling system in your body. They bring information to your brain from the external world as well as from the internal Organs. Every nerve is getting a solid blood supply for its survival. When you get a clot in a blood vessel, which nourishes a certain nerve, it will be deprived of the blood supply and ultimately dies resulting in Neuropathy. Once this occurs, the nerves stop sending messages to the brain from internal organs. 

In a nutshell, a patient won’t even be aware, if a sudden heart attack or a stroke pops up” Dr. Perera highlights. 

Annual vision check-ups are mandatory
The inner layer (retina) of the eye comprises tons of blood vessels. High glucose concentration damages the retina (the inner layer of the eye ball). An unfavorable, hostile blood supply causes clots and damages the main blood vessels in the retina. As a response to that, the inner layer of the eye makes more and more immature new blood vessels. However, the good news is these changes would hardly give you any visual disturbances. 

However, these new vessels are unhealthy and easily breakable. Hence, they rupture and would bleed into the eyeball which ultimately causes visual impairments and blindness. 
“Being hard to recover if you delay identifying the problem, it is advisable to visit regular eye screenings, and get checked by responsible specialists” Dr. Mrs. Perera added.
Get your urine checked for micro albumin once in every six months.

As far as the diabetes complications are considered nephropathy plays a vital role. When your kidneys are exposed to a high sugar concentration, holes which filter out blood become enlarged. Through a healthy filter of a kidney (glomeruli) protein doesn’t leak since the holes are smaller than the protein. When the holes become enlarged protein can easily go through the filter. We identify the protein leak by doing a urine Micro-albumin test. This is the earliest sign of kidney impairment. However if you detect this issue early, we can reverse the condition with the support of medication as well as good sugar control. Most of the time diabetics don’t check their urine micro album leak and they end up in kidney failure which is not reversible at all.

Cellulitis in Diabetic patients is not uncommon
According to the doctor, any kind of skin damage (even an insect bite) can give rise to cellulitis. “When you are a diabetic your immune system is not healthy enough to attack bugs (bacteria/ virus). Cellulitis occurs when bacteria, most commonly streptococcus and staphylococcus, enter through a crack or break in your skin. It makes its babies (bacteria multiplication) and will actively destroy your skin. It will be a shiny skin which is red and warm to touch .Wound care is of utmost importance for a diabetes patient. Foot hygiene should be given prominence. Since the body fails to respond to stimuli, the risk of injuries are extreme. Every night patients should do a thorough foot inspection for potential injuries as a habit. Once injured at this stage, the patient is prone to Cellulitis. This, supported by recurring wounds might potentially lead up to amputation of the organ under consideration,” emphasized Dr.Perera.
Do not ever turn a blind eye to Sexual disability (impotence)

“According to some of the latest researches when you are a diabetic with impotence it foretells a heart attacks or a stroke in 4 yrs. However if you are able to voice this issue out without any hesitation and any further delay, a mere control of blood sugar levels not only with medication, but also with the support of exercise and diet, would do miracles” she underscored.
Metformin, the miracle drug and misconceptions to leave behind as you walk into 2020.

According to the guidelines, Metformin is the first line treatment in terms of managing diabetes. It has been derived from a plant called ‘French lilac’, found in 1922. After doing so many researches on animals as well as human, scientists introduced the best out of French lilac plant as metformin pills, produced at very safe concentrations as a chemical. 

When your blood creatinine is high it indicates that creatinine (toxins) doesn’t filter from the kidneys since it has stopped filtering. It happens when your sugar damaged your blood vessels in the kidneys to a point where it doesn’t filter metformin as well. So doctors immediately stop metformin when there is a kidney damage solely because it tends to accumulate in the blood without filtering through kidneys. 

“Therefore, it is important to know that Metformin is not stopped due to any harmful effect of its composition, but due to harmful effects of sugar dysfunctional kidneys doesn’t filter metformin. It’s always best to take it and reduce high sugar levels which in turn it protects your kidneys” said Dr. Perera.

The role of Kamaranga and Kowakka 
According to some of the researches done on Kamaranga, they have found that it impairs the filtration ability of kidneys. But taking those once in a while is not harmful as far as your kidneys function well. However, not many researches have been done around Kowakka and other herbals. 

“What needs be kept in your mind is, as far as your sugar control is good, don’t try to take the above since it drops your sugar further and you would end up in hypoglycemia which is detrimental than having high sugar. Hypoglycemic can damage brain cells (neurons)” sais the doctor. 

Take home message
Watch out your starch and sugar intake  during this festive season. Stick to the safe limits and maintain a sound compliance on anti-diabetic drugs. Always make sure to seek medical advice when necessary. 

Diabetes is a condition which can give rise to deadly complications, but can easily be controlled with early medical intervention. So, always make sure to read around, get medical advice, get rid of myths, beliefs and share correct information with your loved ones because one simple act of yours can make a huge difference in the incidence of non-communicable diseases like these.