Top 10 Facts on Diabetes

Did you know?
• World Diabetes Day falls on the 14th of November? Why that specific day?
• The details on diabetes are inscribed in manuscripts dating back to 1500 BC?
• Doctors actually tested the patient’s urine to confirm the disease condition back in 17th century?
• The vast majority of diabetic patients do not know that they are diabetic and hence are not receiving the proper care?
• Diabetes in pregnancy is much more common in Nepal than the world average?
• Severe COVID (cytokine storm) is linked with uncontrolled diabetes?

Do read the interesting facts on diabetes, as Medicos Next brings up an issue to mark the World Diabetes Day.

Diabetes is a chronic disease condition in which the blood glucose levels remain above normal limits. The body either does not produce enough insulin or fails to respond to the hormone to keep the blood sugar levels steady. Studies indicate that 19% of people of above 40 years of age living in urban areas in Nepal suffer from diabetes. Globally, an estimated 451 million people had diabetes, according to 2017 data, and that more than 224 million adults with DM remain undiagnosed as a result of a combination of lack of awareness, poor health systems, slow onset of symptoms, and slow disease progression.

Let us learn some interesting facts about diabetes.

Fact 1

Diabetes history
Diabetes is a pretty old disease, and old Egyptian manuscripts dating back to 1500 B.C. mention diabetes as a disease characterized by ‘too great emptying of urine’. Indian physicians called it madhumeha (honey urine), because the urine from a diabetic person attracts ants.

Fact 2

Diabetes Mellitus—coining the name
The term mellitus (Latin, ‘sweet like honey’) was coined by British Surgeon-General John Rollo in 1798 to distinguish this diabetes from the other diabetes (insipidus,) in which the urine was tasteless. Did you just notice reading “urine was tasteless” and felt disgusted thinking, who tastes urine in the first place? It was actually a way of diagnosing the diabetes before chemical tests and dipsticks became a common method to distinguish diabetes. Thomas Willis, a London based physician, actually started the practice of tasting the urine of his patients to check if the urine was ‘honeyed’ back in the 17th century.

Fact 3

World Diabetes Day November 14
World Diabetes Day (WDD) was created in 1991 by International Diabetes Federation (IDF) and the World Health Organization (WHO) in response to growing concerns about the escalating health threat posed by diabetes. World Diabetes Day is marked every year on November 14, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922.

Fact 4

Prediabetes is unreported
Prediabetes is impaired glucose tolerance, and it is a considered as serious health condition, where blood sugar levels are higher than normal, but not high enough yet, to be diagnosed as type 2 diabetes. People are often unaware of contracting diabetes, and this is more common with prediabetes.

Fact 5

Types of Diabetes Mellitus
Diabetes Mellitus are of three types: Type 1, Type 2, and gestational. Type 1 diabetes is an autoimmune disease where the body fails to produce insulin and is dependent on external source of insulin. It usually affects children and teenagers, but can appear later in life, too. Type 1 diabetes is also called insulin-dependent diabetes. Type 2 diabetes used to be called non-insulin-dependent or adult-onset diabetes. About 90% of people with diabetes have type 2. In Type 2 diabetes, either the insulin production is low, or body does not respond to insulin the way it should. Gestational diabetes is high blood sugar (glucose) that develops during pregnancy and usually disappears following childbirth. It can happen at any stage of pregnancy, but is more common in the second or third trimester. Gestational diabetes is more of a risk for the baby than the mother.

Fact 6

Signs and symptoms
• blurry vision
• intense thirst
• need for frequent urination
• fatigue
• numbness or tingling in the hands or feet

Fact 7

Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation.

Fact 8

Diabetes is preventable
The classical risk factors for Type 2 diabetes include aging, family genes, and being overweight or obese. However, staying healthy through proper diet and about 30 minutes of exercise every day, or on most days, can drastically decrease the chance of getting Type 2 diabetes.

Fact 9

Diabetes in Nepal
Nepal Diabetes Association reported that diabetes affects approximately 15% of people above 20 years and 19% above 40 years in urban areas. According to WHO, diabetes affects more than 436,000 people in Nepal, and this number will rise to 1,328,000 by 2030.
A study, “Burden of Diabetes and Prediabetes in Nepal”, published in Springerlink in July 2020, states that in 2017, almost 10,000 deaths were attributed to diabetes. It further states that only half of patients with diabetes are aware of their diabetic status, and even fewer are taking anti-diabetic medicines. Only a third of those under therapy had their blood glucose under control.

Fact 10

Gestational diabetes in Nepal
Gestational diabetes is said to be present in 2% to 10% of pregnancies, and usually goes away after childbirth. Gestational diabetes (GDM) is said to be more common in the Asian population, and a study conducted in Nepal comprising of 200 pregnant women showed that 27% of them had GDM. Having family history of diabetes and being obese are important risk factors for GDM. Timely screening is a must if you are pregnant and have any of the risk factors.

As we wind up:

Uncontrolled diabetes and severe COVID-19
Diabetes is a common risk factor for severe COVID-19, and a group of researchers from the University of Michigan have identified that an enzyme called SETDB2 implicated in the non-healing, inflammatory wounds found in people with diabetes is the culprit. A decrease in the level of SETDB2 in the immune cells results in exaggerated immune response (cytokine storm) in severe COVID patients.

Is diabetes reversible?
There is this question in many patients’ head: Is it actually possible to reverse or cure diabetes? The answer is not a straightforward yes or no, but rather, maybe, in some cases. People saying that they have “reversed” their diabetes means that they were able to stop using diabetes medication after making healthy lifestyle changes, such as losing weight, following a healthful diet, and exercising. If prediabetes, type 2 diabetes, or gestational diabetes is detected early in an individual, who immediately initiates healthy lifestyle changes, it may be possible to reverse or at least stop the progression of the disease.

What can you, as an individual, do to prevent or control diabetes?
As an individual, one must work to achieve and maintain a healthy body weight. You must be physically active, with at least 30 minutes of regular, moderate-intensity activity on most days. Develop the habit of eating healthy diet of three to five servings of fruit and vegetables a day, and reduce sugar and saturated fat intake. Make sure to avoid tobacco use and harmful use of alcohol. Last, but not the least, test blood glucose and glycated hemoglobin (HbA1C) levels regularly.

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