Diabetes is a lifelong condition that causes a person’s blood sugar to rise above normally expected levels. According to reports from the World Health Organisation, one person dies every eight seconds and one limb is lost every 30 seconds worldwide due to the effects and complications of diabetes.
The condition occurs when there are insufficient levels of functioning insulin in the body system. Insulin is a substance (produced in the body by an organ called the pancreas) which is needed to help the body make use of much-needed sugar (also known as glucose) within the bloodstream for energy and other purposes. Insulin controls the amount of sugar (glucose) in your blood. A person is said to be ‘diabetic’ when the level of ‘sugar’ in the bloodstream rises to abnormal levels due to absence of insulin or failure of the body to respond to insulin produced by the pancreas.
The number of people affected by diabetes around the world has increased dramatically in the last few decades. In Africa, it is estimated that there are over 10 million people currently living with diabetes.
In Ghana, approximately 4 million people are affected by diabetes. Although information available from research is scanty and unreliable throughout Ghana and Africa, it is likely that there are large numbers of people with undiagnosed diabetes throughout the continent.
There are two main types of diabetes, referred to as type 1 and type 2.
- Type 1 diabetes (juvenile diabetes, or ‘early-onset’ diabetes) – is the type of diabetes that usually develops in children and young adults. In type 1 diabetes, the body stops making insulin completely causing a person’s blood sugar (or glucose) level to become very high.
With type 1 diabetes, the illness usually develops quite quickly, over a few days or weeks, as the body stops making insulin. Type 1 diabetes is treated with insulin injections and a healthy diet.
- Type 2 diabetes – is far more common than type 1 diabetes. This type of diabetes is called maturity-onset or non-insulin-dependent diabetes. Type 2 diabetes usually develops after the age of 40 (although it sometimes occurs in younger people) and is more common in people who are overweight or obese.
With type 2 diabetes, the illness and symptoms tend to develop gradually over a few weeks or months. Many people have type 2 diabetes for several years without knowing as the early symptoms can be mild and slow to develop.
This is because in type 2 diabetes (unlike type 1), although your body still makes insulin, you either do not produce for your body’s needs or the cells in your body are not able to use the insulin it produces properly (a situation called insulin resistance), or both.
Diabetes can cause a variety of symptoms. If you are diabetic, you may:
- feel very thirsty
- urinate frequently, particularly at night
- feel constantly tired
- experience weight loss and loss of muscle bulk
Other (less frequently occurring) symptoms of diabetes may include:
- itchiness around the vagina or penis, or regular bouts of thrush (a yeast infection)
- blurred vision
- muscle cramps
- skin infections
It is important to visit your doctor as soon as possible if you think you might have diabetes. Early diagnosis and treatment are likely to reduce your risk of developing complications later in life.
Type 2 diabetes (or maturity-onset diabetes) usually affects people over the age of 40. However, people in a younger age group are also increasingly being affected. Type 2 diabetes is more common in people of African, South Asian and Middle Eastern descent. Approximately 4 million people in Ghana are affected by diabetes while a significant number of true diabetics are yet to be discovered mainly for reasons such as poor access to medical care, inadequate diagnostic facilities and low levels of patient education and awareness.
The condition occurs when there are insufficient levels of functioning insulin in the body system. Insulin is a substance (produced in the body by an organ called the pancreas) which is needed to help the body make use of much-needed sugar (also known as glucose) within the bloodstream for energy and other purposes. Insulin controls the amount of sugar (glucose) in your blood. A person is said to be ‘diabetic’ when the level of ‘sugar’ in the bloodstream rises to abnormal levels due to the absence or failure of insulin production.
In type 2 diabetes, not enough insulin is produced to maintain a normal blood glucose level, a situation known as insulin ‘deficiency’; or your body is unable to make effective use of the insulin that is produced, a condition known as insulin ‘resistance’.
Treatment for diabetes, therefore, relies on the use of insulin or medicines that help the body make better use of the insulin it produces; or often a combination of both.
Diabetes cannot be cured. However, it is important that the condition is diagnosed as early as possible and treatment started to keep your blood sugar levels as normal as possible, control your symptoms and reduce the chances of health problems and complications developing later. It is a well-known fact that most deaths resulting from diabetes are a result of complications (such as heart disease and stroke) arising from poorly controlled disease. Most diabetics are able to live a ‘normal’ healthy life provided the condition is well controlled and supported by a good, healthy diet and lifestyle.
In some cases of type 2 diabetes, it may be possible to control your symptoms by altering your lifestyle, such as eating a healthy diet alone. However, it is important to continue to monitor your blood sugar levels as you may eventually need medication to keep your blood sugar normal. Such treatment will usually take the form of tablets, to begin with, but later on, your doctor may advise the use of insulin to help control the condition better.
If not treated, diabetes can cause many health problems. Large amounts of glucose in the bloodstream can result in damage to blood vessels, nerves and organs. Type 2 diabetes is therefore a common cause of heart disease (including angina and heart attack), stroke, kidney failure, eye damage, nerve damage, foot problems, sexual (and erection) problems and miscarriage and stillbirth.
Untreated diabetes can lead to a variety of different health problems. High blood sugar levels can damage organs, nerves and blood vessels, causing them to become blocked and leaky. Even mildly raised blood sugar levels that do not cause any symptoms can have damaging effects in the long term.
If you have diabetes, you are up to five times more likely to develop heart disease or have a stroke. Prolonged, poorly controlled high blood sugar levels increase the likelihood of atherosclerosis (a condition which causes hardening and narrowing of the arteries).
This may result in a poor blood supply to your heart, causing angina (a dull, heavy or tight pain in the chest). A high blood sugar level also increases the chance that a blood vessel in your heart or brain will become blocked, leading to a heart attack or stroke respectively.
High blood sugar levels can damage the tiny blood vessels which feed your nerves. This can cause a tingling or burning pain that spreads from your fingers and toes up through your limbs. It can also cause numbness or loss of feeling which can lead to ulceration of the feet. If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhoea or constipation.
Retinopathy is a condition often caused by diabetes in which the retina (the light-sensitive layer of tissue) at the back of the eye is damaged. Blood vessels in the retina can become blocked or leaky, or can grow haphazardly due to the effects of diabetes on the eye. These changes prevent light from fully passing through to your retina. If it is not treated, it can damage your vision.
If you are diabetic, it is important that you ask your doctor to arrange an annual eye check in an ophthalmology (or eye) unit capable of examining and photographing the internal structures of your eye. If significant damage is detected, you may be referred to an ophthalmologist (a doctor who specialises in treating eye disease).
The better you control your blood sugar levels, the lower your risk of developing serious eye problems.