NOVEMBER is Diabetes Awareness Month and diabetes, often referred to as ‘sugar’ in Jamaica, is a potentially life-threatening illness and is the second-leading cause of death for Jamaicans under the age of 70 years.

Locally the month of activities is being celebrated under the theme ‘Access to diabetes care… The time is now!’

Diabetes is a chronic condition in which blood sugar levels are high. The hormone insulin — made in the pancreas — is essential for storing glucose (sugar) from our digested food.

In people with diabetes, the body stops producing insulin, or cannot use it properly, causing high blood glucose levels (hyperglycaemia).

The Jamaica Health and Lifestyle Survey III (2016-2017) indicates that one in every eight people, 15 years and older, has diabetes.

Four out of 10 people in Jamaica who have diabetes are not aware of their status and over time, uncontrolled hyperglycaemia can cause diabetic complications — nerve damage, eye damage, kidney damage, poor circulation, heart disease being chief among them and even premature death.

With the disease, long before symptoms appear or tests reveal abnormally high blood glucose levels, changes are taking place that eventually lead to full blown diabetes.

There are three main types of diabetes:

Type I diabetes — also known as juvenile diabetes, in which people are insulin-dependent, which means they must take artificial insulin daily to stay alive.

Type II diabetes — when the body is unable to make enough insulin, or cannot properly use the insulin it makes.

Gestational diabetes — which affects some women during pregnancy, due to the body not being able to use insulin properly.

Type II diabetes is the most common type of diabetes. It most often occurs in adulthood but teens and young adults are now being diagnosed with this type because of high levels of obesity in this age group.

Type II diabetes occurs when the body does not make or use insulin well. Treatment with pills, insulin injections or both, is needed to help control this type of diabetes.

You are at risk of developing type II diabetes if you’re:

• Obese or overweight

• Physically inactive

• Eating unhealthy food

• Getting older

• A smoker and/or heavy drinker

• Have high blood pressure and high blood cholesterol

• Have a family history of diabetes

Lifestyle changes are key for prevention and treatment of type II diabetes.

Gestational diabetes occurs in pregnant women who were not previously known to have diabetes. In gestational diabetes, high blood sugar levels may develop during the pregnancy due to the influence of pregnancy hormones. Most of the time it goes away after the baby is born. But, even if it goes away, these women and their children have a greater chance of getting type II diabetes later in life.

Further, the results of a blood test may indicate pre-diabetes. Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of full-blown type II diabetes.

Persons who are found to have pre-diabetes should make immediate lifestyle changes to help lower their blood sugar levels to normal, so that they can slow or stop their progression to developing type II diabetes.

Screening for diabetes

A blood glucose test measures the amount of sugar (glucose) in the blood.

You can do a blood glucose test to check if you have diabetes or pre-diabetes. Ask your health-care provider about getting tested.

Signs and symptoms of diabetes

• Increased hunger and thirst

• Frequent urination

• Vaginal infections

• Slow healing wounds

• Blurred vision

• Extreme tiredness

• Nausea and vomiting

• Weight loss

• Weight gain

• Impotence

Complications of diabetes

Diabetes can affect every organ in the body. If it is not controlled, you may develop complications or problems, such as:

• stroke

• heart disease

• foot disease — ulcers or sores that may led to amputation if not properly treated

• nerve damage — this can cause numbness, tingling or pain in the toes and fingers

• kidney disease (kidney failure)

• eye disease — reduced vision and blindness

• skin conditions

• gum disease and loss of teeth

• sexual problems like impotence in men

Controlling diabetes

If you have diabetes:

• Go to your doctor for regular check-ups

• Eat healthy foods

• Be physically active

• Maintain a healthy weight

• Check your feet daily for cuts, sores, bruises, rashes, swelling or signs of infection

• If you smoke, quit

• Maintain a normal blood pressure and blood cholesterol level

• If you drink, ask your doctor how much is right for you

People with diabetes need to learn how to do their test and what the measurements mean. This knowledge can literally mean the difference between life and death. Blood glucose levels need to be maintained within a certain range to help us remain healthy. For most people with diabetes, normal glucose levels while you are fasted fall between 3.9 and 7.2 mmol/l — that’s the same as 70 and 130 mg/dl. Glucose levels should also be less than 10.0 mmol/l (or 180 mg/dl) two hours after you have eaten.

Blood sugar levels measuring above these values are indicative of high blood sugar or hyperglycaemia, and if these levels remain high you are likely to develop complications.

Watch for low blood sugar levels or hypoglycaemia (about 3.2 mmol/l or 60 mg/dl) and pay attention to the early warning signs (such as dizziness/drowsiness, confusion, nervousness, shaking, sweating or hunger). Treat low blood sugar promptly by quickly by eating or drinking a simple sugar source, such as glucose tablets/sweets or fruit juice.

Doing your HbA1c blood tests is a great way for your doctor to know if your diabetes is well controlled.

Also talk to your doctors about doing regular checks on your eyes, feet, kidneys, heart, blood pressure and blood cholesterol to ensure you are on track to preventing or slowing the development of complications from diabetes.