Signs that diabetes may be approaching
DIABETES is a disease in which your blood glucose (or blood sugar) levels are too high. With type 1 diabetes your body does not make insulin, and with type 2 diabetes, the more common type, your body does not make or use insulin well.
As a result, the glucose stays in your blood and can make you pre-diabetic, which if not managed properly through diet and weight control, can lead to type 2 diabetes.
Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Additionally, pregnant women can also get diabetes, called gestational diabetes.
Internist Dr Jomo James said there may be no signs that you may be pre-diabetic, and the abnormality only comes to detection through a blood screen test.
Of note he said there may be risk factors that are clearly evident, such as:
1. Being overweight or obese, and the more overweight the higher the risk.
2. Poor diet, or a diet rich in carbohydrates and/or fat.
3. Poor lifestyle decisions such as smoking, alcohol and a sedentary lifestyle.
According to Dr James, diabetes can be diagnosed by a routine screening test in which the following are done:
1. Fasting glucose test. Dr James said this is where your glucose is tested early in the morning after an eight-hour overnight fast.
2. A glucose challenge test. “Here you’re given a precise amount of glucose mixed with water to drink and your glucose level is checked two hours later,” he said.
3. The glycated haemoglobin test/HbA1c. Dr James said this is a test which usually reflects the state of glucose levels in your blood for the past three months.
He explained that depending on the values, you may fall in one of three categories — normal, pre-diabetes, and/or diabetes.
Pre-diabetes is likely to be detected in your 40s or 50s, as that is the time, particularly in our population, that a private physician will screen for diabetes.
“By convention, screening for diabetes should start at age 45 — outside of overt risk factors, and if the tests described above are normal, then the testing is repeated every three years. But for those considered at higher risk for diabetes, screening should start earlier,” he said.
He added: “Pre-diabetes is considered a warning sign for the future development of diabetes progression, but it is not inevitable and it should be viewed as an opportunity to improve your health. It is well documented that promotion of healthy lifestyle changes, proper diet, weight loss and regular exercise do prevent or slow down progression to diabetes. In addition, limited alcohol consumption and cessation of smoking also helps.”
He emphasised that pre-diabetes is a warning that should be a red flag that the path to diabetes is fast approaching and may be inevitable if lifestyle changes are not made.
Dr James also said bariatric surgery for weight loss has worked miraculously in curing both pre-diabetes and diabetes.
He emphasised that through weight loss, proper diet, exercise and a healthy lifestyle, the outcome of having diabetes can be positive. He added that in extreme cases, drugs and surgery can offer a cure.
