Diabetes mellitus is the common serious metabolic disease of humans.
It is characterised by hormone induced metabolic abnormalities, by long term complications involving eyes, kidneys, nerves and blood vessels.
Persistently elevated plasma glucose levels with or without symptoms can be a diagnostic feature.
The problem is with people who are asymptomatic and have normal plasma glucose levels, they are for one reason or another are potential diabetics. For these people GTT is done and if found to have raised plasma glucose levels are termed as ‘chemical’ diabetes.
The mechanism is thought to be epinephrine discharge, it blocks insulin secretion, which stimulates glucagon release, activates glycogen breakdown and it impairs insulin action in larger tissues such that the increased glucose production in liver and results in impaired disposal capacity of the glucose load.
Any fever, lack of proper diet and lack of physical exercise and give false positive reports.
Diabetes can be classified into primary and secondary. Genetic factor plays an important role in primary diabetes. Secondary diabetes can be due to pancreatic disease, hormonal abnormalities, drug and chemical induced, insulin receptor abnormalities, genetic syndromes and others.
FBS > 126.
PLBS >200.
HBA1c >6.5%
Diabetes mellitus is a easily manageable complaint with proper diet, medication and exercise it can be done.
Diet: diet modification is the first line of treatment in diabetes.
An appropriate diet maintains body at near ideal weight, minimises hyperglycemia and protects against hypoglycaemia in patients requiring insulin.
Decrease in saturated fat and increase in poly unsaturated fatty acids can help in delaying atherosclerosis.
Increased amount of fiber in diet helps in control of diabetes.
In normal adults the BMR is about 1500 kcal per day. Anything less than these calories can lead to weight loss even in sedentary individual. In practice most obese patients don’t comply with it even though they are at risk of diabetes.
The carbs should form around 40-50% of the total calories.
Vegetables which contain little carbs, fat and protein can be eaten in any amount.
Vegetables like beet, carrots, green peas, pumpkin, rutabags, wintersquash and turnips should not be consumed. If consumed should be limited to ½ to 1 cup per day.
Diabetes when not properly managed can lead to complications in the important organs of the body which cannot be repaired.
Conventional treatments are readily available which can help in keeping this complaint under control.
I have observed in my practice that most of the people don’t want to adhere to strict diet and exercise and just want to pop in medicine to keep their sugar levels under check. This is a bad practice which eventually results in uncontrolled diabetes and results in peripheral neuropathy, retinopathy, renopathy, cardiopathy and impotency etc.
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