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DIABETES: Much more than just the BLOOD SUGAR!

Diabetes is one of the most talked about diseases across the world affecting around 455 million people worldwide and the numbers are mounting rapidly every year. Unfortunately, India is amongst top 3 countries with high diabetic population and the number has doubled in 13 years in India with a whooping increase from 32 million in 2000 to 63 million in 2013.

Seeing such exponential increase, India certainly has a challenge to face which deliberates all of us to know the disease well and understand its adverse effects.

Diabetes is not just having high blood sugar levels! It is much beyond that. Besides few manageable complications of skin disease, pregnancy complications, hypoglycaemia (Low blood glucose), hyperglycemia (High blood glucose), Mental Health, hearing loss or gum diseases, the devastating effect of diabetes can be seen in the form of few major complications that may lead to surgical interventions at times. Let’s see how:

COMPLICATIONS OF DIABETES

The fact that diabetes may be the world’s 7th largest killer by 2030 (Source: WHO), urges us to share the various complications that may arise in badly controlled diabetic patients. 

  • Cardiovascular problems–Diabetes may affect the heart and blood vessels resulting into fatal complications such as coronary artery disease (heart attack) and stroke (blood supply to part of your brain is suddenly interrupted). These conditions may probe you to rush to hospitals for immediate surgical intervention that may involve Cardiac Surgery (coronary artery bypass grafting (CABG) , carotid artery surgery, carotid stenting )
  • Eye complications– Chronic diabetic cases may have severe eye problems that may lead to Vision impairment  due to diabetic retinopathy, Glaucoma,  cataracts  all resulting into surgical interventions. Huge strides may be required for the treatment of diabetic retinopathy. When laser treatment in the form of photocoagulation (laser treatment for retinal repair) fails and the retina gets detached or when lot of blood leaks into the eyes, vitrectomy surgery (to remove scar tissue and cloudy fluid from inside the eye) may be required.
  • Neuropathy (Nerve Damage)- Nerve damage from diabetes is called diabetic neuropathy. It is more common in chronic patients. Diabetes can cause damage to the nerves throughout the body when blood glucose levels are too high. This can lead to problems with digestion, erectile dysfunction and many other functions. Among the most commonly affected areas are the extremities, in particular the feet leading to pain, weakness and loss of feeling in the foot, ulcers, and sometimes gangrene which may require foot amputation as well.
  • Kidney disease (Diabetic Nephropathy): Diabetes can damage the kidneys and cause them to fail. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. Subsequently, they start to leak and useful protein is lost in the urine. Moreover, failing kidneys lose their ability to filter out waste products, resulting in kidney disease.

Reducing the burden of diabetes

Diabetes certainly increases the risk for many serious health problems, but the good news is that with the correct treatment and preventive measures, many people with diabetes are able to prevent or delay the onset of above complications.

PREVENTION

The scary picture of complications can be averted by taking few preventive steps that needs to follow the strict rule book of diet, exercise, regular checkups, change in lifestyle and practicing good foot care. 

TREATMENT

Handling diabetes doesn’t begin or end with insulin injections only. It is much beyond that.

-Diabetics can get rid of their symptoms without medication, through a combination of exercise, diet and body weight control.

-Since Type 1 diabetics cannot use oral pills, they require regular insulin injections. Insulin may be taken by means of a shot (often several times a day), or infused through catheter (a small needle) attached to an insulin pump. Type 2 diabetic are usually treated with tablets, but sometimes insulin injections are also required.

-Oral antihyperglycemic drugs reduce blood glucose levels by enhancing insulin secretion by the pancreas, increasing the sensitivity of the peripheral tissues to insulin and by impairing gastrointestinal absorption of glucose.

SURGICAL TREATMENT

Considering the colossal burden of diabetes in our country, metabolic surgery represents a cutting edge in diabetic treatment.

Bariatric surgery has proven successful in treating not just obesity but also type 2 diabetes. This surgery constitutes a powerful option to improve diabetes in patients affected by severe obesity by:

  • Lowering blood sugar
  • Reducing the dosage and type of medication required
  • Improving diabetes-related health problems

Pancreas Transplant

pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one that can produce insulin) into a person who usually has diabetes. Whole organ pancreas transplant is often performed when a patient also needs a kidney transplant.

Islet Transplantation

Islets are cluster of cells (beta cells) scattered throughout the pancreas and produce the hormone insulin. In this procedure, the islets from pancreas are purified, processed and transferred into another person. The advantages of this transplant over pancreas transplantation are that it does not require a major operation and the procedure has a small complication rate. 

IDENTIFY YOUR STAGE

“Diabetes can be curbed at the initial level by introducing lifestyle changes, controlled through medicines in early stages and treated by administration of external insulin or surgeries in advanced stages. So identify your present status and act now!”

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