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Control Diabetes, Don’t Let Diabetes Control You!


My mother wakes up at 5am every morning, says her prayers, and heads off to the kitchen to make breakfast for the family. Now, don’t misconstrue this to think that we don’t have household help, but like most mothers in Bangladesh, my mother would rather do the cooking herself. After breakfast, she leaves the house by 8am to go to work at her own school where she is the Principal. She returns by 3pm, spends time with her grandchildren, and by 7pm is back in the kitchen to make dinner. Her day finally ends at 12am, when she eventually goes to bed.

For someone in her 60s, my mother has incredible energy, not to mention that she has been diabetic for the last two decades. However, she wasn’t always quite as fit. Before she was diagnosed with diabetes, she used to be fatigued all the time and would frequently be hungry or thirsty. Once she began to follow the doctor’s instructions on managing her diabetes – including modifying her diet and exercising – she started to feel better and is now in control of her condition.

Diabetes is a chronic disease in which the body cannot produce insulin or cannot properly use the insulin that it produces. Insulin is a hormone that controls the amount of glucose in the body. As a doctor, I understand diabetes better than most people and, with the firsthand experience I gathered of how to tackle this disease, I realized how crucial it is to be aware of this disease that may lead to death if poorly managed.

Given the state of healthcare in Bangladesh, where there is a palpable void in terms of providing trusted and quality healthcare, I have contemplated for a long time how I could make a difference. When I first heard about Praava Health and met with the CEO Ms. Sylvana Sinha, I instantly knew that this is the kind of healthcare company that I had always imagined to be working for, a healthcare company that cares about people, provides empathy, and most importantly, provides accurate diagnosis and test results. Praava Health will assist people to understand their conditions and be better equipped to deal with their diseases.

I take diabetes so personally and spend a considerable amount of time researching and learning about it because I believe such a widespread disease that affects so many people needs to be taken care of – and Praava will help to do that.

Globally, diabetes is a leading cause of blindness, kidney failure, heart attacks, and stroke. According to the World Health Organization (WHO), in 2014, the prevalence of diabetes in adults over the age of 18 rose to 8.4%. There were a reported 7.1 million cases of diabetes in Bangladesh alone in 2015 and that number is 1.71% of the total number of people with diabetes in the world. A nationwide survey done in 2014 found that 9.7% of adults in Bangladesh were suffering from diabetes – nearly doubling from 5% in 2001. Even more surprisingly, an additional 22.4% of Bangladeshi adults was pre-diabetic.

Despite the increasing prevalence of diabetes, the International Diabetes Federation reported recently that over 52.1% of people with diabetes in south Asia were unaware of their condition.  A recent study in Bangladesh actually found that 56% of diabetics did not even know they had the disease and only 40% were regularly receiving treatment. 

It is imperative for Bangladeshis to educate themselves on prevention and management of diabetes. Properly managed, many diabetics live long, healthy, fulfilling lives.

 

Prediabetes

Ask your doctor if you should take a blood glucose screening test if you have any of the below risk factors for prediabetes:

  • You are overweight, with a body mass index above 25

  • You are inactive

  • You are over the age of 45

  • You have a family history of type 2 diabetes

  • You developed gestational diabetes while pregnant or gave birth to a baby that weighed more than 4 kilograms

  • You have polycystic ovary syndrome

  • You have high blood pressure

  • Your high-density lipoprotein (HDL) cholesterol is below 0.9 millimoles per liter, or your triglyceride level is above 2.83 millimoles per liter

There are three types of diabetes: Type 1, Type 2, and Gestational. I will broadly explain what the types are, including the symptoms, causes, risk factors, and treatment for each.

 

Type 1 Diabetes

This is also known as juvenile diabetes and mostly develops at a young age. Older people may also develop it, but the chances of that are low. In this type of diabetes, the immune system destroys cells in the pancreas called beta cells that produce insulin, so, the body is no longer able to make insulin.

Causes:

The reason this type of diabetes develops is still unclear, but scientists have found that type 1 diabetes can develop in people who have a particular HLA complex, human leukocyte antigen, which triggers an immune response in the body.

Symptoms:

  • Thirst

  • Hunger (especially after eating)

  • Fatigue

  • Rapid breathing

  • Belly pain

  • Frequent skin and urine infection

  • Frequent urination

Risk Factors:

  • Family History

  • Genetics

  • Age

Treatment:

  • Insulin

  • Carbohydrate counting

  • Blood sugar monitoring

  • Eating healthy food and managing sugar intake

  • Exercising regularly and keeping weight in check

 

Type 2 Diabetes

This is the most common form of diabetes. Someone could suffer from Type 2 diabetes for years without even knowing that. In this type of diabetes, the body creates insulin but the cells do not know how to use it properly, which doctors call “insulin resistance.”

Causes:

The exact reason this type of diabetes develops is also unknown but factors such as genetics, environment, excess weight, and inactivity play a key role.  

Symptoms:

  • Increased hunger (Polyphagia)

  • Increased thirst (Polydipsia)

  • Frequent urination (Polyuria)

  • Weight loss

  • Fatigue

  • Areas of darkened skin

  • Frequent infections

  • Blurred vision

Risk Factors:

  • Age

  • Prediabetes

  • Weight

  • Family history

  • Fat distribution

  • Physical inactivity

Treatment:

  • Healthy eating

  • Physical activity

  • Monitoring blood sugar regularly

  • Diabetes medication and insulin

 

Gestational Diabetes

Gestational diabetes develops in about 4–5% women during pregnancy. Steps must be taken to control gestational diabetes during pregnancy, otherwise it can lead to the development of type 2 diabetes.

Causes:

During pregnancy, the placenta that make hormones in the body can lead to a buildup of blood sugar. Generally, enough insulin can be produced by the body to handle this but if not, then gestational diabetes develops.

Symptoms:

Typically, there are no noticeable symptoms for this kind of diabetes, but doctors recommend screening tests between weeks 24 and 28 of pregnancy.

Risk factors:

  • Overweight before pregnancy

  • Higher blood sugar level

  • Family history of diabetes

  • Previous history of gestational diabetes

Treatment:

  • Regular monitoring of blood sugar level

  • Regular urine test for ketones

  • Healthy diet

  • Exercise

 

As terrifying as the thought of living with diabetes might be, especially since even in 2016 there is no cure, it is not all bad news. An individual with diabetes can lead a completely normal life if they alter their lifestyle somewhat and take proper medication.

And as I always say to anyone with diabetes – “Control diabetes, don’t let diabetes control you!”