Chronic, Progressive, raised blood glucose, lack of insulin and/or inability to respond to insulin.

According to World Health Organization diabetes means a chronic elevation of blood glucose in which the high concentrations of blood glucose result from deficient production or action of insulin. (WHO 2002)

A condition in which the amount of glucose in the blood is too high because the body cannot use it properly (Diabetes UK 2008)

Types of Diabetes

There are three main types of diabetes:

Type 1 or insulin dependent diabetes- This is immune system related or juvenile-onset diabetes. It is caused by an auto-immune reaction where the body’s defence system attacks the insulin-producing cells. People with this of diabetes produce little or no insulin; it can affect people of any age but usually affects children and young adults. Sufferers of type 1 diabetes need insulin injections every day in order to control the levels of glucose in their blood, without which they will die.

Type 2 or non- insulin dependent – this form of diabetes is caused by insulin resistance and relative insulin deficiency. It at times manifests itself in adults and especially in ethnic groups with high diabetes prevalence. It is often associated with obesity which itself can cause insulin resistance and lead to elevated blood glucose levels.

Gestational diabetes- which consists of high blood glucose levels in some women during pregnancy.

This type accounts for over a quarter of pregnancies worldwide and it is linked with complications during and after birth. It usually disappears after birth but women with this condition and their children are at risk of developing type 2 diabetes in later life.

There are other specific types which could be caused by Pancreatic disease, drug or chemical induced.

Signs and Symptoms

SOME OF THE WARNING SIGNS OF DIABETES ARE:

Frequent urge to urinate
Excessive thirst
Increased hunger
Tiredness
Tingling sensation or numbness in the hands and feet
Blurred vision
Frequent infections
Weight loss
Vomiting and stomach pain
Lack of interest and concentration
Slow- healing wounds

If you experience any of the above speak to someone or consult a health professional.
 

Complications

It is essential that diabetics are aware of the complications that can occur as a result of having diabetes to ensure that the first symptoms of any possible illness are spotted before developing.

Diabetes complications involve the disruption of a variety of bodily systems and complications may occur over many timescales- from the date of diagnosis to years after diabetes has developed.

The majority of diabetes complications occur due to fluctuations in the blood glucose levels particularly elevated blood sugar over a long period of time. Controlling blood glucose levels and blood pressure has been proven to reduce the risk of diabetes complications.

EMBARRASSING CONDITIONS
Yeast Infections- Infections such as thrush can be embarrassing but are in fact very common in both men and women and are often easily treated.

EYES & VISION
Retinopathy- Diabetic retinopathy usually only affects people who have had diabetes for a long time and can result in blindness. Checking of the eyes is very crucial.

CONSTIPATION
Constipation- Bowel issues such as constipation are often due to a change in diet particularly related to a reduction in intake of insoluble fibre.

HIGH BLOOD PRESSURE
High blood pressure- high blood pressure affects almost 50% of people with diabetes.

FATTY LIVER DISEASE
Fat build up within the liver is common in people with type 2 diabetes.

NEPHROPATHY
Diabetes affects the arteries of the body and as the kidneys filter blood from many arteries, kidney problems are a particular risk for people with diabetes. Nephropathy patients could benefit from weight loss surgery.

NEUROPATHY
Diabetes neuropathy is a nerve disorder of which there are 2 types- peripheral and Autonomic, caused by either type 1 or type2 diabetes. Tight control of blood sugars helps to delay neuropathy. 1 in 5 diabetics have neuropathy and type2 can be reversed by eating 600 calories a day. High fat ketogenic diet can also reverse diabetic kidney disease. Researchers have found that diabetic complications can be reversed in mice studies by dietary methods alone so there may be hope for us too.

COMPLICATIONS AND POOR CONTROL
Type1 diabetes rarely results in retinopathy and nephropathy within the first five years but kidney damage and eye diseases have been found to be more common amongst those with poor control.

Type2 diabetes may often result in vascular complications such as heart attacks, stroke and problems with circulation.

By closely controlling blood sugar levels blood pressure and cholesterol, people with diabetes can help lower their risk of diabetes complications. Moreover, a life style involving a good diet, regular exercise and no smoking also help to reduce diabetes complication risks, Diabetes complication is broken down by areas of the body and the related organs and is complemented with the guides to each of the major complications, screening and prevention.Risks of diabetes complications climb once HbA 1c levels exceed 9% and again increase significantly above 12%.

Risk Factors

DIABETES RISK FACTORS

Having a family member with type1 diabetes increases the risk of developing the condition, as do the presence of environmental factors; increased height and weight development, increased maternal age at delivery and exposure to some viral infections have also been linked to the risk of developing type 1.

Some of the risks associated with type 2 diabetes include:
Obesity
Increasing age
Diet and physical inactivity
Insulin resistance
Family history
Ethnicity

Type 1 diabetes cannot be prevented at present. Type 2 diabetes however can be prevented in many cases by maintaining a healthy weight and being physically active.

International Diabetes Federation recommends that all people at high risk of developing type2 diabetes be identified through opportunistic self-screening. They can be easily identified through a simple questionnaire to assess risk factors such as age, waist circumference, family history, cardiovascular history and gestational history.

Once identified, people at high risk of diabetes should have their plasma glucose levels measured by health professionals to detect Impaired Fasting Glucose or Impaired Glucose Tolerance, both of which indicate an increased risk of type2 diabetes. Prevention efforts should target those at risk in order to delay or avoid the onset of type2 diabetes.

According to International Diabetes Federation, there is substantial evidence that achieving a healthy body weight and moderate physical activity can help prevent the development of type 2 diabetes. In primary prevention there is an important role for the diabetes educator to help people understand the risks and set realistic goals to improve health. The federation recommend a goal of at least 30 minutes of daily exercise, such as brisk walking, swimming, cycling or dancing. Regular walking for at least half an hour per day for example has been shown to reduce the risk of type 2 diabetes by 35-40%.

Management

Presently there is no cure for diabetes but effective treatment exists in developed countries. If you have access to the appropriate medication, quality of care and good medical advice, you should be able to lead an active and healthy life and reduce the risk of developing complications.

Good diabetes control means keeping your blood sugar levels as close to normal as possible. This can be achieved by a combination of the following:

Physical Activity
Monitoring Body Weight
Healthy Eating
Monitoring for Complications
Avoiding Alcohol and Tobacco

Prevention

At present, type 1 diabetes cannot be prevented. The enviromental triggers that are thought to generate the process that results in the destruction of the body's insulin-producing cells are still under investigation. There is a lot of evidence that lifestyle changes (achieving a healthy body weight and moderate physical activity) can help prevent the development of type 2 diabetes.

Diabetes reduce your risks

Swimming, cycling, brisk walking and dancing- 30 minutes of exercise a day can reduce your risks of developing type 2 diabetes by 40%.Obesity, particulary abdominal obesity, is linked to the development of type 2 diabetes. Weight loss improves insulin resistance and reduces hypertension. People who are overweight or obese should therefore be encourgaged to acheive and maintain a healthy body weight.

Physical activity is one of the main pillars of the prevention of diabetes. Increased physical activity is important in mainaining weight loss and is linked to reduced blood pressure, reduced resting heart rate, increased insulin sensitivity, improved body composition and psychological well-being.

A balanced and nutricious diet is essential for health. A healthy diet reduces risk factorsfor cardiovascular diseases. 

Other behaviours to consider include:

Smoking- a well-established risk factor for many chronic diseases, including diabetes and its complications. As well as other harmful effects, smoking increases abdominal fat accumilation and insulin resistance. All smokers should be encouraged to quit smoking. However, weight gain is common when quitting smoking and therefore dietary advice on avoiding weight gain should also be given (e.g. managing cravings and withdrawl symptoms by using short bouts of physical activity as a stress-relief activity, rather than eating snacks.)

Stress and depression- There is evidence of a link between depression and both diabetes and cardiovascular disease.

Sleeping patterns- Both short (<6h) and long (>9h) sleep durations may be associated with a higher risk of developing type 2 diabetes. Sleep deprivation may impair the balance of hormones regulating food intake and energy balance. Long sleep durations may be a sign of sleep-disordered breathing or depression and should be treated appropriately. There is also a close association between obesity and obstructive sleep apnoea syndrome (OSA), the most common form of sleep disordered breathing.

Community Outreach

FODSL has embarked on series of community outreach to raise diabetes awareness and health promotion activities within Freetown and the provincial towns across Sierra Leone.Since 2013, we have been raising diabetes awareness campaign in health centers, government and private institutions,market places, and other social gathering.we have also been on both print and electronic media.

During the just concluded Holy Month of Ramadan (June,2017), we held series of sensitizations in diffrent mosques across Freetown and the provinces on Ramadan and Diabetes.That is the potential risk of diabetic patients when fasting.We are presently raising Type one and gestational diabetes awareness among young adults and pregnant women respectively.