‘Maintain healthy body weight to prevent diabetes’

To prevent diabetes, health experts have said there is need to maintain healthy body weight. In addition, they advised that the individual should be physically active for at least 30 minutes three times a week. The activities should range from moderate to intense and regular.

Other recommendations include eating healthy diet, avoiding sugar, saturated fats and smoking, all of which increase the risk of diabetes and cardiovascular diseases.

The health experts highlighted these last week, when the World Diabetes Day was observed. They described the ailment as a chronic, non-communicable disease in which there is persistent raised blood sugar, hyperglycemia, in the body system.

Former President, Association of Resident Doctors in Lagos University Teaching Hospital (LUTH), Dr. Olubunmi Omojowolo, said diabetes occurs when the pancreas, an organ in the body, does not produce enough insulin.

He said: “The exact cause of type 1 diabetes is unknown. Usually, the body immune system, which normally fights harmful bacteria and viruses, mistakenly destroys the insulin, producing islet, or islets of Langerhans, cells in the pancreas.

“Type 2 diabetes develops, when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. Exactly why this happens is also unknown, although genetics and environmental factors, such as being overweight and inactive, seem to be contributing factors.

“Hyperglycemia or raised blood sugar is a common effect of uncontrolled diabetes and over time, leads to serious damage to many of the body’s systems, especially the nerves and blood vessels. Diabetes may also occur in pregnancy, which is known as gestational diabetes.”

Omojowolo explained that symptoms of diabetes include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes and fatigue, among others.

He said: “Type 1 diabetes is more common in younger people, while Type 2 diabetes is more common in adults, although it is now becoming common in younger people. Women may have more risk factors, such as being more obese, but prevalence of diabetes in both sexes varies in different populations.”

He noted that government can help in preventing diabetes by encouraging people to eat healthy and exercise via public health campaigns, providing an enabling environment, such as side walks and cycling paths, so that people can exercise more. Increasing taxes on tobacco and enforcing the “no smoking in public” laws are other useful means.

He said: “People should cultivate the habit of eating lots of fruits and vegetables. They should also go for routine health checks to be sure they are in good health.

“Impairment of growth and susceptibility to certain infections may also accompany chronic hyperglycemia. Acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis or the non-ketotic hyperosmolar syndrome. Long-term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading to renal failure; peripheral neuropathy with risk of foot ulcers, amputations, and Charcot joints; and autonomic neuropathy causing gastrointestinal, genitourinary, and cardiovascular symptoms and sexual dysfunction. Patients with diabetes have an increased incidence of atherosclerotic cardiovascular, peripheral arterial, and cerebrovascular disease. Hypertension and abnormalities of lipoprotein metabolism are often found in people with diabetes.

“In the other, much more prevalent category, type 2 diabetes, the cause is a combination of resistance to insulin action and an inadequate compensatory insulin secretory response. In the latter category, a degree of hyperglycemia sufficient to cause pathologic and functional changes in various target tissues, but without clinical symptoms, may be present for a long time before diabetes is detected. During this asymptomatic period, it is possible to demonstrate an abnormality in carbohydrate metabolism by measurement of plasma glucose in the fasting state or after a challenge with an oral glucose load.”

Family Physician, Dr. Chukwuma Ogunbor, said treatment of diabetes is based on controlling blood sugar and glucose levels, which is the major goal, to prevent complications of the disease.

He said: “Type 1 diabetes is managed with insulin, as well as dietary changes and exercise. Type 2 diabetes may be managed with non-insulin medications, insulin, weight reduction, or dietary changes.

“The vast majority of cases of diabetes fall into two broad etiopathogenetic categories. In one category, the type 1 diabetes, the cause is an absolute deficiency of insulin secretion, which may lead to critical condition, if not properly treated. Individuals at increased risk of developing this type of diabetes can often be identified by serological evidence of an autoimmune pathologic process occurring in the pancreatic islets and by genetic markers, which need urgent control.”