Still don’t know about diabetes? – What you don’t know can hurt you!

complications of diabetes

Subhash took his fasting on Shiv Ratri seriously. He decided that he wouldn’t even sip water for a whole day. Unfortunately at around 5 PM, he started feeling shaky, had profuse sweating, and extreme fatigue. He fainted and was rushed to the hospital by his colleagues. Doctors diagnosed that he had type 2 diabetes. There are millions of people like Subhash who do not know that they have diabetes as they are not aware of the symptoms of diabetes. 

In fact, the knowledge of diabetes even among educated Indians is modest despite having a family member with diabetes. And among people with diabetes, though there is some knowledge of the symptoms of diabetes and its management, attitude towards diabetes is far from positive.

Knowledge and attitudes on diabetes in India

Many organizations have conducted study after study on the knowledge people have regarding diabetes. These studies were based on questionnaires with questions on age, gender, socioeconomic status, knowledge of risk factors, symptoms of diabetes, diabetes treatment and complications.  

From outright bizarre and dumb ideas to dangerous misconceptions, people have strange beliefs and unscientific perceptions of diabetes. If you are someone with scientific temperament, these misconceptions are bound to give you a facepalm moment!   

9 embarrassing misconceptions people in India have of diabetes

  1. Eating sugar causes diabetes
  2. Diabetes occurs only in old age
  3. Soaking feet in water can control blood sugar levels and the symptoms of diabetes
  4. You can treat diabetes by quitting table sugar
  5. Herbal supplements are better than diabetes medications
  6. Diabetes can be cured with yoga and diet changes
  7. Diabetes is caused due to spiritual problems
  8. There is no role of diet and lifestyle modification in diabetes treatment
  9. And the worst among all, diabetes is contagious!

Many educated people are not aware of the symptoms of diabetes, tests to diagnose diabetes, and its complications to organs. When it comes to attitudes of people regarding treatment for diabetes, the situation gets murkier.

Here are 4 dangerous misconceptions people in India have on diabetes medications.

  1. Diabetes medications cause organ damage
  2. Taking insulin injections is harmful
  3. Herbal “insulin plants” are more effective and do not cause any side effects
  4. Cow urine can work better than diabetes medications

It is unfortunate that people believe in these misconceptions despite the fact that more than 75 million Indians have been diagnosed with diabetes and there are many who are undiagnosed. Diabetes causes many cases of:

  • Vision loss with diabetes retinopathy
  • End-stage kidney disease with diabetic nephropathy
  • Foot amputations with diabetic neuropathy
  • Cardiovascular diseases and stroke
  • Sudden cardiac death

That is why what you don’t know can hurt you!

It’s time you and your family know about diabetes. It’s time you share the knowledge of the symptoms of diabetes, types of diabetes, how it is diagnosed, and the options in treatment for diabetes.

What is diabetes?

Diabetes mellitus is a chronic disease that is caused by deficiency in the insulin produced by pancreas or due to the ineffectiveness of insulin. In the first case, lack of insulin causes high concentrations of glucose (sugar) in the bloodstream. This is called type 1 diabetes.

In the second case, though insulin is produced in the pancreas, it does not work effectively. Insulin assists glucose derived from food to enter muscles and tissues to provide energy. When insulin does not work effectively, muscles and tissues do not receive energy and glucose remains in the bloodstream. This is called type 2 diabetes.

Diabetes is characterized by high blood sugar levels. When blood vessels have high blood sugar levels, the excess sugar tends to slowly damage the smaller blood vessels, nerves, and organs. This is the main cause for all complications in diabetes and a major reason for many hospitalizations.

Diabetes also causes blood sugar fluctuations. Sometimes, blood sugar levels are high leading to hyperglycemia. Sometimes blood sugar levels are low leading to low blood sugar levels or hypoglycemia.

While high blood sugar levels cause long term damage, low blood sugar levels can lead to acute conditions. Low blood sugar levels leads to fatigue, fainting, and even coma.

Symptoms of diabetes

It is very important for people to realize the symptoms of diabetes as early diagnosis can prevent organ damage and other complications of diabetes.

  • Frequent urination (more than 6 times or more than 2.5 to 3 liters)
  • Excessive thirst
  • Frequent hunger
  • Fatigue
  • Blurry vision
  • Wounds and bruises do not heal quickly
  • Tingling sensation or numbness in hand, feet
  • Frequent vaginal or urinary infections
  • Erectile dysfunction
  • Dry mouth
  • Fruity smelling breath
  • Irritability

What are the different types of diabetes?

Diabetes occurs in three major forms and other minor forms. The three major forms include:

  • Type 1 diabetes
  • Type 2 diabetes
  • Gestational diabetes

What is type 1 diabetes?

Among all people with diabetes, 10% have type 1 diabetes. It is an autoimmune condition and generally occurs in children. In type 1 diabetes, the body’s own immunity system starts attacking the beta cells of the pancreas. Beta cells produce insulin. When beta cells are destroyed, there is a serious insulin deficiency.

People with type 1 diabetes need to be on insulin therapy (either twice daily or basal-bolus), and they have to monitor their blood sugar levels daily with the help of a glucometer or at a clinic. Apart from insulin therapy and self-monitoring, people with type 1 diabetes need to get a diabetes diet plan and regular physical activity. They also need to get periodical screening for diabetes complications.

Doctors that treat type 1 diabetes include endocrinologists, and diabetes doctors.

What is type 2 diabetes?

Type 2 diabetes is a metabolic disorder. In this condition, insulin is produced in the pancreas, but the cells of the body offer a resistance to this insulin. This is called insulin resistance. When the cells of the body do not respond to insulin, glucose produced in digestion is not absorbed by the tissues and it remains in the bloodstream.

Type 2 diabetes is generally associated with obesity, sedentary lifestyle, poor dietary choices, family history, and high blood sugar levels. People with type 2 diabetes are also prone to have high cholesterol levels. They are prone to cardiovascular diseases, and other complications of diabetes.

Treatment of diabetes type 2 involves oral diabetes medications or insulin therapy. This is decided by a diabetes doctor or a diabetologist.

People with type 2 diabetes also need to monitor their blood sugar levels are recommended by their doctors. Following a diabetes diet plan, taking diabetes medications, self-monitoring, physical exercise, and periodical screening tests are parts of diabetes care.

What is gestational diabetes?

Gestational diabetes refers to a type of diabetes that occurs in women during pregnancy. Even women who do not have diabetes before may have high blood sugar levels in pregnancy due to gestational diabetes. Hormonal changes that occur during pregnancy block the action of insulin leading to high blood sugar levels.

It is very important to manage gestational diabetes as improper management can lead to complications to the fetus and the mother. Risk of C-section delivery and giving birth to a baby with more than normal weight (macrosomia) are just a few complications of gestational diabetes.

 Treatment for gestational diabetes involves diet modifications, frequent self-monitoring of blood glucose levels, and if suggested, insulin therapy.

Tests for diabetes

Even if you do not have diabetes, if you are above the age of 30 years, if you have a family history of diabetes, you are overweight, and lead a sedentary lifestyle; it is advised that you get yourself tested for diabetes at least once a year.

Tests to diagnose diabetes include:

  • Random blood glucose test
  • Fasting blood glucose test
  • Postprandial blood glucose test
  • HbA1c test

Apart from these tests, people with diabetes need to get some other tests periodically in order to avoid/detect early complications of diabetes. These tests include:

  • Lipid profile test
  • Dilated fundus examination (eye test)
  • Urinalysis
  • Glomerular filtration rate (GFR)
  • Albumin to creatinine ration (ACR)
  • Blood urea nitrogen (BUN)
  • ECG
  • 2D-Echo
  • Thyroid function test
  • Biothesiometry (foot examination)

These tests should be done as per the advice of a diabetes doctor. Getting these tests helps your doctor to alter or continue current diabetes medications and reduce/avoid the risk of any diabetes complications.