The top 3 causes of death in Trinidad & Tobago are heart disease, diabetes, and stroke. This article will delve a little deeper into diabetes- what it is, what causes it, types of diabetes, treatments, preventative measures one can take to reduce the risk of obtaining this non-communicable disease, and ways to better manage your diabetes if already diagnosed.
I'm almost certain that each of us reading this knows someone with diabetes. Perhaps yourself, or maybe a loved one. Regardless, I hope this helps you find a little more clarity where you may have been a bit unclear before. Our health is our wealth and it is our responsibility to do our best to take care of it.
What is Diabetes?
Diabetes is a chronic, non-communicable disease that takes place when someone's blood glucose is too high. This can occur if the pancreas is not producing enough of the hormone insulin or when the insulin that the pancreas produces cannot effectively be used by the body. In 2019, diabetes was found to be the ninth leading cause of death worldwide, according to the World Health Organization. It is, as previously mentioned, the 2nd leading cause of death in Trinidad & Tobago as of 2019.
Insulin is a hormone produced by the beta cells of the islet of Langerhans in the pancreas. It is responsible for the regulation of blood sugar, to ensure it does not get too high or low. When a meal is consumed, blood glucose spikes as carbohydrates are broken down by the intestines, and beta cells are stimulated to release insulin into the bloodstream. Insulin helps to move glucose into cells where it can be used as energy. By doing so, insulin action causes heightened blood glucose levels to return to a normal level. The more glucose present in the blood, the more insulin the pancreas will release.
Hyperglycemia (high blood glucose levels) is linked to serious health problems if left untreated. Over time, hyperglycemia can lead to an increased risk of cardiac disease, kidney disease, stroke, and nerve and vision problems. As such, it is important that hyperglycemia be either prevented or treated as soon as possible to ensure a healthy body.
Types of Diabetes
There are 3 main and common types of diabetes: Type 1, Type 2, and Gestational Diabetes.
Type 1 Diabetes (T1D):
Often called insulin-dependent diabetes, type 1 diabetes is thought to be a result of an autoimmune response where the body's immune system attacks the beta-cells that produce insulin in the pancreas. Persons with T1D have to take insulin daily in order to survive as the beta cells are destroyed and cannot produce any insulin. Insulin is administered as an injection into the fat under the skin in order for it to get into the blood and regulate blood glucose. It cannot be taken as a pill, orally, as it would be digested in the intestines and not reach the bloodstream. T1D is often diagnosed in kids, teens as well as young adults, it is known to have quick symptomatic development. Around 5% - 10% of persons diagnosed with diabetes have type 1 diabetes.
Type 2 Diabetes (T2D):
Often referred to as non-insulin dependent diabetes, type 2 diabetes is a result of the body not being able to effectively use insulin in regulating blood glucose levels. Normal blood glucose levels cannot be maintained as the cells do not respond normally to insulin (insulin resistance). In order to attempt to get cells to respond to the hormone, the pancreas produces more insulin, and since cells are not responding normally, blood glucose still rises despite the presence of more insulin and the pancreas soon reaches a point where it can no longer regulate the level of blood glucose. The vast majority of diabetics have T2D, more than 95%. T2D is often diagnosed in adulthood as symptoms appear to be slow-developing but it is now increasingly being seen in children. This type of diabetes is usually brought on by unhealthy lifestyle habits like lack of physical activity, exercise, poor eating habits, and excess body weight.
Gestational Diabetes:
Gestational diabetes occurs during pregnancy in women who have never been diagnosed with diabetes prior. It is categorized by increased blood glucose levels (hyperglycemia), where the values are below that of diabetes but higher than normal blood glucose levels. Persons diagnosed with gestational diabetes are at an increased risk of complications both during pregnancy and labor and may, along with their unborn child, be at an increased risk for type 2 diabetes later in life. It is important for pregnant persons to get prenatal screening to be able to diagnose or rule out gestational diabetes as it is not diagnosed by symptoms but rather by prenatal screening.
Symptoms of Diabetes
- Slow-healing wounds
- Polyuria (increased frequency of urination)
- Feelings of intense thirst and hunger
- Unintentional weight loss
- Feelings of exhaustion
- Fruity Breath
- Numbness of extremities
- Blurred vision
Treatment
- Type 1 diabetes is treated with insulin injections daily as previously indicated, to allow cells to uptake glucose.
- Type 2 diabetes may be treated orally with medications that act by blocking stomach enzymes from digesting carbohydrates, thereby not allowing excess glucose to be released into the blood, inhibiting glucose production and release from the liver (again to ensure that blood glucose levels are maintained and do not spike) or by pancreatic stimulation resulting in the production and release of more insulin to hopefully allow cells to take in more glucose and lower the naturally high blood glucose.
- Gestational diabetes is usually treated with proper eating habits, and scheduled exercises. It can also include insulin injections and proper recording of blood glucose as the other main types do, to regulate blood glucose levels.
Management and Prevention of Diabetes
Figure 1 shows typical ways in which people with diabetes can better manage their diabetes in conjunction with their medications/insulin injections and those without diabetes can prevent or delay the onset of the disease.
American Diabetes Association. 2022. “How to Treat Gestational Diabetes | ADA.” Diabetes.org. 2022. https://www.diabetes.org/diabetes/gestational-diabetes/how-to-treat-gestational-diabetes.
American Diabetes Association. 2015. “Insulin Basics | ADA.” Diabetes.org. 2015. https://www.diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-basics.
CDC. 2022. “What Is Diabetes?” Centers for Disease Control and Prevention. July 7, 2022. https://www.cdc.gov/diabetes/basics/diabetes.html
CDC. 2022. “Type 2 Diabetes.” Centers for Disease Control and Prevention. March 2, 2022. https://www.cdc.gov/diabetes/basics/type2.html.
Institute for Health Metrics and Evaluation. 2015. “Trinidad and Tobago.” IHME. September 9, 2015. https://www.healthdata.org/trinidad-and-tobago.
Mayo Clinic. 2021. “Type 2 Diabetes - Diagnosis and Treatment - Mayo Clinic.” Mayoclinic.org. 2021. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199.
NIH. 2022. “What Is Diabetes?” National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK | National Institute of Diabetes and Digestive and Kidney Diseases. July 15, 2022. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes.
World Health Organization. 2021. “Diabetes.” Who.int. World Health Organization: WHO. November 10, 2021. https://www.who.int/news-room/fact-sheets/detail/diabetes.
Once again, great stuff!
ReplyDeleteInteresting. Have to work on my sugar addiction🥲
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