According to WHO, 8.5 percent of world population suffers from diabetes. However in Pakistan, 12 percent of the total population is diabetic. In 2015, 86,000 deaths were directly or indirectly related to the disease in the country. This means almost 10 people die from diabetes every hour.
“Alarmingly, three-fourth of all the future diabetics would hail from developing countries such as Pakistan,” says Dr Sheraz Khan, an endocrinologist at Shifa International Hospital, Islamabad.
Diabetes is a “silent killer” that shows no symptoms in most of the patients. They usually get to know about it accidently or when a complication arises. Such was the case of 24 year old Moosa Sheikh.
The resident of Sheikhupura was unaware of his deteriorating health until recently when he had to undergo a medical test for a new job. He was diagnosed with type 2 diabetes. This came as a shocking surprise to him especially as he did not have a family history. Nevertheless, as a hostelite he led a seden-tary lifestyle and was overweight. “I followed an unhealthy diet that included junk and fatty foods.” Moosa regrets not knowing earlier that his lifestyle could risk his health to this extent. “I wish I had taken my health seriously.”
What diabetes is
Diabetes occurs when pancreas stops producing insulin or the produced insulin is not adequate for the body. Insulin is a hormone that balances blood sugar level. As a result, body does not get sufficient energy to carry out routine tasks.
Types of diabetes:
Type 1 and Type 2 are two primary t y p e s o f t h e disease.
I n t y p e 1 , p a n c r e a s c o m p l e t e l y stops making insulin. It mostly occurs in chil-dren and is an a u t o i m m u n e
(abnormal functioning of the immune system that causes it to produce antibodies against your own tissues). In type 2, which is more common in adults, the produced insulin is not sufficient for the body. 80 to 85 percent of the patients suffer from this type.
Gestational and secondary diabetes are some other forms of the disease.The first occurs in women during pregnancy. “Gestational diabetes increases risk of further complications in pregnancy and can even affect the unborn child,” explains Dr Sheraz.
Secondary diabetes however, occurs when another condition or disease affects the pancreas, hindering its function. “Infection or tumor in the organ or its surgery can be a cause.Even using certain drugs can cause the problem,” adds Dr Shahid Hameed, a diabetologist at Al Razi Hospital, Lahore. Prediabetes or borderline diabetes is another type which should be considered as a warning sign for overweight or obese people. A prediabetic’s sugar level is higher than the normal but not high enough to be called a diabetic. Normal fasting blood sugar level is 100 milligrams per deciliter. “Borderline lies between 110 mgdl to 125 mgdl. While an individual who has sugar level more than 126 mgdl while fasting is considered a prediabetic,” explains Dr Shahid.
Diabetes keeps progressing with time and deteriorates the individual’s health, if left uncontrolled.Because of the number and severity of complications, experts believe diabetes is the mother of many diseases. Its complications include heart, kidney and eye-related issues, immune disorders, stroke, constipation or loose motions, impotence in men or vaginal infections in women,abscess and gum and teeth related problems.
“What happens is that the insulin-producing beta cells start to destroy with time in type 2 patients. And after about a decade, these cells completely destroy in 80 percent of patients,” informs Dr Sheraz.
What causes diabetes:
Highlighting the main causes of the disease, Dr Shahid says family history, sedentary lifestyle, unhealthy food and excess weight or belly fats are to be blamed.
“Family history, excess weight and borderline diabetes, triples the risk,” says Dr Sheraz, before adding that screening therefore needs to be done every year, especially after the age of 35.
Risks for Pakistan:
WHO ranks Pakistan as the seventh largest country with diabetes and the disease is still on the rise. It will be the fourth largest country by 2030. “The number of diabetologists and endocrinologists are much less than the increasing number of patients,” says Dr Shahid. “We need to increase awareness among people to control the rapid rise in diabetes,” adds Dr Sheraz.
Diabetes is a chronic disease that can be prevented. Its complications can also be delayed with good control.
“Moreover, the prediabetic stage can be reversed easily through simple lifestyle changes,” says Dr Shahid.
Dr Sheraz advises adopting simple techniques to staying active all day. Prefer using stairs instead of the elevator. Walk to cover short dis-tances instead of a using a vehicle. Moreover, take timeout during working hours. Get up from your seat if constantly sitting and stand for a while if sitting for long. “Also, avoid sitting in front of the screen for long hours and taking heavy meals before going to bed at night.”
Routine is the key
Following a proper routine is essen-tial for good health. “People with bad meal timings are more prone to acquiring various diseases. Diabetes is one of them. Organize life and divide proper timing for meals, work, exercise and sleep,” says Dr Shahid.
It is usually believed, eating excess sugar makes you diabetic. Although it does not. However, foods high in carbohydrates and fats do. “Fatty and junk food, unhealthy snacks and fizzy drinks can raise blood sugar level. These foods should be avoided. Switch to organic foods and include vegetables, fruits and grams in your diet. Also take plenty of water,” says Dr Rezzan Khan, a nutritionist at Shifa International Hospital, Islamabad.
Maintain a balanced diet combining all forms of food together. “Eat a good breakfast, moderate lunch and light dinner,” advises Dr Sheraz.
Other than this, “drinking karaily ka pani (bitter gourd juice), eating jaman ki guthliyan (java plum seed) or cinna-mon does not cure diabetes. It can just help control sugar level,” reveals Dr Shahid.
What to eat for breakfast
Dr Rezzan says a “good breakfast” includes proteins and carbohydratetogether. “Take a small-sized whole-wheat chapatti or paratha using a teaspoon of vegetable oil. One to two slices of brown bread can also be an option. Also, have an egg and tea with less amount of sugar.” She further suggests those who do not prefer an early morning breakfast can eat a light one at around 9 am to 10 am.
When it comes to lunch
“Many people eat lunch outside and buy food from hotels which is a major reason for the rise in health prob-lems,” says Dr Shahid. He advises taking leftover dinner from home instead.
For a nutritious lunch, Dr Rezzan suggests eating a salad that includes one or two fruits and vegetables. “Stay away from “slow poisons” such as fried, processed, and bakery foods and carbonated drinks,” she warns.
What’s for dinner
Different people have different routines. So, their meal timings largely depend on that. “People who take an early dinner, for instance around five and probably sleep around 10 or later at night can have a good dinner. As they have enough time to digest,” says Dr Rezzan, while adding that a heavy meal should not be preferred if you sleep right away.
Reduce weight & lose belly fats
Weight reduction is the key in preventing diabetes. Exercise and do physical activity during the day. An increased waist size is also a warning sign even if you are not overweight. It is the main risk factor that increases other health risks such as high blood pressure and cholesterol level, and heart diseases. “Belly fats are known as central obesity. Such people should consider themselves at higher risk of developing diabe-tes,” says Dr Sheraz.
This feature is published in Shifa News magazine in November 2016 edition (with my name).