World Diabetes Day

Impact of type 2 diabetes mellitus and strategies for mitigation

Type 2 Diabetes Mellitus is a chronic medical condition characterized by high levels of blood sugar (glucose) due to the inability of insulin to act properly and due to decreased insulin production. It can affect each and every organ of the body if not managed properly.

Some of the key impacts of diabetes if not controlled include:
Heart disease: Diabetes is a major risk factor for heart disease. It can block the blood flow to the heart leading to heart attack. It can also affect the pumping of the heart leading to heart failure. Patients can experience shortness of breath due to heart failure.

Stroke: Patients with uncontrolled diabetes can develop paralysis of hands or legs due to decreased blood flow to the brain.
Nerve damage or Neuropathy: High blood sugar levels can damage the nerves, leading to neuropathy. This can result in pain, tingling, or numbness in the hands and legs. When it becomes severe, it can affect the power of the leg muscles leading to slippage of chappals from the legs.

Kidney disease or Nephropathy: Diabetes is the most common cause of kidney failure worldwide. Initially, patients may notice swelling around the eyes or frothing of urine. Later, if the kidney failure worsens, there can be swelling of the legs and decreased urine. Ultimately patients may need dialysis or kidney transplantation.
Eye disease or Retinopathy: Elevated blood sugar levels can damage the blood flow to the eyes, leading to a condition called diabetic retinopathy. This condition can cause vision problems and, if left untreated, even blindness.

Foot problems: Diabetes can lead to poor blood flow to the legs. This can result in cramps, and pain, and later it can lead to blackish discoloration of the toes or leg ulcers. Severe cases may even require amputation. Proper foot care is essential for individuals with diabetes to prevent serious issues.
Increased Infection Risk: People with diabetes are more susceptible to infections, particularly skin and urinary tract infections. High blood sugar levels can weaken the immunity.

Mental Health Impact: Living with a chronic condition like diabetes can lead to stress, anxiety, and depression. Some persons may experience diabetes burnout, which is the feeling of being overwhelmed by the demands of managing the condition. This can lead to a lack of motivation, self-care neglect, and a sense of hopelessness.
Quality of Life: People living with diabetes require constant monitoring, medication, and lifestyle changes, which can impact an individual's overall quality of life. Dietary restrictions, physical activity, and medication adherence are necessary components of managing the disease.

Economic Burden: Diabetes demands consistent medical care, including medications, blood sugar monitoring, regular doctor visits, and, in some cases, hospitalizations. These costs can be substantial, particularly for individuals without adequate insurance coverage. Managing diabetes complications, such as heart disease, kidney disease, neuropathy, and retinopathy, adds to the economic burden. These complications often require specialized treatments and interventions.
Reduced Life Expectancy: If not well-managed, diabetes can lead to a reduced life expectancy due to the increased risk of complications like heart disease, stroke, and kidney failure.

Strategies to mitigate the impact of diabetes
Mitigating the impact of diabetes requires a multifaceted approach that encompasses lifestyle changes, medical management, and a supportive environment. Here are some key strategies to mitigate the impact of diabetes:
Regular Monitoring: Regularly monitoring blood sugar levels is essential for managing diabetes. This helps individuals and healthcare providers to make informed decisions about treatment and lifestyle adjustments.

Healthy Eating: A balanced diet is a cornerstone of diabetes management. Focus on consuming a variety of nutrient-dense foods, including whole grains, lean proteins, fruits, vegetables, and healthy fats. Limit or avoid high-sugar and high-carbohydrate foods. Pay attention to portion sizes to help manage blood sugar levels. Measuring and understanding portion sizes can prevent overeating and sudden spikes in blood sugar.

Regular Physical Activity: Engaging in regular physical activity is crucial for managing diabetes. Exercise can help insulin to work better, lower blood sugar levels, and promote overall health. Aim for a combination of aerobic exercise (like walking, jogging, or cycling) and strength training. It is recommended to do at least 150 minutes/week of regular physical activity, at least 5 days/week.

Medication Adherence: It's essential to take medications as directed by the healthcare provider. Adhering to medication regimens helps control blood sugar and reduce the risk of complications. Many persons avoid the medications due to fear of the side effects of medications. it is essential to understand that many of the current medications for diabetes not only improve the blood sugar levels, but also improve the functioning of vital organs like the heart, brain, and kidneys.

Stress Management: Chronic stress can affect blood sugar levels. Engage in stress-reduction techniques such as mindfulness, meditation, deep breathing exercises, and hobbies to alleviate stress.
Regular Check-ups: Schedule regular check-ups with healthcare providers to monitor the progression of diabetes and assess for potential complications. These appointments provide an opportunity to adjust treatment plans as needed.

Education and Self-Management: Educate yourself about diabetes and how it affects your body. Understand the importance of self-management, including blood sugar monitoring, medication, and dietary choices. Empowering yourself with knowledge is key to effective management.
Preventive Care: Focus on preventing complications. This includes regular eye exams to detect diabetic retinopathy, dental care to prevent gum disease, and foot care to avoid diabetic foot ulcers.

Weight Management: For individuals with type 2 diabetes who are overweight, weight loss can significantly improve blood sugar control. Consult with a healthcare provider for a personalized weight management plan.
Stop smoking: Smoking is detrimental for people with diabetes as it increases the risk of cardiovascular complications. Quitting smoking is a vital step in managing the condition effectively.

Regular Sleep Pattern: Prioritize healthy sleep patterns. Lack of sleep can affect blood sugar control and increase insulin resistance.
Vaccinations: Stay up to date with vaccinations, including the flu vaccine and other recommended immunizations, to prevent illnesses that can complicate diabetes.

By adopting these strategies and maintaining a proactive approach to diabetes management, individuals can significantly mitigate the impact of the condition, improve their quality of life, and reduce the risk of complications.
(Dr Akhil Krishna is Associate Consultant, Department of Endocrinology and Diabetes, KIMSHEALTH)