June 05-20, 2008
FJ, Volume 22, Number 15
August 05-20, 2008
Dear Dra. Denise,
My tatay has diabetes and his kuya also has diabetes. Does that mean I will get diabetes, or can I prevent it somehow?
Diabetes mellitus (DM) is a common long-term metabolic disturbance characterized by high fasting blood sugar. It is a syndrome caused by an absolute or relative lack of insulin, resistance to the action of insulin, or both. When severe, it affects the body’s breakdown of carbohydrates, fats, and proteins. Severe long-term DM may lead to complications involving small blood vessels, large blood vessels, and nerve damage, affecting multiple organs and systems.
The goals of therapy are to control the symptoms; to establish and maintain optimum metabolic control, while avoiding low blood sugars; to prevent or minimize the risk of complications; and to achieve optimal control of other associated illnesses like high blood pressure and high cholesterol
Therapy includes teaching the diabetic about diabetes, the role of diet, exercise and medications, how and when to self-monitor, management of sick days, recognition and treatment of low blood sugar, the major side effects of medications and how to adjust drugs in response to changes in diet and activity, and care of the feet. Individualized diet management counseled by a dietician should be done. Total calorie intake should be reduced to decrease weight and improve metabolic control. Self-monitoring of blood sugar levels is important. Physical activity and exercise improve heart function, enhance sensitivity to insulin, lower blood pressure and cholesterol levels, and improve sugar control. Medications should be adjusted with meals and exercise. Regular doctor check-ups should include blood pressure measurements; foot exams; blood tests of long-term control (usually every 3-6 months); checks of the glucose monitor; diet and diabetes management skills reinforcement; kidney function tests; fasting cholesterol tests (every 1-3 years if initially normal); and eye exams.
To screen for diabetes, a fasting blood glucose level should be measured every 3 years in those over age 40. Earlier and more frequent testing may need to be done in those with higher risk: first degree relative with DM, member of high-risk population (aboriginal, Hispanic, Asian or African descent), history of impaired sugar tolerance or impaired fasting sugar, presence of complications associated with DM, vascular disease, history of DM during pregnancy, high blood pressure, high cholesterol, overweight, abdominal obesity, and certain diseases. Since your tatay is a first-degree relative, you are at a higher risk and should have your blood tested.
Those with high blood sugars but below the diabetes threshold are considered to have prediabetes (includes both impaired fasting glucose and impaired glucose tolerance). Those with metabolic syndrome (obesity, high blood pressure, high cholesterol, insulin resistance, and sugar abnormalities) have a significant risk of DM and of heart and blood vessel disease.
Some studies have shown that progression to DM in high-risk individuals may be preventable: diet modification with restriction of calories and reduced fat intake combined with supervised, moderately intense physical activity of about 150 minutes a week can reduce the risk of DM by 58% at four years. The associated weight loss was about 5% of initial body weight. Some diabetes medications given to high-risk individuals have also shown to help delay/prevent the development of diabetes. There are no known safe and effective measures to prevent type I DM, which tends to affect those at a younger age.
It is great that you are looking after your health—an ounce of prevention is worth a pound of cure! Your health (not just physical/body, but also emotional, spiritual, and mental health) is foremost in your own hands; health starts at home. Alagaan ninyo ang katawan at kalusugan ninyo! Take care, and mind your health!
No comments:
Post a Comment