Disclaimer: We are not medical experts. This article is intended for educational purposes only. And though all information are provided in good faith, we cannot guarantee their accuracy. As such Londoni cannot be held responsible for any problem which you may experience as a result of this article.
Please consult your local doctor or a specialist for your medical problem.
We sincerely hope that you - or anybody else that is suffering from this illness - make a quick recovery and have great health.
What happens if I just ignore it?
Left untreated, diabetes can cause many different health problems. Large amounts of glucose can damage blood vessels, nerves and organs. Even a mildly raised glucose level that does not cause any symptoms can have damaging effects in the long term.
If people living with Type 1 diabetes don't receive treatment they can develop very high blood sugar levels (hyperglycaemia) within days. Because there is no insulin to drive the sugar from the blood into the cells, the kidneys try to remove the excess glucose. This leads to frequent urination, dehydration and intense thirst. At the same time, the body starts breaking down fat for fuel to counter the low levels of sugar available to the cells. This leads to toxic levels of acids building up in the blood - a life-threatening condition known as ketoacidosis.
Those with Type 1 can also suffer a dangerous complication of treatment known as hypoglycaemia, which can cause a coma. This occurs when blood sugar levels fall dangerously low as a result of taking too much insulin, or sometimes by skipping a meal. The brain requires a constant supply of glucose from the blood otherwise it can't function properly.
If treatment doesn't effectively control high blood sugar levels, it leaves a person with diabetes more vulnerable to infections. Over time it can also damage the small blood vessels and nerves throughout the body, including the smaller vessels at the back of the eye, which can result in blindness, and the kidneys, leading to kidney failure.
In the long-term, diabetes raises the risk of many conditions, including peripheral vascular disease (when the arteries to the extremities are damaged by atherosclerosis) and peripheral nerve damage. Together they can result in ulcers, infections, gangrene and amputations. It can also increase the risk of impotence, heart attacks and strokes.
BBC - Science
Blindness caused by 'Diabetic retinopathy'
To see, light must be able to pass from the front of the eye through to the retina, located at the back of our eye. The retina converts the light into electrical signals which are then sent to the brain which interprets them to produce the images that we see. For the retina to work properly it needs constant supply of blood, which it receives through a network of tiny blood vessels. If someone suffers from high blood sugar level (i.e. diabetic patient) then, overtime, these blood vessels become blocked, leaky or grow haphazardly. This damages the retina and stops it from working. If it's not treated, it can lead to blindness.
In the medical profession, this damage to the retina caused by complication of diabetes is known as "Diabetic retinopathy". During the initial stages, retinopathy does not cause any noticeable symptoms. You may not realise that your retina is damaged until the later stages, when your vision becomes affected.
If you have diabetes and start to notice problems with your vision, contact your GP or diabetes care team immediately.
As retinopathy can cause blindness, it is very important that it is identified and treated as early as possible. You must make sure you get your eye screened once a year to reduce the risk of vision loss.
Treatment for retinopathy will depend on the stage the condition has reached. For example, if retinopathy is identified in its early stages, it may be possible to treat it by controlling your diabetes more effectively. If you have more advanced retinopathy, you may need to have laser surgery to prevent further damage to your eyes.
You can reduce your risk of developing retinopathy by controlling your blood sugar level and keeping your blood pressure as close to normal as possible.
To reduce the risk of eye problems, blood glucose, blood pressure and blood fats need to be kept within a target range, which should be agreed by you and your healthcare team. The aim of your diabetes treatment, with a healthy lifestyle, is to achieve these agreed targets. Smoking also plays a major part in eye damage so, if you do smoke, stopping will be extremely helpful.
If it is poorly controlled, diabetes can damage nerves and blood vessels. Nerve damage is called neuropathy and there are three types: Sensory Neuropathy, Motor Neuropathy, and Autonomic Neuropathy. All three types can affect your feet. The reduced sensation of the nerves means that you're more likely to develop an open sore on your feet, known as 'foot ulcer', and the reduced blood supply means the ulcer is more likely to become infected. The infection is likely to further restrict blood supply, leading to gangrene, the decay and death of body tissues. Gangrene can affect any part of the body but typically starts in the toes, feet, fingers and hands (the extremities).
Once gangrene has developed, it is sometimes necessary to amputate (cut off) the affected limb to prevent the spread of infection and further damage to healthy tissue.
People with diabetes are more likely to be admitted to hospital with a foot ulcer than with any other complication of diabetes. This is because diabetes may lead to poor circulation and reduced feeling in the feet.
If you have diabetes you also have a higher chance of getting skin infection if the diabetes is poorly controlled or you have neuropathy. This is because you may not realise you have developed an infection until it is already widespread and harder to treat.
Consult your GP or practice nurse immediately. They'll give you advice and information or help you make an appointment with a foot specialist (podiatrist or chiropodist).
Check your feet every day: if you notice any of the danger signs you should make an appointment with your GP, podiatrist or nurse immediately. Do not try to treat injuries, corns or other foot problems yourself. Seek professional help. And never use corn removal plasters: they contain acid which can cause the skin to break down.
Did you know...
These things do not cause diabetes:
- Virus or germs - you cannot catch diabetes like a cold.
- Stress, though it may make the symptoms worse in people who already have the condition.
- An accident or an illness won’t cause diabetes, but may reveal the condition if it is already there.
- Diabetes only affects old people = False. Diabetes affects all age groups.
- Diabetes is not a killer disease = False. Diabetes is a global killer, rivaling HIV/AIDS in its deadly reach. The disease causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke. However, if you manage your diabetes properly, you can prevent or delay diabetes complications.
- People with diabetes can't eat sweets or chocolate = False. If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more "off limits" to people with diabetes than they are to people without diabetes. The key to sweets is to have a very small portion and save them for special occasions so you focus your meal on more healthful foods.
- Eating too much sugar causes diabetes = False. The answer is not so simple. Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease. Type 2 diabetes is caused by genetics and lifestyle factors.
- Diabetes predominantly affects men = False. Diabetes affects both men and women, and is rising among women. It is also increasing dramatically among youth and threatening to decimate indigenous populations.
- Diabetes cannot be prevented = False. Up to 80% of type 2 diabetes is preventable by changing diet, increasing physical activity and improving the living environment.
- If you are overweight or obese, you will eventually develop type 2 diabetes = False. Being overweight is a risk factor for developing this disease, but other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.
- People with diabetes should eat special diabetic foods = False. A healthy meal plan for people with diabetes is generally the same as a healthy diet for anyone - low in fat (especially saturated and trans fat), moderate in salt and sugar, with meals based on whole grain foods, vegetables and fruit.
- People with diabetes are more likely to get colds and other illnesses = False. You are no more likely to get a cold or another illness if you have diabetes. However, people with diabetes are advised to get flu shots. This is because any illness can make diabetes more difficult to control, and people with diabetes who do get the flu are more likely than others to go on to develop serious complications.
- If you have Type 2 diabetes and your doctor says you need to start using insulin, it means you're failing to take care of your diabetes properly = False. For most people, Type 2 diabetes is a progressive disease. When first diagnosed, many people with Type 2 diabetes can keep their blood glucose at a healthy level with oral medications. But over time, the body gradually produces less and less of its own insulin, and eventually oral medications may not be enough to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.
The myth that people with diabetes should not eat any sugar still persists, but people with diabetes can eat sugar, but sugar should be limited as part of a healthy diet, good blood glucose control can still be achieved when sugar and sugar containing foods are eaten.
Dietary management of diabetes depends more on eating regularly and including starchy carbohydrate foods like pasta at meals, and including more fruit, vegetables and pulses in your diet. The main thing to consider is the overall balance of your diet - with the emphasis on long-term health and weight control.
How do I deal with it?
At present diabetes cannot be cured, but treatment aims to keep your blood glucose levels as normal as possible to control your symptoms and minimise health problems developing later.
You can't do anything about your age or your genetic predisposition. On the other hand, the rest of the factors predisposing to diabetes, such as overweightness, abdominal obesity, sedentary lifestyle, eating habits and smoking, are up to you. Your lifestyle choices can completely prevent Type 2 diabetes or at least delay its onset until a much greater age.
If there is diabetes in your family, you should be careful not to put on weight over the years. Growth of the waistline, in particular, increases the risk of diabetes, whereas regular moderate physical activity will lower the risk. You should also pay attention to your diet: take care to eat plenty of fibre-rich cereal products and vegetables every day. Omit excess hard fats from your diet and favour soft vegetable fats.
What you can do to lower your risk of developing Type 2 diabetes
Treating Type 1 diabetes
As your body cannot produce any insulin, you will need to have regular insulin treatment to keep your glucose levels normal. You will need to learn how to match the insulin you inject to the food you eat, taking into account your blood glucose level and how much exercise you do. This skill needs to be practised and learnt gradually. Many diabetic care centres now provide courses to teach these skills.
Insulin comes in several different forms, each of which works slightly differently. For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but do not last very long (rapid-acting). Your treatment may include a combination of these different insulin preparations.
Some people with Type 1 diabetes may benefit from a fairly new procedure known as islet transplantation. It involves implanting healthy islet cells from the pancreas of a deceased donor into the pancreas of someone with Type 1 diabetes.
Islet transplants have been shown to be an effective way of reducing the risk of severe hypoglycaemic attacks or 'hypos' (where a person’s blood sugar falls to an abnormally low level).
So far, the results of islet transplants carried out in the UK have shown a significant reduction in the number of hypos, from 23 per person per year before transplantation to less than 1 per person per year afterwards.
NHS - Diabetes
Treating Type 2 diabetes
In some cases of Type 2 diabetes, it may be possible to control your symptoms by altering your lifestyle, such as eating a healthy diet.
However, as Type 2 diabetes is a progressive condition, you may eventually need medication to keep your blood glucose at normal levels. To start with this will usually take the form of tablets, but later on it may include injected therapies, such as insulin.
What food should I have?
Healthier alternative for common food
|Whole milk (or pasteurised milk)||Semi-skimmed, 1% fat or even skimmed milk|
|Sugar-coated breakfast cereal||Whole grain breakfast cereal such as porridge or shredded whole grain wheat cereal with no added sugar|
|A sprinkle of sugar on your breakfast cereal||Topping of fresh or dried fruit, which counts towards one of your five a day|
|Full-fat Greek yoghurt||Lower-fat or fat-free Greek yoghurt, or natural low-fat yoghurt|
|White breads, bagels and muffins||Whole grain varieties|
|Butter and cheese in your jacket potato||Reduced fat spread and reduced salt and sugar baked beans|
|Tuna melt panini||Tuna salad sandwich on wholemeal bread without mayo|
|Cheddar cheese filling in your sandwich||Reduced-fat hard cheese|
|Pasta with cream or cheese sauce||Pasta with tomato or vegetable sauce|
|Creamy soup (e.g. cream of mushroom or chicken)||Vegetable-based soup (e.g. leek and potato, carrot and coriander, etc)|
|Jack potato with cheese, coleslaw or rich meat sauces||Jack potato (without butter) with baked beans, vegetable chilli, tuna (no mayonnaise), or cottage cheese|
|Low-fat salad dressing|
|Creamy or cheesy sauces on your pasta, meat or fish dishes||Tomato- or vegetable-based sauces|
|Fatty meat (e.g. lamb breast)||Leaner cuts of meat|
|Frying meat||Grilling meat|
|Deep-fried, thinly cut chips||Thick-cut, reduced-fat oven chips. Avoid adding extra salt. Avoid soggy batter and soggy chips as this is a sign that they have absorbed lots of fat from being cooked in oil at the incorrect temperature|
|Battered fish||Fish coated in breadcrumbs|
|Cannelloni (as spinach replaces some of the meat)|
|Single, whipping, double or soured cream||Low-fat or diet yogurts|
|Fizzy drink||100% fruit juice (with no added sugar) mixed with soda water|
|Sugary drinks||Glass of water|
|Cordial||Cordial with no added sugars|
|Coffee made with whole milk||"Skinny" coffee made with semi-skimmed or skimmed milk|
|Hot chocolate made with whole milk and served with whipped cream||Hot chocolate made with skimmed milk and no cream|
|Milkshake||Fruit juice or sparkling water|
Pastry (especially flaky and puff)
Milk puddings using semi-skimmed milk
Roasted nuts in oil and salt
|Other nuts (e.g. almonds, walnuts, and brazil nuts) in small amounts (e.g. a handful a day)|
Different foods will affect you in different ways, so it is important to know what to eat and when to get the right amount of glucose for the insulin you are taking. A diabetes dietitian can help you work out a dietary plan that can be adapted to your specific needs.
NHS - Diabetes
Diabetes UK has over 250 recipes online which have been calorie-counted, adapted, tasted and nutritionally analysed for diabetes. There are countless recipes for people with special dietary requirement such as dairy free, suitable for freezing, gluten free, and vegetarian. The website address is: http://www.diabetes.org.uk/Guide-to-diabetes/Recipes/.
There's no need to throw away your favourite cookbooks because you have diabetes. You can modify your recipes by reducing the amount of fat, salt and sugar, and increasing fibre. High sugar and high fat foods do not need to be excluded from your diet altogether if you have diabetes.
I'm Bengali, why should I care about diabetes?
Greater chance of getting the disease
South Asian, which includes Bengalis, are more likely to get diabetes (along with Black African and African Caribbean) then any other ethnicity. This means that diabetes has greater chance of affecting you or someone close to you than most of the other people in the world.
Those of Asian descent - South-East Asia in particular - develop diabetes at a lower body weight. So, even though they may not be as heavy, their sensitivity to diabetes occurs at a lower body weight.
Dr. Ann Albright, Centers for Disease Control and Prevention (USA)
According to the International Diabetes Federation (IDF), in 2012 in South-East Asia - comprising Bangladesh, India, Sri Lanka, Bhutan and Mauritius - 1 in 4 people (25%) between the age of 20-79 years old died due to diabetes. Over half the population - 51% - were undiagnosed and it was estimated that there was 36 million undiagnosed cases. In 2013 over 72 million people were diagnosed with diabetes in this region, and the number is set to increase to an astonishing 123 million by 2035.
Over 5 million diagnosed cases in Bangladesh. Many more undiagnosed.
Bangladesh has 13th most highest cases of diabetes in the world. In 2012 an estimated 5,521,410 people were diagnosed with diabetes with a further 2,760,710 undiagnosed cases. This resulted in 107,330 known diabetes-related death. These grim statistics were slightly more favourable the following year. In 2013 approximately 5.5% of it's 92 million plus adult population (between the age of 20 -79) were diagnosed with diabetes. However, the World Health Organization (WHO) predicts that by 2030 over 11 million people - or 11,140,000 - in Bangladesh will be diagnosed with diabetes.
|Adult population (20-79 year old)||No. of diabetes cases||Diabetes-related death||Undiagnosed cases|
|Total||Male||Female||Rural setting||Urban setting|
When it comes to diabetic care, Bangladesh is one of the lowest investors in the world - and ranks in the bottom 10 nations, slightly ahead of poorer African nations. In 2012 an average of $28 (USD) was spent per person with diabetes. This increased to $41 the following year.
|Ranking||Best||$ USD||Worst||$ USD|
|Breads made with ghee (e.g. parathas, puris, peshwari naan)||Wholemeal or grainy bread|
|Chapatis, rotis, naan bread||Chapatis without fat (e.g. no ghee or butter). Choose healthier spreads (polyunsaturated or monounsaturated fat and low-fat varieties) rather than butter|
|Omlettes cooked in butter
|Omlettes cooked in tiny amount of olive oil
Boiled or poached eggs
|Frying||Grill, boil, steam and bake. Tandoori grilling is the best form of cooking where minimal or no oil is used and the intense heat cooks the food quickly, sealing in all the nutrients|
|White rice||Brown (basmati) rice. Or have smaller portion (i.e. fistful) of white rice|
|White (plain) flour or chapati||Wholemeal flour or chapati|
|Fried rice||Boiled rice|
|Vegetable cooking oil||(Extra virgin) olive oil, soya, sunflower oil. Use oil sparingly. Using non-stick cookware for deep-frying can help you to limit the use of oil when cooking curries|
|Chicken with skin||Skinless chicken grilled or roasted without fat|
|Fatty meat (e.g. lamb breast, duck)||lean meat (e.g. lamb or beef) grilled or roasted without fat
Liver and kidney
Cut down on fat by changing the menu and cooking dishes that require no frying.
|Deep-fried fish||Fish (white and oily) grilled, steamed, baked, poached or fried in tiny amount of oil|
|Deep-fried vegetables||Fresh or frozen vegetables
Raw, boiled, steamed or grilled vegetables
|Creamy curries||Tomato base or use low-fat yogurt as a substitute|
|Butter or ghee||Lower-fat, unsaturated fat spreads|
|Coconut milk or cream||Skimmed milk, cashew nut paste or poppy seed paste|
|Snacks & desserts:|
|Indian sweets||Jelly (sugar-free), milk puddings using semi-skimmed milk, or sorbets|
The Diabetic Association of Bangladesh has a blog written in Bangla where they publish latest articles on Diabetes. In addition, many world renowned health organisations, such as Diabetes UK, also have online resources written in Bangla to cater for the Bengali audience.