Obesity or excess weight are the two main modifiable risk factors for diabetes. For patients with diabetes, the presence of obesity increases the risk of almost all of the risk of diabetes.
World Diabetes Day: Diabetes can lead to several complications if not controlled
We treat diabetes not just to get the diabetes levels to normalcy but to prevent complications of diabetes which have a direct impact on the quality and quantity of life for a diabetic patient. Diabetes can afflict any or every organ in the body, however, the major complications of diabetes include the brain (it can cause a stroke), in eyes (can cause retinopathy – can lead to loss of vision), in the heart (which can cause heart attack, heart failure), liver and kidney (failure of these organs), involvement of nerve or blood vessels of the legs (which can lead to ulcers or amputation of the lower leg).
Science has proven that diabetes is a cardiovascular disease risk equivalent, that is, the presence od diabetes has a possible impact on the longevity of a person, similar to that of a person with established heart disease. For somebody who has diabetes without heart disease, compared to that of a person with heart disease, their life expectancy is generally almost the same. Diabetics are also at a higher risk of cardiovascular diseases. Their risk is also further magnified in the presence of diabetes, especially if a person is obese, has uncontrolled blood pressure, abnormal cholesterol levels, fatty liver, excessive smoking or consumes alcohol regularly. These are important ways in which uncontrolled glucose levels and diabetes along with these multiple risk factors predispose these patients to a heightened risk for cardiovascular disease.
How to manage diabetes?
Controlling your blood sugar levels and other restrictions are part of managing one's diabetes. Treatment of diabetes, however, is not just focused on blood glucose levels, it also includes prevention of other complications. For this, diabetes treatment requires a multipronged approach, which must include a balanced, healthy diet, regular exercise, weight reduction, blood sugar control and more importantly, especially in today's day and age, appropriate usage of diabetes medications which decides their blood glucose-lowering effect can protect their vital organs. Along with this, optimal blood pressure and cholesterol control go a long way in reducing the complications of diabetes.
Regular blood sugar monitoring at home, so that the patient is aware of their progress, can help them know when they need to institute corrective measures. Regular lab monitoring of the average blood sugar control over three months also called the glycosylated haemoglobin (hba1c), annual screenings of complications which must include regular eye-checks including the retina evaluation. The patient must maintain the regularly scheduled visit to the diabetes care team. If they smoke or consume alcohol, cigarette and alcohol cessation is very important in improving their quality and quantity of life. Enhancing their mental health by indulging in more and more yoga and meditation are important ways of attaining optimal health for a diabetic.
Should diabetics be on heart medications?
Diabetics are usually on medications for not just diabetes, but also for blood pressure, cholesterol, blood thinners. All of these contribute to a healthy heart. Some of the newer diabetes medications have potential protective effects on the heart.
Should the diabetics who are obese work on reducing their body weight?
Obesity or excess weight are the two longest modifiable risk factors for the causation of diabetes. For patients with diabetes, the presence of obesity increases the risk of almost all of the risk of diabetes. The scientifically driven strategy for weight loss, not only helps with the prevention of diabetes but also helps prevent complications of diabetes.
When it comes to the quantity of weight loss, we should start with the target of 10%. Most of the health benefits on diabetes and cardiovascular risk factors, cardiac health start appearing. Once we achieve that, with further weight loss, moving towards the ideal body weight, the health benefits increase. However, in today's date, when all of our strategies are majorly driven and supported by science, we use body composition to help us individualise the weight loss strategy and possibly provide greater benefits of weight loss for the patient.
The theme for this year's diabetes day is access to diabetes care, and it comes at a very relevant moment. In the last couple of years, through the enhancement of technology and use of telemedicine, have taken a quantum leap towards the best possible access to the patients.
(By Dr. Jasjeet Singh Wasir, Associate Director, Endocrinology and Diabetology, Medanta)
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