Nearly half a million adult people in Kenya have Type 1 and Type 2 diabetes.
The United Nations report on ‘The State of Food Security and Nutrition in the World’ estimates that the prevalence for Type 1 and Type 2 diabetes is expected to hit 4.55 per cent from the current estimate of 3.3 per cent by the year 2025.
There are two types of diabetes: Type 1 and Type 2 diabetes. Type 1 diabetes is less common that Type 2 diabetes.
This feature explores the causes, symptoms, treatment and prevention of Type 1 and Type 2 diabetes, start with:
Type 1 diabetes
What is it?
Type 1 diabetes was previously referred to as insulin-dependent, juvenile or childhood-onset.
According to the Centre for Disease Control (CDC), Type 1 diabetes involves the deficient production of insulin.
With Type 1 diabetes, patients are no longer able to produce insulin on their own and are required to inject it as a way of controlling blood sugar levels.
“If the patient has Type 1 diabetes, their pancreas will not be able to make insulin or will tend to make very little insulin,” the CDC cites. Insulin is a hormone that is made in the pancreas.
The pancreas is a gland that is located behind the stomach. Insulin helps in the control of the amount of glucose in the bloodstream. It also helps the blood sugar enter the cells in the body for use as energy.
This means that the body will still be able to break down carbohydrates from food and drink and turn them into glucose.
However, when the glucose enters the bloodstream, it will find that there is no insulin to help it move into the body’s cells.
“Without insulin, blood sugar is unable to get into cells. It instead builds up in the bloodstream,” the CDC cites. “High blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes.”
Causes and risk factors
The actual cause of Type 1 diabetes is not fully known. However, according to the Centre for Disease Control, Type 1 diabetes is thought to be caused an autoimmune reaction.
“This means that the body attacks itself by mistake in a reaction that destroys the cells in the pancreas that make insulin,” the CDC cites. These cells are known as beta cells.
The CDC states that the destruction of the beta cells can go on for months or years before any symptoms can start to appear. The CDC states that there are two main risk factors for Type 1 diabetes. These are:
- Family history: You will have elevated risk for Type 1 diabetes if your parent, brother or sister has had Type 1 diabetes.
- Age: Type 1 diabetes is most common in children, teens, and young adults. However, you can get Type 1 diabetes at any age.
Symptoms
Symptoms of Type 1 diabetes can occur over time and can also occur suddenly. They can be severe when they show up. According to the World Health Organization, symptoms of Type 1 diabetes usually include:
- Excessive urination, especially at night
- Feeling very thirst regardless of regularly drinking (polydipsia)
- Constantly feeling hungry
- Unintended weight loss
- Blurred vision
- Fatigue
- Thrush that keeps coming back
- Fruity-smelling breath
- Cuts and grazes that are not healing
Treatment
There’s no known cure for Type 1 diabetes. According to the CDC, treatment for Type 1 diabetes usually involves blood glucose control. People with Type 1 diabetes mainly require treatment with insulin.
There are patients who will inject it and others who will prefer to use a pump. “If you have Type 1 diabetes, you’ll likely take a combination of insulin,” states the CDC.
It is also recommended that for better management of Type 1 diabetes, you must make your own effort adhere to the physician’s recommendations for living a healthy lifestyle.
“The patient must endeavor to undergo regular health checkups and blood sugar control management, and keep abreast on Type 1 diabetes self-management information and education,” recommends the CDC.
If you are a parent and your child has Type 1 diabetes, the CDC recommends that care will need to be undertaken day by day.
“This care will involve healthy foods, giving insulin injections, and watching for and treating low blood sugar also known as hypoglycemia,” the CDC states.
Type 2 Diabetes
Out of both Type 1 and Type 2 diabetes, the majority of people who get diabetes are diagnosed with Type 2 diabetes. The World Health Organization (WHO) estimates that up to 95 per cent of all cases of diabetes involve Type 2 diabetes.
Causes
Unlike Type 1 diabetes where your pancreas is not able to make insulin or makes very little insulin, in Type 2 diabetes, your cells will not respond normally to the insulin your pancreas makes. This is known as insulin resistance.
“Your pancreas makes more insulin to try to get your cells to respond. In the end, your pancreas is unable to keep up and your blood sugar rises. This leads to pre-diabetes and eventually Type 2 diabetes,” the Centre for Disease Control cites.
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Apart from Type 2 diabetes, the CDC says that high blood sugar is damaging to your body and can trigger secondary health complications including heart disease, stroke, vision loss, amputation of feet, gangrene (death of body tissue due to a lack of blood flow), and the kidney disease.
Symptoms
The symptoms of Type 2 diabetes are very similar to those of Type 1 diabetes. “Type 2 diabetes is more complicated than Type 1 diabetes. It shares almost similar symptoms, but its symptoms are less observable,” the WHO states.
This means that the disease is diagnosed several years after it started building up and its complications and impact on the body have manifested. The WHO lists these symptoms as including:
- A regular urge to urinate more than normal. This is happens especially at night
- A consistent feeling of thirst
- A nagging feeling of fatigue (or feeling extremely tired than you have previously felt)
- Losing weight rapidly even though you have not been working out or dieting (also known as unintentional weight loss)
- An itchy feeling around your penis or vagina. Or a consistent feeling of thrush. Thrush is a common fungal (yeast) infection that affects both men and women.
- Getting cuts or wounds that don’t appear to heal or that take longer than normal to heal
- Getting blurred vision
- Tingling or loss of feeling in the hands or feet
Risk factors
Obesity is considered the leading risk factor for diabetes, and is estimated to account for between 80 and 85 per cent of the risk of developing Type 2 diabetes.
According to the Centre for Disease Control (CDC), there are other factors that will put you on an elevated risk for Type 2 diabetes. These include:
- Being found to have pre-diabetes. Pre-diabetes is a condition in which you have high blood sugar, but not high enough to be classified as Type 2 diabetes.
- Being overweight. The WHO defines overweight as having a Body Mass Index (BMI or weight-for-height) greater than or equal to 25.
- Being aged 45 years or older.
- Having a parent, brother, or sister who has Type 2 diabetes.
- Being physically active less than 3 times a week.
- Having previously had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed over 4 kilograms.
- Having non-alcoholic fatty liver disease.
- Having low HDL. This means low levels of the good cholesterol.
- Having a high triglyceride level. This is a type of blood fat.
According to the CDC, gestational diabetes will tend to go away after birth. However, it will have elevated your risk for Type 2 diabetes.
Also, it will leave your baby at an elevated risk of developing Type 2 diabetes later in life. Your baby will also be at risk of developing obesity in childhood or teenagehood.
“You’ll be at risk of gestational diabetes if you have had gestational diabetes during a previous pregnancy, have given birth to a baby who weighed over 4kgs, are overweight, are more than 25 years old, have a family history of Type 2 diabetes, and have the polycystic ovary syndrome (PCOS) hormone disorder,” cites the CDC.
Management
According to Johns Hopkins Medicine, treatment for Type 2 diabetes is aimed at keeping your blood sugar levels as close to normal as is possible. Johns Hopkins Medicine says that this involves:
Regular checkups
Have your A1C level checked several times a year. Take this test at least twice a year if your blood sugar level is stable within the recommended range.
Keep your clinical appointments so that tests are done consistently and the results produce the required health projections.
Check your feet daily for any sores. During your clinical appointments, your doctor will also examine sores and infections on your feet. These can aggravate to bigger problems if untreated.
Medications and insulin
You may be given one or more types of oral medications. All medications will be aimed at lowering and controlling your blood sugar. If oral medications don’t work, you may be given insulin to self-inject.
Physical activities and weight loss
You should have at least 150 minutes per week of physical exercise. You should not allow two days to go by without exercising.
When sitting for lengthy periods, for example in the office or during a long flight, get up for light activity every 30 minutes.
Make the effort to lose five to seven per cent of your current body weight. Consult with your doctor on the healthiest ways to go about this.
Eating plan
You will need to eat foods that don’t cause your blood sugar to rise too quickly. Consult your doctor to get the best meal plan that you will follow.
There are also steps you can take to avoid risks that set you up for Type 2 diabetes.
For instance, the CDC states that you can prevent yourself from acquiring gestational diabetes by making lifestyle changes prior to getting pregnant.
“Prior to getting pregnant, make lifestyle changes including losing weight if you’re overweight, eating a healthy diet, and getting regular physical activity,” the CDC recommends.