Know symptoms, save yourself from diabetes

Dr Vipin Mishra - Consultant Endocrinology at Zulekha Hospital Dubai gives insights on how to spot diabetes

What is needed to increase awareness of diabetes in families?
Diabetes is to a very great extent a preventable disease. For that reason and for proper care of the sufferer, a high level of awareness about the diseases amongst the masses is the need of the day. Awareness about diabetes in families can be increased by two agencies. Firstly, everyone can play a huge role by providing full information about the seriousness of the problem, signs of early recognition, dos and don'ts to keep the problem in control and changing the attitude of the masses towards injectable anti diabetic medicines. Secondly, hospitals and health centers can create high awareness by arranging support group meets for patients with diabetes specialists.

What are the first symptoms that could be a warning sign of diabetes?
Diabetes may cause unaccounted weakness, fatigue and exhaustion, dizziness and pain and burning in legs. Sometimes severe diabetes may cause excessive thirst, excessive urination and excessive hunger along with weight loss. However, in 50 per cent of the cases the onset of diabetes is without any symptoms. Blood sugar levels start rising gradually without the sufferer realizing anything and the diagnosis is made when there is some complication. So, annual blood sugar check is encouraged for everybody after the age of 40, and for those who have a family history of diabetes, the annual check should start at 30.

Is diabetes often hereditary? So if one person has it in the family you should perhaps be on guard? How often is it a hereditary case?
Diabetes is a hereditary disease and a positive family history is available in up to 75% of the patients. However an absence of family history doesn't make a person immune from diabetes. Likewise a positive family history is not a one hundred percent guarantee of getting diabetes. It is absolutely important that if diabetes is in the family then all other family members should adapt to a healthy lifestyle which is quite successful in prevention of diabetes.

Are many people/families unable to spot the signs? Is this a concern?
Many people are not able to spot the signs of diabetes either because of lack of awareness, or because of diabetes developing insidiously without any symptoms, which is the case in about half of the cases of diabetes. Yes, it is a cause for concern as rising sugar levels would damage the vital internal organs which would ultimately lead to serious complications and shorten the lifespan.

Generally, how aware are families about diabetes?
With the passage of time and now because of increasing coverage about diabetes in the media, awareness level has significantly increased in the last ten years. Yet, the awareness level is far from ideal. One other problem that we generally observe is that many people knowing fully well about diabetes, still do not do anything to avoid it. It looks like they keep on waiting for something big to happen to change their lifestyle. This is an additional attitude problem and not just an awareness problem.

Can you please give me a case study that can elaborate on the family role in diabetes management and care?  
A 42-year-old Indian expat was admitted to the hospital with a serious abscess in the groin. He was admitted through the Emergency Room as he had excruciating pain and high fever. He was subjected to an emergency surgery to drain out the pus collection. Blood tests revealed a very high random sugar value of 486 and an HbA1C of 13.6. I treated him with multiple doses of insulin for more than three months. On enquiry he told me that his sugar was observed as borderline high for the last three years. Doctors had advised him to take medicines and follow a strictly disciplined lifestyle. He never took the medicines but followed the prescribed diet only for one month. After that he checked the sugar values one year back when he was clearly diabetic with fasting sugar at 140 and Hba1C at 7.1.

He was again advised medicines and a lifestyle change. He took the medicines for one month, but could not change lifestyle because of work pressure and strong personal liking for certain high caloric foods. He was not doing any physical activity or exercise. He had gained 10 kg of weight in the last 3 years. His admission to the hospital and surgery and all the physical agony was totally avoidable if he had understood the significance of diabetes, taken the medicines, changed the diet appropriately and had started on some regular exercise program. It's very clear that the whole family was unaware of healthy living. Better family awareness about diabetes could have very well avoided all the problems that this patient had.

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