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Diabetes - Living with diabetes
One of South Africa’s biggest killers
Last updated: Thursday, November 09, 2006

Diabetes is the third leading cause of death by disease in this country, and millions of South Africans remain undiagnosed - largely due to a lack of education.

Sylvia Anne Lombard, nursing service manager at Clinix Selby Park Hospital, a part of the Clinix Health Group, says the disease is common in the elderly, with up to 50% of people older than 65 suffering with diabetes to some degree.

 
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With Diabetes Day on 14 November, Clinix Health Group, the largest black-owned health group in South Africa, will be running several initiatives at its five hospitals (Clinix Private Hospital Soweto, Lesedi Private Hospital, Clinix Private Hospital Sebokeng, Clinix Private Hospital Vosloorus and Clinix Selby Park Hospital) next week.

What is diabetes?
Diabetes is a disorder of metabolism - the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood, which is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where cells for growth and energy use it. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

In people with diabetes, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

"The medical term for the disease is Diabetes Mellitus, with 'mellitus' being a Greek word for 'sweet as honey'," says Lombard. "This is a fitting description of the disease as diagnosis is obtained by tracing the sugar levels in urine."

The major classifications of diabetes are:

  • Type I diabetes
  • Type II diabetes
  • Gestational diabetes mellitus - this usually starts during pregnancy, in the second or third trimester.
  • Diabetes mellitus associated with other conditions or syndromes. Also known as secondary diabetes, it is accompanied by conditions known or suspected to cause the disease e.g. hormonal abnormalities, medications such as cortico sterioid and estrogen-containing preparations.

What are the symptoms?
The signs of diabetes include excessive thirst, frequent urination, feeling very hungry or tired, unexplained weight loss or weight gain, sores that heal slowly, loss of sensation or tingling in the feet, and blurry eyesight. Some people experience one or more of these signs, while others have no signs at all.

How to manage it
"It is very important to pay close attention to your diet, exercise routine, medication and insulin levels," says Lombard. "If you do so faithfully, it helps to keep diabetes related complications such as heart and kidney disease, nerve damage and blindness at bay."

The main goal of diabetes treatment is to normalise insulin activity and blood glucose levels to reduce the risk of further complications. Careful screening and monitoring of patients is a key step when intensive therapy is initiated. The therapeutic goal for diabetes management is to achieve normal blood glucose levels without seriously disrupting the patient's usual lifestyle and activity.

There are five components of diabetes management:

  • Nutritional Management - Nutrition, diet, and weight control are the foundation of diabetes management.
  • Exercise - Exercise is extremely important in managing diabetes because of its effects on lowering blood glucose and reducing cardiovascular risk factors. General precautions for exercise in diabetes include using proper footwear to prevent injury, avoid exercise in extreme heat or cold, inspect feet daily after exercise prolonged injuries or broken skin, and avoid exercise during periods of poor metabolic control.
  • Monitoring glucose levels and ketones - Blood glucose monitoring is a corner stone of diabetes management, and Self-Monitoring of Blood Glucose (SMBG) levels by patients has dramatically altered diabetes care.
  • Pharmacologic therapy - When administering insulin, it is very important to read the label and doctors script carefully to ensure that the correct type of insulin is administered.
  • Transplantation - Transplantation of the entire pancreas or segment of the pancreas is being performed on a small group of patients, and it has shown promise.

"The patient must receive health education on the possible complications of insulin therapy and must also be taught self-care," says Lombard. "Compliance to the therapeutic plan, which includes diet, self-medication and monitoring blood glucose levels, is the most important goal of self-care.

"In addition to follow-up care with professionals, participation in support groups is encouraged, providing the patient with an opportunity to share valuable information and experiences and to learn from others," she concludes.

Press release issued for and on behalf of Clinix Health Group by Cathy Findley Public Relations.


 
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