Understanding and living with Diabetes

“Diabetes” is twice as common now as it was 10 years ago. Some say this increase is due to better screening procedures, however, it can in part also be attributed to people’s greater longevity. Our bodies decline with age and the chance of developing diabetes increases as a result, but what is more worrying is that nowadays, diabetes is being more frequently discovered in younger people, such as those in their 30s.

People who are diabetic from a younger age have to live their whole lives with this condition. If you imagine becoming diabetic at the age of 30 and living until you are 80, that is 50 years, more than half of your life. Furthermore, greater complications will also, inevitably, ensue as a result of diabetes. On average, people who have been diabetic for over 10 years can have complications, including heart disease, high blood pressure, cholesterol, or kidney disease, among many others.

The majority of diabetics inherit the condition from their parents. Statistics show that over half the people with diabetes also have a family member with the condition, indicating that a part of diabetes results from our genetics. If our mother or father is diabetic, we are more likely than other people to also be diabetic. If both our mother and father are diabetic, however, we are up to 2 times more likely to also be diabetic. Whether the onset of the condition occurs quickly or slowly depends on our lifestyles: knowing what to eat, knowing to take exercise, knowing whether to change your lifestyle or not. Even if you don’t have diabetes, you should still visit a doctor, as diabetes is gradual, rather than presenting clear symptoms that make you feel unwell. You could have already had diabetes for a long time if you have symptoms such as often feeling thirsty, having a dry throat, and eating well but still losing weight. If we were to look back at your medical history for the last 5 – 10 years, we may see a slight incline in blood sugar levels. If these levels were allowed to continue climbing, it would surely lead to diabetes. On the other hand, if we were to go back to that day and control the blood sugar levels from the start, diabetes may not develop at all.

• Type 1 is diabetes in children. While this type is uncommon in Thailand, at around only 5%, it is commonly found in Scandinavia, in up 30% of children. As the body is unable to produce insulin from childhood, these children must live with diabetes their entire lives.
• Type 2 is diabetes in adults. This type occurs in anyone in general, and is related to age, our heredity, and our lifestyles.
• Type 3 diabetes is gestational diabetes. Nowadays, 1 in 4 women will have diabetes during pregnancy as more women are having children later in life than they used to. While women may want to take more time to prepare themselves financially before bearing children, they are also allowing diabetes more time to develop. Women who have gestational diabetes are more likely to have diabetes in the future.
• Type 4 diabetes results from certain diseases, such as alcoholic pancreatitis; from certain medicines; or from some types of tumour. This type of diabetes is relatively uncommon.

Focussing on diabetes treatment is a last resort. We cannot stop ourselves aging, nor can we change our genes. We can, however, control our environment. If we can diagnose diabetes in its early stages, when blood sugar levels are not high, and act quickly, we can control it well and may even prevent any complications from developing.

‘Controlling’ in this case means modifying our behaviour. Whether diabetes can be controlled depends on our eating habits and lifestyle. Some people say that diabetics can eat almost nothing, but in fact they can eat all kinds of food, even durian! Diabetics just cannot eat in the same way as those without diabetes. They need to watch how much they eat of some foods, which must be eaten sparingly, like rice and flour, while other foods should be eaten in higher volumes, such as fruit, vegetables, and meat, which are still required by the body. For people who do not have diabetes, they have a chance to protect themselves against it by controlling themselves in this way, while those who have diabetes already have the opportunity to avoid complications in the future.

Diabetes is incurable; it does not require waiting for surgical treatment, but it does require understanding. Nowadays, it is not enough to rely on doctors alone, and people with diabetes must be able to rely on themselves. Doctors provide classes on diabetes for those who have this condition, teaching them how they can care for themselves, how to manage their diet, how to make wise choices when buying food by checking labels for calorie counts and sugar contents, and how much they should be eating.

The important thing for diabetics is that they must know their own sugar levels and be able to carry out finger prick tests at home, helping them better control their blood sugar. For example, if they eat a type of food that raises their blood sugar during one meal, they will know to reduce it or modify what they eat for their next meal. For one patient, who likes to eat durian, in his first meal he ate one whole segment and saw the result from the finger prick test shoot up. In his second meal, he therefore reduced this amount and ate a partial segment of 3 seeds, causing his sugar levels to lower, but still not enough to be clear of harm. In his third meal, he tried eating a smaller, partial segment, with only 1 seed, and saw his blood sugar results remain at an adequate level. This patient has learnt that he can eat durian, but only a partial segment with 1 seed per time. In this way, he does not have to refrain from his favorite food, and will be happier as a result. Being diabetic does not mean that you cannot eat any food, only that you must know how much of certain foods you should eat to stay safe.

Even though diabetics can monitor and control their blood sugar levels well at home, they should still see a doctor periodically, every 4 – 6 months, so that the doctor can screen for any complications, such as retinopathy, hypertension, heart disease, strokes, etc. Visiting a doctor to check for complications early-on can help avoid problems, as once these complications set in, they can be permanent. For instance, if the diabetes affects the eye and has already caused blindness, the blood sugar levels can return to normal, but the sight will not. However, if these complications are screened for and discovered quickly, they may be prevented. In the case of diabetes affecting the eye, for example, we are able use laser treatment before blindness sets in.
Finally, some words of encouragement from the doctor: “People with diabetes need encouragement, especially the elderly. Some people can become depressed when they get diabetes, and have a negative outlook on it. They think they’ll go blind, they’ll lose a leg, they’ll never be happy again, they can’t eat anything, and the cost of treatment is high. In reality, diabetes is not as scary as you think. If we come to know and understand the mechanisms of diabetes, we can still easily live our lives to the full. I would like people to see diabetes as just a natural degeneration of the body’s health; it is not a disease, but it is a risk. If we live a long time, we must accept the chances of becoming diabetic as it stems from the degeneration of our own bodies. We must know what we have to learn, so that we can live with diabetes. At times, we may have to take medicine, or have injections, but if we can control it well, we can live together happily. We must not only rely on our doctors for care, but must also care for ourselves. The most important thing is to have regular health check-ups to identify diabetes in its early stages, and to start controlling it if discovered. If we can just do these things, we’ll be able to live happily with diabetes”.