Diabetes Mellitus – A not so sweet story.

Dr. Sivaisen Kistensamy, Specialist Physician at Melomed Richards Bay
MBCHB, FCP(SA), MMED (Internal Medicine)

Diabetes mellitus is the body's inability to adequately process glucose owing to an impaired tolerance to insulin, or a deficiency of insulin. As a result, glucose is present in high concentrations in the blood rather than in the places where it is required.
Over a prolonged period, this dysfunction results in a number of complications that progressively worsen. Due to the fact that glucose is our main substrate for energy, the resulting effect is on multiple organs.
South Africa has the highest prevalence of diabetes mellitus in Africa, at 11.3%. This equates to 1 in 9 South Africans with the disease.

Difference between Type 1 and Type 2 diabetes

Type 1:

Pancreas produces little or no insulin.
• Doctors don’t fully understand what causes Type 1 diabetes
• Can’t be cured

Type 2:

Cells are resistant to insulin or body does not produce enough of it.
• Lifestyle factors can put you at risk
• Can be avoided and even reversed

One of the important goals of treating diabetes mellitus is to detect it early to, if possible, prevent or treat the disease adequately to prevent complications. These include stroke, blindness, heart attacks, renal failure, amputation of limbs, and more. People should take heed of symptoms such as excessive thirst, blurred vision, increased frequency of urination, and weight changes, as these are indicators of hyperglycaemia.

What are the symptoms?
• Extreme thirst
• Frequent urination
• Numbness in hands or feet
• Feeling hungry even while eating
• Slow-healing cuts
• Blurred vision

What parts of the body can be affected by diabetes?
• Nervous system
• Eyes, teeth and gums
• Coronary arteries
• Kidneys
• Blood vessels
• Feet and skin

One should seek medical consultation as soon as possible, because almost half (45.4%) of people living with diabetes in South Africa are undiagnosed. The longer you wait, the more damage is done. Treatment of diabetes mellitus includes lifestyle changes and medication. Determined by the doctor, medication can be oral hypoglycaemic agents or injectables, mainly insulin, depending on the control required.
Monitoring of diabetes does not only include checking a patient's blood glucose level, but the eyes, feet, nerves, kidneys and heart should also be assessed at least twice a year to pick up early on any possible complications.

Why is it dangerous?

High blood sugar can:
• Increase risk of heart disease or heart failure
• Lead to stroke
• Threaten vision, limbs and extremities

As a specialist physician, I see many patients presenting with diabetes mellitus and more often than not, they present with advanced disease and established complications that could have been avoided