There are almost seven billion people living on this planet as I write... and of these, 1.7 million suffer from diabetes.

Diabetes can be a condition one can live with if controlled well but if not it can turn into a relentless monster of self-destruction and even death- Moira Mizzi

In 20 years’ time the number is expected to double simply because we’re living longer, getting fatter, moving less and our numbers are always increasing even though we know more about contraception.

Diabetes mellitus is a disease that results either in a lower production of insulin (Type I or insulin dependent diabetes mellitus) or in a decreased sensitivity of the cells to it (Type II or non-insulin dependent diabetes mellitus).

In both cases the decreased presence of insulin results in less sugar being taken in the cells and so more of it will remain in the bloodstream with harmful effects.

Type I diabetes mellitus usually presents in childhood and adolescence, accounting for about 10 per cent of all diabetic cases.

It is thought to be an autoimmune disease, that is a condition where the body’s immune system attacks a person’s cells and systems.

Although a genetic predisposition cannot be excluded, environmental causes like viral infections have also been implicated. The only way to control this type of diabetes is to give injections of insulin on a regular basis.

Type II diabetes mellitus, on the other hand, usually presents itself later on in life, typically in or after the mid-40s and accounts for the rest of all cases.

Unlike its insulin-dependent counterpart, it has a strong genetic predisposition and thus a strong family history.

Other factors that can increase the risk of acquiring this type of diabetes are a high blood pressure, a high level of triglycerides (a type of fat) in the blood, a high fat and alcohol intake, obesity and a sedentary lifestyle, which basically sums up the way of life for most of us.

The hallmark of diabetes is damage to the smallest blood vessels, or what we medics call the microcirculation, resulting in a decreased blood supply to the affected area and irreversible tissue damage.

The most common organs affected are the eyes, the kidneys, the toes and tips of fingers and the sensory nerves with blindness, renal failure and limb amputation as the worst scenario.

Uncontrolled high blood sugar, especially if coupled with increased blood fat levels, can pave the way for progressive blockage of the major arteries of the heart and brain, which in certain people with other risk factors can lead to heart disease, cerebrovascular accidents or stroke.

As soon as the diagnosis of diabetes is made it is important that a battery of tests is carried out to obtain baseline information on the status of major organs such as the kidneys, heart, liver, peripheral circulation and eyes.

These tests should be carried out on a six-monthly to yearly basis, depending on the severity of the disease and the age of the patient, to make sure that none of these complications has set in.

Diabetics who are on drug treatment, especially on insulin, should also learn to check their sugar levels at home on a regular basis using the wide array of gluco-meters now available on the market.

Whatever the age at the time of diagnosis, the rationale of management of the diabetic patient rests on a triad of diet, exercise and when necessary, drug treatment to regulate the body.

Contrary to popular belief, drug treatment in Type II diabetics comes in when adequate diet and exercise alone fail to keep our blood sugar under control.

This is a sign either that the pancreas is not matching the blood sugar levels with parallel increases in insulin or that there was an increase insulin resistance at the cellular level; the latter is usually more prominent in obese people.

I do not believe I need to go into the best food that diabetics should eat considering that every one of them is drilled to exhaustion on what types of food to avoid and how much of each food group to eat everyday.

The Health Department offers regular free check-ups, both at the local health centres and at the Diabetes Clinic at Mater Dei Hospital.

The relevant medication is also given free of charge, so it is really surprising that we still encounter such a high numbers of uncontrolled diabetics on a day-to-day basis.

Preventing the onset of the condition, and getting affected with its complications once the disease sets in, can mean radical lifestyle changes, which is not something that can be done at the flick of a button – especially if a person is wading through their fifth or sixth decade.

That is why it is essential to start teaching our children from a very young age to eat healthily and do regular exercise, but to do this we need to understand the rationale behind it ourselves.

Failing that, I believe that as a society and especially as health-care professionals and family members of diabetic individuals, we are duty-bound to support these individuals when the going gets tough for them to effect such changes in their lives.

Diabetes can be a condition one can live with if controlled well, but if not it can turn into a relentless monster of self-destruction and even death.

Dr Mizzi is one of the medics at a top cosmetic clinic.

Facts

Type 1
Patients with this type of diabetes will have to take insulin injections for the rest of their lives for the body does not produce insulin.

Some people may refer to Type 1 as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes.

People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years.

They will need to carry out regular blood tests and follow a special diet, keeping proper blood-glucose levels.

Type 2
Losing weight and following a healthy diet with plenty of exercise while monitoring blood glucose levels helps many people control Type 2 diabetes.

For their bodies do not produce enough insulin for proper function, or the cells in the body do not react to insulin.

Approximately 90% of all cases of diabetes worldwide are of this type.

It is typically a progressive disease, gradually getting worse and the patient will probably end up having to take insulin, in tablet form.

Overweight and obese people have a much higher risk of developing Type 2.