Melomed Articles

18 February 2019 - Dr. Jashira Naidoo

Diabetes: What You Need To Know

Diabetes mellitus is an increasing global public health problem characterised by beta cell dysfunction and insulin resistance. The prevalence of diabetes is increasing worldwide due to ageing populations, physical inactivity, obesity, rapid urbanisation, and changing lifestyle and food consumption patterns. According to the International diabetes Federation, the number of people with diabetes worldwide is projected to increase from 382 million in 2013 to 592,000,000 x 20 35. Diabetic nephropathy, also known as diabetic kidney disease, is one of the most important long-term complications of diabetes and the most common cause in stage renal disease worldwide. Diabetic kidney disease occurs in type I and type II diabetes myelitis and other secondary forms of diabetes and is defined instructional and functional renal damage manifested is clinically detected albumin urea in the presence of normal or abnormal glomerular filtration rate. Is also regarded as a characteristic microvascular complications of diabetes that is related to the duration of diabetes and involve complex interactions between environmental factors and genetic determinants.

CKD develops over the initial tender 15 years of disease onset in type I diabetes, whereas the onset is not a defined in type II due to the late diagnosis of diabetes in some patients. Is also known that the longer life expectancy of diabetic population and improve treatment under disease management have significant influence on the incidence and prevalence of CKD. Patients with DKD also account for one third of patients demanding renal transplantation all these factors impart a huge burden on health care costs and resources. Hence, surveillance, prevention, and control of diabetes mellitus, the KD, and related complications are becoming increasingly important.

Early detection of diabetes is critical, as appropriate treatment will prevent the complications of diabetes and a significant burden displaces on an individual's quality of life, morbidity and mortality. Early detection of impaired fasting glucose or impaired glucose tolerance allows early intervention with appropriate lifestyle change and can define even prevent the onset of diabetes. Thus, early detection play an important role in optimising health.

At risk patients to consider for screening for diabetes include:
overweight obese
past history of diabetes during pregnancy
first-degree relatives were diabetes
hepatitis infection
predisposed ethnic groups including people from the middle eastern nations
chronic corticosteroid therapy
solid organ transplants
HIV-infected patients with receiving combined antiretroviral treatment
cystic fibrosis

Screening for diabetes should be undertaken annually though with a fasting glucose level. Always consider diabetes mellitus in high-risk population groups as noted above. In type II diabetes symptoms include fatigue polyuria, polydipsia, weight gain weight loss, blurred vision and recurrent skin infections. Once diabetes is diagnosed aspects of management include the following: patient education, glycaemic control to prevent diabetic complications, cardiovascular risk reduction such as smoking cessation and treatment of lipids and hypertension, routine complication screening for eyes feet and urine. There has to also be a need to identify appropriate sat strategies to reduce weight if obesity is present. Obstructive sleep apnoea needs to be identified and treated and if their mood disorders present though should be identified and treated as well.


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