Taking Care of Your
SUGAR
12
Diabetes Mellitus or ‘Sugar” as it is commonly known
in Trinidad and Tobago literally means “Sweet urine”
and it is called this because that’s how Doctors used
to diagnose it in the olden days – they would literally
taste their patient’s urine. Thankfully, in these modern
times, doctors do not have to subject themselves to that
anymore.
In fact Diabetes mellitus occurs when the body cannot
deal with glucose or ‘sugar” the way it is supposed to
do, so that the levels of sugar in the blood are higher
than they should be.
In Type 2 Diabetes the body does not start off being
short of Insulin, but is in fact resistant to it. This means
that the organ that produces Insulin- which is called,
the pancreas- has to work harder to produce more
Insulin to keep the blood sugar under control. Over
time the pancreas gets tired, and may not be able
to keep up with Insulin production and this is when
people with Type 2 Diabetes would need Insulin
injections. Insulin resistance is primarily caused by
increased weight, particularly “Belly Fat”.
Type 2 Diabetes is very common in Trinidad and
Tobago. The World Health Organization (WHO)
estimates that 9% of adults worldwide have Type 2
Diabetes. In Trinidad that rises to 12-13 % and this is
probably an underestimate since it can take many years
for people to be diagnosed, as it can be asymptomatic
for a long time. As much as 50% of pancreatic
function may be lost by the time a person is diagnosed.
It is actually the No. 2 Killer in Trinidad and Tobago.
People with a family history or who are of East Indian
or Afro-Caribbean descent are at increased risk,
especially if they tend to put weight on their abdomen
(belly).
Men with a waist line above 40 inches or
102cm or women above 34.5 inches or 88cm should
definitely assume themselves to be at higher risk and
should get tested.
If you are unsure if you are at risk, you can take this
online test:
(Please note
that in this test “South Asian” is similar to “East
Indian”.
How is it Diagnosed?
You will need to have an early
morning fasting glucose test. This means nothing to eat
or drink except water for 8 hours prior to the test.
If you are already diabetic there are certain tests which
all people with Diabetes should have annually:
Kidney function -
This includes a blood test as well as a
special early morning urine test to see if the kidneys are
leaking microscopic bits of protein. This is important
because if present, the blood pressure needs to be more
aggressively controlled to protect the kidneys. A special
class of drug called an Ace Inhibitor should also be
considered to protect the kidney.
Blood Pressure (BP)-
This may be even more important
in prolonging life than the blood sugar! For this reason,
people with should maintain a BP of 135/85 or less.
High blood pressure is 1.5-3.0 times more common
in people with Diabetes and we know that tight BP
control reduces the risk of death related to Diabetes
and also progression of kidney and eye disease.
Eye Test -
Diabetic Eye Screen – This is not just a test
of your vision done by the optometrist. It is a special
test done to look at the back of the eye, the retina
with a special piece of equipment. It is not the same
thing as a quick look in the Doctor’s office with an
ophthalmoscope. Pictures are sometimes taken. This is
important because retinopathy can cause blindness and
if picked up early enough blindness can be prevented.
The pressures in your eyes should also be measured.
Tight blood sugar control and blood pressure control
help to prevent this.
Foot Check -
This is to check circulation, nerve supply
and skin. In fact if you have tingling or numbness
or you feel like you are walking on cotton wool you
