George Herald | Diabetes - the scourge of our age

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Diabetes - the scourge of our age
10:38 (GMT+2), Thu, 09 August 2012

LIFESTYLE NEWS - Diabetes is a huge problem across South Africa and on the rise in most Western countries. Diabetes SA's research shows that approximately 4 to 6 million people in South Africa have diabetes and most of them are unaware that they have this condition. Read more on the subject on page 28 as part of our Women's Day special.

Type 1 Diabetes
Symptoms usually start in childhood or young adulthood. People often seek medical help because they are seriously ill from sudden symptoms of high blood sugar.

Episodes of low blood sugar level (hypoglycemia) are common. It cannot be prevented.

The improved analogue insulin available does enrich the quality of life but demands intensive management, monitoring, carbohydrate counting and performing the resultant adjustments according to the day to day demands as dictated by physical activity and sick days, etc.

The person with Type 1 diabetes needs to have a very high knowledge regarding his or her insulin management. In fact they should have more knowledge than the doctor treating them. The new insulin pump which is like a small computer and looks like it could be a cellphone is connected to the body with an infusion set. It is in theory the nearest thing to an artificial pancreas.

Discipline, testing and monitoring is still required, to do carbohydrate count, and to know how to adjust for sick days, exercise and stress levels. There is constant development on the pump so that the upgrade in the workings can assist in closing the loop in trying to imitate the function of the pancreas.

All this is extremely expensive as the pump alone ranges in price from R15 000 to R40 000 and the monthly consumables a further R2 000 to R3 000. Several people in George have this system. A further advantage is that it is good for all ages but it is not a replacement for the responsibility of monitoring your situation. In the Southern Cape, Dr Jacque van Staden is the accredited contact person.

Type 2 Diabetes
The person may not have symptoms before diagnosis. Usually the disease is discovered in adulthood, but an increasing number of children are being diagnosed with the disease.

There are no episodes of low blood sugar level, unless the person is taking insulin or certain oral diabetes medicines. It can be prevented or delayed with a healthy lifestyle, including maintaining a healthy weight, eating sensibly, and exercising regularly.

GLP-1 or Glucagon-Like Peptide-1 is an injectable medication that has been improving in performance for many years. The basis of the medication originates from the spit of the Gila monster lizard that is found in the Southern United States and Mexico. Today it is manufactured artificially.

GLP-1 is the additional medication needed when a patient has lost control of their sugar level despite Metformin and other diabetic medication.

GLP-1 helps with the control of weight which equals a reduction in insulin resistance. It is suppressing the Glucagon effect and glucose release from the liver, stimulating insulin secretion and thereby reduce the blood glucose. Weight control and aspiring to maintain the correct weight has notable health advantages that manifests in a much better quality of life.

DPP-4 is another group of incretins that is orally administrated. There has been very exciting advances made in recent years with DPP-4 but it is costly and not covered by all medical aids.

ARTICLE: MYRON RABINOWITZ