The name diabetes itself is derived from the Greek verb diabainein, which means to stand with legs apart, as when passing urine. The ancient Greeks understood that there was a medical condition that caused an excessive amount of urine production, which is a feature of diabetes. There are actually two different kinds of diabetes, diabetes insipidus and diabetes mellitus. Mellitus literally means ‘honey-sweet urine’ and this form of the disease is associated with sugary urine (in early days, doctors would sometimes taste people’s urine to make a diagnosis).
With this issue of HealthFirst focusing on the efforts to reduce diabetes in the UAE, it is perhaps important to explain a little about the disorder in easy-to-understand terms. Although the profile of diabetes has successively raised in the UAE over the past few years – thanks to the important ongoing health campaigns supported by the government – there are still many who don’t fully understand why it is such a risk to health. So if you are someone who needs simple and straightforward information about the condition and why you should avoid it, here is a brief guide.
The name diabetes itself is derived from the Greek verb diabainein, which means to stand with legs apart, as when passing urine. The ancient Greeks understood that there was a medical condition that caused an excessive amount of urine production, which is a feature of diabetes. There are actually two different kinds of diabetes, diabetes insipidus and diabetes mellitus. Mellitus literally means ‘honey-sweet urine’ and this form of the disease is associated with sugary urine (in early days, doctors would sometimes taste people’s urine to make a diagnosis). Insipidus relates to being insipid or bland, so patients with diabetes insipidus have a completely different disorder that involves passing large quantities of urine that doesn’t contain sugar.
The excessive urine production in diabetes mellitus is related to the body having an insufficient amount of the hormone insulin to control and utilise glucose for energy. This unused sugar circulates in the blood stream and collects in the kidneys, where it pulls in water through osmosis. This water is passed out as urine, causing dehydration. This dehydration then leads to excessive thirst and an increase in fluid consumption to compensate. As the blood sugar levels continue to remain high, the cycle of drinking fluids and passing urine persists unabated, unless the diabetes itself is treated.
It is diabetes mellitus that is by far the most frequently seen of the two forms and it is this disorder’s predominance that has led to it being referred to by the single word diabetes alone. Diabetes mellitus has three types; Type I, Type II and gestational . Type I diabetes is diagnosed when there is absolutely no insulin in the body to control the levels of sugar and the symptoms are most pronounced in this type. Type II diabetes is diagnosed when there is some insulin production, but not enough to properly control the blood sugar, so in general sugar levels remain less elevated than in Type I but are still higher than normal. Gestational diabetes occurs when there is an insufficiency of insulin during pregnancy; something that can cause babies to be born with a high birth weight.
Diabetes mellitus affects around 20 per cent of the population in the UAE, with the incidence being slightly higher in nationals (approximately 24 per cent) than it is in expatriates (about 17 per cent). Recent studies have suggested that this figure rises to 40 per cent in the age group 60 years and above. The increasing prevalence of Type II diabetes in this part of the world can be seen to be related to the area’s rapid urban development. A modern transport system has meant that the car is used for even the shortest of journeys, reducing the need for walking which would otherwise burn calories. Elements of the western lifestyle have taken hold as an inevitable part of this progress and fast food restaurants offering meals with high levels of fat and sugar have proliferated. The overall result of these changes has meant that more and more people across the region are consuming an excess of calories which are not being lost through exercise. Consequently, levels of obesity have rocketed in the UAE. Obese individuals have a greater body mass and more sugar to convert to energy, which means that there production of insulin is no longer sufficient to control these increased levels. Obesity is therefore a condition that goes hand-in-hand with a consistently raised blood sugar level.
One of the main problems in trying to combat Type II diabetes is that in the short term, there are no real ill effects associated with it. Those with the condition often experience no immediate health problems, so they do not necessarily feel the urge to address the issue. The symptoms of excessive urine production and thirst that are common to Type I diabetes are not as severe in Type II, so many will not even be aware that they have the disorder. However, there are still significant long-term problems that can result from having Type II diabetes.
The main health concerns arising from Type II diabetes occur from the persistently elevated sugar levels, which causes the blood to become sticky and to form tiny clots. Over time, these clots damage the lining of the arteries, which become stiff and easily blocked. The worse affected vessels are the smaller ones, such as those found in the eyes, the kidneys, the heart, the brain and the extremities of the limbs. Long-term Type II diabetes can therefore lead to blindness, kidney failure, heart attacks, strokes and limb amputations. The difficulties often only start years down the line, when a lifetime of stickier blood running through vessels has caused cumulative damage to the lining of the arteries. These arteries can become blocked off and if located in the heart, eyes, kidneys or brain, can cause heart attacks, blindness, kidney failure and strokes. Arteries in the legs that become blocked off can result in amputation of the lower limbs.
There is good news, however, and that is that obesity-related Type II diabetes is relatively easy to avoid. It involves making a few simple lifestyle adjustments, which mostly boils down to diet and exercise. There is sometimes a need to control Type II diabetes through oral medication, but many people can avoid developing the condition by both reducing their calorie intake (eating more fruit, fibre and vegetables) and by increasing their calorie expenditure through a moderate amount of exercise. Ensuring that body weight is kept within a healthy range will help control blood sugar levels and will also help keep blood pressure lowered, as obesity can also cause a raised blood pressure. Having a raised blood pressure, or ‘hypertension’ is a condition that can compound the already negative effects of a high blood sugar level, as it puts more pressure on blood vessel walls.
With the current UAE health campaigns taking place at the moment around the November 14 World Diabetes Day, it is easy enough to find out whether you may be at risk of developing diabetes and to learn how to take steps to avoid it. Events such as the month-long Know Diabetes community health initiative, which takes place throughout November at Dubai Festival City, offer free health screenings to determine whether you need to make some small changes to your lifestyle. A Body Mass Index check compares your weight against your height and will let you know if you are overweight; a random blood sugar test from a simple pin-prick on a finger will inform you of how high your sugar levels are and a blood pressure check can find out if you are putting a strain on your heart. Advice on how to change your habits to healthier ones is also available from professionals in the field. In short, there’s absolutely nothing to lose and everything to gain. Diabetes may be a condition that can cause problems if left unchecked, but checking it itself should not be a problem.