INTRODUCTION

According to the World Health Organization, a few decades back diabetes was an uncommon disease,
in both developed and developing countries. Today, the story is different. It is currently estimated that
over 143million people worldwide are affected by the disease. This figure is ever increasing, by 2020
over 220million people are expected to be living with diabetes, if the current trend continues.

WHAT IS DIABETES?

Diabetes is a disease in which the body does not produce or properly use Insulin. Insulin is a hormone
that is needed in the body to control the rate at which sugar, starch and other food are converted into
glucose required as energy for daily life. The hormone is produced and released into the blood by an
organ called ‘Pancreas’. This insulin helps to maintain the blood glucose level within a normal range.
The World Health Organization (WHO) puts this normal range between 60 – 100mg/dl or 2.5 to
5.5mmol/l (Before taking any food for the day, hence this value is called “Fasting Blood Glucose”).

WHAT CAUSES DIABETES?

As with hypertension and other non communicable diseases, no clear cut cause(s) can be attributed to
the most prevalent type of diabetes. However, some factors are known to increase one’s chances of
becoming diabetic and these are called risk factors. For example, indolent and well-fed populations are
2 – 20times more likely to develop type II diabetes than active and lean population of the same race.
Some other factors known to increase one’s chances of getting diabetes include:

OBESITY: It is estimated that three quarter (¾) of all Type II diabetes patient are obese. Indolent and
affluent lifestyles tend to contribute to this. It is believed that a 10kg loss of weight can reduce fasting
blood sugar level by almost 50md/dl. An active lifestyle with frequent exercise is also known to
increase Insulin sensitivity.

The International standard for measuring overweight and obesity is based on a value called BODY
MASS INDEX (BMI). This value is derived by dividing the body weight (in Kilograms) by the square of
height (in metres).

I.e. BMI = Body weight (Kg) / Height2 (Metres).

Note: 1ft = 0.305metres.

For adults, a BMI less than 25kg/m2 is preferred.

25 – 29kg/m2 is considered overweight and above 30kg/m2 is Obesity.

FAMILY HISTORY: A family history of diabetes increases one’s chances of getting the disease. In
such a situation, leading a healthy lifestyle and constant monitoring of one’s blood sugar level
becomes very important.

AGE AND RACE: Most Type II diabetes patient are over 40yrs at presentation of the disease.
However, the proportion of increase in the incidence of this disease with age is higher for those with a
family history of diabetes, obese and probably those leading sedentary lifestyles. Moreover, diabetes
tends to be more prevalent among Africans, African Americans, Latinos, Native Americans and Asian
Americans. Belonging to any of the races is a risk factor in itself.

HISTORY OF GESTATIONAL DIABETES: High blood sugars in an expectant woman also increase
her chances/possibility of developing permanent diabetes later in life.

TYPES OF DIABETES

INSULIN DEPENDENT/TYPE I DIABETES:

This type of diabetes was initially called Juvenile onset diabetes because it affects adolescents and
young adults. It is caused by a sudden failure of the pancreas to produce insulin.

NON-INSULIN DEPENDENT/ TYPE II DIABETES:

This is the most prevalent type of diabetes, accounting for more than 80% of all diabetic cases. It is
found in adults and the elderly. This type of diabetes develops gradually over a long period of time
(unnoticed) and is characterized by insufficient insulin, deficient insulin in the blood or the inability of
the body to utilize the insulin present (Insulin resistance). Because of its slow and gradual occurrence,
it is mostly undetected until one or more of its long-term complications appear.

GESTATIONAL DIABETES:

This type of diabetes occurs during pregnancy and disappears after delivery, within 3weeks. An
estimated 3% of all pregnancies are accompanied by gestational diabetes and almost half of these
patients are prone to developing permanent diabetes later in life.

YOU CAN PREVENT/DELAY DIABETES! Diabetes has no permanent cure. Once it develops, it is
managed through life. Before diabetes presents in people, it is almost always preceded by a situation
called PRE- DIABETES. This is a situation where the blood glucose is higher than normal, but not yet
enough to be diagnosed as diabetes. Unfortunately, you cannot know when you fall into this category,
if you have not been monitoring your blood glucose regularly.
Pre-diabetes is itself a serious medical situation, though it can still be reversed by making changes in
diet pattern and increasing physical activity. To determine one’s blood sugar a test called Fasting
Blood Glucose has to be conducted. This test measures the amount of glucose (sugar) in one’s blood
before taking any meal for the day. An individual with a pre-diabetes blood glucose level needs to take
urgent steps to reduce his blood glucose or risk life long diabetes.

The following tips can help reduce your risk to diabetes:

* Reduce weight. Obesity seems to be the single most significant factor in diabetes. Reducing body
weight and fat and maintaining an average body weight is very essential. To this end a body mass
index (BMI) less than 25kg/m2 for males and less than 24kg/m2 for females is recommended.

* Increase Physical Activity. It is an established fact that diabetes is more common among people
that lead a sedentary affluent lifestyle. Simple dynamic exercises like brisk walking for 30-50mins daily,
3-5times weekly has been shown to be very helpful. Exercise reduces bodyweight and fat, increases
functionality of the heart, reduces the chances of diabetes and also boosts emotions and healthy living.

* Cut down or cut out alcohol. Alcoholic intake of more than 2units per day has been shown to
adversely affect the body. Alcohol being an addictive drug makes it very difficult to maintain a definite
amount of intake for a long time. It is better therefore to strive to cut out alcohol completely.

* Avoid Smoking. Cigarette smoke has been shown to contain several poisonous substances.
Cigarette smoking and alcohol have been related to several diseases. Stopping smoking will definitely
reduce the chances of several other ailments apart from diabetes.

* Learn good eating habits, such as;

Cut down on fatty food and junks

Eat more of fish and poultry (without the skin is better).
Garlic reduces blood pressure, cholesterol; add it to your meal plan once in a while.
Cut the number of eggs you take to 3- 4 weekly (better boiled than fried).
Reduce salt intake.
Eat more of vegetables and fibre rich food, especially fruits.
Finally, constantly monitor your fasting blood glucose, as this is the only way to know when
you are getting into trouble.
WHAT IS BLOOD PRESSURE
This is pressure of the blood in the arteries of the body. It is needed to keep the blood flowing, to
deliver oxygen and nutrients and to carry waste products to the kidney and liver.

WHAT IS HIGH BLOOD PRESSURE

Blood pressure rises and falls during the day depending on physical activity, emotions etc. When
blood pressure stays elevated over time it is called high blood pressure or hypertension. Once
hypertension develops it can become a lifelong condition.
Fortunately there is action that can be taken to prevent and/or control hypertension.

RISK FACTORS OF DEVELOPING HYPERTENSION

There are a number of risk factors associated with the development of hypertension as well as general
heart disease most of which are controllable.

Family history of hypertension

Excess weight

Alcohol intake

Physical inactivity

Smoking

Increased salt intake

High cholesterol

Signs of hypertension
In the early stages there are no clinical symptoms. However the followings signs may be present:

Frequent headaches

Dizziness

Early fatigue

Swelling of feet and ankles

Cramps in the legs

Most symptoms present when vital organs have started to get damaged.

Diet and blood pressure

The components of your diet affect your blood pressure. Therefore it is important to balance your
meals and consume moderate quantities.
Diet alongside medical therapy and lifestyle modification aid in lowering, controlling and preventing
hypertension.
Dietary and lifestyle recommendations

Consume foods high in fibre e.g. grain and legumes

Eat plenty of fruits and vegetables e.g. apples, citrus fruits, green leafy vegetables

Avoid alcohol/tobacco in any form; it constricts blood vessels, inhibits circulation and may raise
your blood pressure

Reduce salt intake

Avoid black tea or coffee

Ensure enough rest and drink 6 to 8 glasses of water a day (approximately 2 litres)

Exercise regularly for 30 minutes, 3 to 5 times a week

CONCLUSION

Diabetes and Hypertension being so interlinked requires a comprehensive plan of care, and this
revolves round one’s dietary habits, social and environmental factors. Several lifestyle changes like
regular exercise, maintaining a moderate body weight, reduction of fat intake and high fibre diet all
help to live a normal healthy life. These measures are known to increase insulin sensitivity and also
reduce blood pressure.

It is better and cheaper to prevent an illness than to treat it when it has become stronger. Moreover,
preventive health cannot be divorced from regular medical checks, as these two go hand in hand.
There is no way to detect non-communicable diseases without undergoing regular medical checks.
The importance of these checks cannot be over emphasized. Be alive to your health, and live a
healthier life free from the pains of diabetes and hypertension.