Diabetes – The Silent Killer

Diabetes – The Silent Killer

The Silent Killer


Very often we come across people who have increased urge for water and food and have more frequency of going to the toilet. These problems are often ignored and many individuals are unaware that these symptoms can be due to a well known medical condition called “Diabetes”. Affecting more than 371 million people worldwide, Diabetes is a global challenge, both for the physicians as well as patients.

According to the estimates of the International Diabetes Federation, at least half of the people with Diabetes do not know that they have it. China tops the list and our country Pakistan also with 6.6 million affected souls, has the tenth highest Diabetic population in the world.

The situation is alarming and demands development of strategies at the global level with increased emphasis on preventive medicine and primary care.

It is not for uncommon for people to argue about the rational for treating Diabetes and many affected individuals who initially have no symptoms just pay a deaf ear to any advice that demand changes in their lifestyle or use of medicines. “I am alright”!!! what’s the matter if your lab results show a reading of blood glucose level that you consider abnormal?? This is a frequently encountered scenario by the treating physicians and what may be considered as “mere treatments of reports” is of very much value in the long term.

The justification is that Diabetes is known to affect all major organs of the body. If left untreated, it can affect the heart and blood vessels, eyes, nerves, teeth and kidneys. According to estimates, each year this silent killer is responsible for 4.8 million deaths worldwide.

Cardiovascular complications can be fatal as they can leads to heart attacks and strokes. Nerve damage can give rise to many types of symptoms like pain, burning and tingling sensation in the extremities and there may also be loss of sensation. Loss of feeling is particularly important as it can allow injuries to go unnoticed and can lead to serious infections and possible amputations.

Diabetes also affects the eyes and most people with Diabetes develop some form of eye disease that results in reduced vision. Regular eye checks and control of blood glucose and cholesterol are very essential to prevent it.

Another major organ that is commonly affected by Diabetes is the kidney. In the long term, Diabetic kidney disease, also known as Diabetic Nephropathy, is a serious complication. High blood glucose levels and high blood pressure can damage kidneys resulting in decrease functioning or even complete failure. Of all people who have Diabetes at least 33% develop kidney damage after 15 years but good control and regular screening can delay or even prevent this complication.

The basic function of kidney is to filter blood and remove waste materials in the form of urine. In people with Diabetes, the high blood glucose level damages the small vessels of kidneys and can impair their ability to filter. The earliest sign is presence of a protein called “albumin” in urine. In the early stage the condition is called “microalbumiuria” and as the disease progresses it leads to a condition called “proteinuria”.Without treatment the kidneys will eventually fail which makes a person dependant on dialysis. The only option to avoid dialysis at this stage is to perform a kidney transplant. The physicians recommend regular screening for presence of microalbumin in urine and also check level of creatinine. (The increasing levels of creatinine in blood are a marker of decreasing kidney function)

To prevent kidney damage, all people with Diabetes must:

·Keep their blood pressure in normal range. (the target levels are to maintain it below 130/80)

·Keep their blood glucose at target.

·Avoid smoking.

·Make exercise a routine, vigorous activity is not required, simply 30 minutes of walk per day is sufficient.

·Avoid self medication as certain over the counter available pain killer can harm the kidneys.

·Follow a healthy meal plan.

·Attend their treating physician regularly and as advised.

In short, early diagnosis and proper management of Diabetes can help prevent or delay complications and this can reduce the mortality and morbidity from this incurable but treatable disease.