Diabetes is a metabolic disease characterised by high blood sugar. Blood glucose, also called blood sugar, is the primary source of energy for the body. It comes from the food you eat and is essential for the maintenance of a healthy body. Brain functions such as learning, thinking, and memory are closely related to glucose levels. Insulin, which is a hormone made by the pancreas, regulates the amount of glucose in the blood. If blood sugar levels are out of target range, serious health conditions including heart disease, vision loss, and kidney disease may result.

What does insulin do in the body?

The carbohydrates you eat break down into glucose and enter the bloodstream. The pancreas responds by producing insulin which helps glucose enter the body’s cells where it is used for energy. When the blood glucose level falls, the pancreas detects the drop and stops insulin production.

However, when the body doesn’t make enough or any insulin, glucose stays in the blood. As a result, the amount of sugar in the blood remains high.

Types of diabetes

Type 1 and type 2 diabetes are the most common forms of the disease. Type 2 diabetes occurs when the body does not make or use insulin well. Although older people are more at risk, type 2 diabetes is more common and can occur at any age. On the other hand, type 1 diabetes (also known as insulin-dependent diabetes or juvenile diabetes) occurs when the body does not make any insulin. Type 1 diabetes is a chronic condition that requires daily treatment with insulin. The condition is often diagnosed in children and young adults.

Gestational diabetes is a form of the disease that occurs in some pregnant women. Most of the time the condition disappears after the baby is born. However, women who suffered gestational diabetes have an increased risk of developing type 2 diabetes later in life.

Prediabetes is another form of diabetes that is frequently referred to as “borderline diabetes”. Prediabetes occurs when the levels of blood glucose are higher than normal, but not high enough to be considered as being in the diabetic range. The risk of higher blood glucose levels is however significant as prediabetes may lead to cardiovascular disease and a progression to diabetes.

What are the symptoms of diabetes?

• Frequent urination
• Excessive thirst or hunger
• Unexplained weight loss
• Blurry vision
• Numb or tingling hands or feet
• Feeling tired all the time
• Sores that do not seem to heal as fast as they should
• Prone to infections
• Very dry skin

What are the risk factors?

Family history and age are considered risk factors for type 1 diabetes. You are at risk for developing type 2 if you:

• Have a parent or sibling with type 2 diabetes
• Are overweight
• Are not regularly active
• Over 45 years of age
• Have prediabetes or have had gestational diabetes
• Have non-alcoholic fatty liver disease
• Are from certain ethnic groups

How to prevent type 2 diabetes

Research indicates that certain lifestyle changes, including losing weight, eating healthy, and getting active may prevent or delay the disease. If you need assistance with diet, speak to a licensed dietitian. Eating well is key to managing blood sugar levels.

Preventing complications

Complications from diabetes include heart disease, chronic kidney disease, nerve damage, foot health, oral health, hearing loss, vision loss, and mental health. In coming articles, we will unpack ways to prevent or delay many of these conditions. However, monitoring your blood sugar is crucial to managing the condition.

Having a reliable way to measure and record your glucose levels will assist your healthcare team to develop the best diabetes plan for you. FORA Africa’s BluCon Waterproof NightRider is an NFC to BLE (Near Field Communication to Bluetooth Low Energy) transmitter. When attached to passive NFC tags like FreeStyle Libre (FSL) and FreeStyle Libre Pro sensor, the device transmits glucose readings to a mobile app enabling Continuous Glucose Monitoring (CGM) on the go. See more information and purchase the device.

What is considered normal blood glucose?

Blood glucose is measured in molar concentrations (mmol/L (millimoles per litre)) and mass concentration (mg/dL (milligrams per decilitre)). In South Africa, blood glucose is measured in mmol/L. If you are non-diabetic, the normal range is 4-6 mmol/l. However, if your fasted blood glucose is over 7 mmol/l or your non-fasted level is over 11 mmol/l, you are considered diabetic.

What is HbA1c?

HbA1c is an average measurement of the percentage of haemoglobin attached to red blood cells that have glucose bound to them. In other words, it is the patient’s average blood glucose levels for the last two to three months. The HbA1c test is used to monitor how well blood sugar levels are being managed.

The following HbA1c level guideline is taken from the South African Diabetes Association’s suggestions:

4 – 6% non-diabetic range.

< 7% well-controlled diabetic.

7% – 8% acceptable diabetic control.

> 8% poor diabetic control – needs attention.

Sources:

Centers for Disease Control and Prevention. n.d. Manage Blood Sugar. Available at: https://www.cdc.gov/diabetes/managing/manage-blood-sugar.html [Accessed 30 June 2022].

Diabetes South Africa. 2022. Prediabetes: what you need to know. Available at: https://www.diabetessa.org.za/prediabetes-what-you-need-to-know/ [Accessed 29 June 2022].

Edwards, Scott. 2016. Sugar and the Brain. Available at: https://hms.harvard.edu/news-events/publications-archive/brain/sugar-brain#:~:text=Brain%20functions%20such%20as%20thinking,communication%20between%20neurons%20breaks%20down. [Accessed 30 June 2022].

National Institute of Diabetes and Digestive and Kidney Diseases. 2016. What is Diabetes? Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes [Accessed 30 June 2022].