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Diabetes

30 December 2023

From the age of 64, one out of every four individuals in Israel is affected by diabetes, a condition characterized by an imbalance in blood glucose levels. Risk factors for the disease are:

  • Family history
  • Obesity
  • Sedentary lifestyle, excessive alcohol intake, smoking
  • Inadequate and poor-quality sleep

Adhering strictly to an active and healthy lifestyle may postpone the onset of diabetes by several years and minimize its complications.

Diabetes symptoms and diagnosis

There are several symptoms that suggest the presence of diabetes, primarily frequent urination during the night, thirst, and mouth dryness.

If the results of diagnostic tests for diabetes indicate a positive response to one or more of the following clauses, you may suffer from diabetes:

  • Glycated haemoglobin (A1C) levels equal to or greater than 6.5%
  • Fasting blood sugar levels equal to or greater than 126 mg/dL
  • A glucose challenge test of 75 mg was performed in a clinic, and after 2 hours, blood sugar levels were equal to or greater than 200 mg/dL
  • A patient with symptoms of hyperglycaemia or hyperglycaemic crisis whose random blood sugar test equals or is greater than 200 mg/dL

How to prevent disease deterioration

After being diagnosed with diabetes, it is crucial to undergo regular monitoring for multiple medical factors, including:

  • A doctor specializing in endocrinology, for performing medical monitoring
  • A nurse, for periodically checking the feet
  • An ophthalmologist, for a fundoscopic examination (examining the fundus for residue)
  • A dietician, for customizing a menu to regulate blood sugar levels and providing recommendations for physical activity

Treating diabetes

The treatment of a patient with diabetes involves customized nutrition and medication therapy. If necessary, regular monitoring of the physical condition and conducting specific examinations are essential for detecting potential complications related to the disease.

Diabetes is defined as an impaired balance of blood sugar levels in various systems that are associated with the hormone insulin. This hormone is produced and secreted by the pancreatic gland. Insulin is secreted into the bloodstream in response to elevated blood sugar levels, which come from dietary intake. Its role is to insert sugar into the cells, providing them with an accessible energy source for their proper functioning. In cases where there is a deficiency of insulin, either partial or complete, or when body tissues, such as muscles, become resistant to insulin (a condition known as insulin resistance), the utilization of sugar is impaired. As a result, elevated levels of sugar persist in the bloodstream.

Prevalence of diabetes

Diabetes is a widespread, chronic condition that consistently increases in prevalence both in Israel and globally. Diabetes holds the fourth position among the leading causes of death in Israel after cancer, heart disease and cerebrovascular accident (stroke). From the age of 64, one out of every four individuals in Israel is affected by diabetes.

According to estimates, around the world, approximately 347 million people are affected by diabetes, with 90% of them being diagnosed with type 2 diabetes, which is the most common form of the disease among older adults. According to estimates, there are approximately 400,000 people diagnosed with diabetes in Israel.

Diabetes signs and diagnosis

There are several symptoms that suggest the presence of diabetes, primarily, frequent urination during the night, thirst, and mouth dryness. If you feel these symptoms, refer to your family doctor and request comprehensive diagnostic tests.

The American Diabetes Association established diagnosis criteria that have been adopted in Israel as well. If the results of diagnostic tests for diabetes indicate a positive response to one or more of the following clauses, you probably have diabetes.

Diabetes symptoms

  • Glycated haemoglobin (A1C) levels equal to or greater than 6.5%.
  • Fasting blood sugar levels equal to or greater than 126 mg/dL.
  • A glucose challenge test of 75 mg was performed in a clinic, and after 2 hours, blood sugar levels were equal to or greater than 200 mg/dL.
  • A patient with symptoms of hyperglycaemia or hyperglycaemic crisis whose random blood sugar test equals or is greater than 200 mg/dL.

Type 2 diabetes complications

Individuals with type 2 diabetes face an elevated risk of developing a range of complications and chronic diseases. Diabetes adversely affects both the quality of life and life expectancy, increasing the susceptibility to severe complications associated with pre-existing conditions and the onset of acute illnesses such as:

Can diabetes be prevented

Type 2 diabetes is linked to a sedentary lifestyle, which is characterized by extended periods of sitting, as well as obesity and lack of physical activity.

By strictly adhering to a healthy and active lifestyle, it is possible to delay the onset of diabetes by several years and reduce the occurrence of associated complications.

Such a lifestyle includes:

  • Regular physical activity, 5 times per week of at least 150 minutes per week.
  • Very little consumption of alcohol.
  • A balanced diet, rich in fiber, low in carbohydrates, cholesterol, and saturated fat, while also incorporating caloric restriction.
  • Maintaining a valid BMI.
  • Regular physical activity
  • Avoid alcohol
  • Balanced diet
  • Valid BMI

Diabetes risk factors

There are various risk factors for diabetes. Initially, it is important to point out that a prediabetic condition may exist in a person’s body for years without them being aware of it. This condition is characterized by elevated blood sugar levels above the norm but not sufficiently elevated to be diagnosed as diabetes. This condition itself is a risk factor for type 2 diabetes, heart disease, and stroke.

Family history: if one parent has diabetes, the likelihood of developing the condition is 2-3 times higher compared to the general population. This chance is multiplied when both parents have diabetes. Specifically, if both of your parents are sick, the likelihood of you developing diabetes is 4-6 times higher compared to the general population. Therefore, you must maintain increased awareness and adopt a lifestyle that helps minimize the risk of illness.

Body weight: obesity is a substantial risk factor for the development of diabetes.

Lifestyle: sedentary lifestyle, excessive alcohol consumption, smoking and lack of sufficient physical activity are additional risk factors for developing diabetes.

Sleep: various studies have indicated that inadequate and low-quality sleep contributes to an increased risk of developing diabetes.

Origin: various studies that were conducted in the United States have indicated that women of Asian or Hispanic descent have a higher risk of developing diabetes.

Diabetes treatment

Treating a diabetic patient has several aspects, most importantly a customary diet and administration of suitable medications. If needed, it is critical to monitor the physical condition regular and get appropriate tests to identify complications that may develop due to the disease, for example periodic diabetic foot tests.

Medications

There are various types of medications available for the treatment of diabetes, which are prescribed by the family doctor under the supervision and guidance of an endocrinologist.

Currently, the field of diabetes is extensively researched, and new medications are now available that effectively manage diabetes without posing harm or endangering the patient through the risk of dangerously low blood sugar levels. The new medications also exhibit fewer daily side effects. Certain medications can be administered orally, while others require daily or weekly injections. Some medications not only aid in balancing diabetes but also contribute to weight loss.

Bariatric surgery: is it feasible for older adults

The possibility of undergoing bariatric surgery and the specific surgical approach should be determined following an evaluation by bariatric specialists. It is advisable to consult with your family doctor and obtain a referral to the appropriate medical services.

Is it possible to stop the progression and deterioration of the disease

After being diagnosed with diabetes, it is crucial to undergo regular monitoring by multiple medical factors:

  • A physician specializing in endocrinology, for performing medical monitoring.
  • A nurse, for periodically checking the feet. The tests include a physical test and a sensory test that can indicate a deterioration of the disease. Nurses can also guide you how to protect the feet skin over time and prevent fungal infection by washing and drying correctly and emphasize the need to do it consistently.
  • An ophthalmologist, for a fundoscopic examination (examining the fundus for residue).
  • A dietitian, for tailoring a menu to regulate blood sugar levels and providing recommendations for physical activity.

It is noteworthy that various studies have demonstrated that obese patients with diabetes that have undergone bariatric surgery lost weight and their blood sugar levels have become much more balanced, leading to a reduction or elimination of certain medications.