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Diabetes

DIABETES
PRE-DIABETIC
By Dr. Shafiq Qaadri, MD

The number of people suffering DIABETES continues to explode. More than 3 million Canadians have DIABETES right now, and even more are

  • PRE-DIABETIC

which means they have DIABETES-in-training. If they dont take care of themselves, they will develop the full condition with time, usually a matter of a few years.

What happens to the body in DIABETES?

CANDY-COATED ORGANS

Just as you can dunk an apple in liquid sugar, and get a Candy-coated apple, similarly you can get Candy-coated organs. When a persons sugar remains high because of diabetes, the

  • Heart
  • Kidney
  • Eyes
  • Nerves
  • Blood vessels
  • Cells

ALL become sugar-coated. And sugar-coated organs and cells dont function, dont work properly. UNDERSTAND, diabetes makes all these organs and part wear out faster.

DIABETES CAUSES HEART DISEASE

  • People need to UNDERSTAND that DIABETES IS HEART DISEASE.

Diabetes, of course, causes more also: kidney disease, amputations, erection problems in men, visual impairment. But diabetic patients should understand that most diabetics will have their major problems with their hearts. Thats another reason why Heart disease is still Canadas number one killer. What doctors regret that many heart attacks could have been prevented. But people still are not getting the message.

CARDIOMETABOLIC SYNDROME

It is also very important to understand that many conditions cluster, collect together, to cause the CardioMetabolic Syndrome. With Obesity, high blood pressure, high cholesterol, high sugars all mixed together, people have extremely high risk for developing

  • Heart attacks
  • Strokes
  • Sudden cardiac death.

To figure out if you yourself have a high chance of developing diabetes, we doctors ask a bunch of questions. In our own minds, we say,

  • I wonder if this person is en route to eventually developing diabetes?
  • Will this patient who is sitting in front of me be one of the ones to clog his blood vessels and damage his heart or have a stroke because of diabetes?

The questions that follow are the questions that we ourselves ask. You should use this list of questions yourself. The more YES answers, the higher your chance of having diabetes and having a heart problem, stroke, kidney damage, or sudden death.

What is important about lists like this is that it helps you to rate yourself; it helps you to understand the kind of questions that we doctors use to find the people who are in danger.

DIABETES RISK TEST
DIABETES QUIZ
DIABETES QUESTIONNAIRE
DIABETES RISK ANALYSIS

Here are the questions:

  1. Are you male?
  2. Are you a man over 35, or a woman over 45?
  3. Did your relativesparents, brothers and sisters, uncles and auntshave heart diabetes?
  4. Did you have a sugar problem when you were pregnantgestational diabetes?
  5. Did you give birth to a large infant, who weighed more than 9 pounds?
  6. Do you smoke?
  7. Have you smoked 10 cigarettes/day for 10 years or more?
  8. Are you overweight?
  9. Are you obese?
  10. Is your waist measurement more than 35 inches/89 cm (for women) or 40 inches/102 cm (for men)?
  11. Do you exercise infrequently?
  12. Do you have arthritis that limits your mobility?
  13. Are you under too much ongoing stress?
  14. Do you argue and get angry very often?
  15. Do you eat too much sugar?
  16. Do you eat few fruits and vegetables?
  17. Do you drink too much alcohol (3 or more drinks a day)?
  18. Do you have high blood pressure, hypertension?
  19. Do you have poorly controlled high blood pressure, well above 130/80?
  20. Do you have high cholesterol?
  21. Do you have kidney disease because of high blood pressure or diabetes?
  22. Are you depressed, sad too much?
  23. Do you have erectile dysfunction, problems with sexual performance?
  24. Are you from a high risk ethnocultural groupblack/African/Caribbean, Chinese, South Asian, Hispanic, or Aboriginal?

As you answer

  • YES

to more and more of these questions, you have a higher and higher chance of having DIABETES. The message to you is to see a physician, and learn what you can do about protecting yourself.

The other special point is that you dont need too many YES answers to start having more and more risk. For example, being male is one risk factor. Being over the age of 35 is another risk factor. Being overweight or under too much stress are also other risk factors. So the entire list can collect quickly and apply to huge numbers of people.

We doctors believe that if you answer YES to 3 or more questions, you need help. You should begin the process of understanding your personal risk, your personal chance, of developing DIABETES.

  • UNDERSTAND, having DIABETES is as if you have already had a HEART ATTACK.

Act before its too latebeyond the hype and scare-tactics, this really is an important and essential message that too few people are benefiting from.

Learn your risks.

Take appropriate action. This will include getting yourself fully tested, and will likely include taking particular medications to protect yourself.

SYMPTOMS OF DIABETES

What will you experience with diabetes? There are a number of symptoms, which include:

  • Being too thirsty
  • Urinating excessively
  • Losing or gaining weight without any diet changes
  • Feeling tired easily
  • Blurry vision
  • Frequent infections that just dont go away
  • Cuts and bruises that take too long to heal
  • Numbness and tingling in the hands and feet
  • Erection problems

Along with DIET, EXERCISE, and WEIGHT LOSS, medications are the mainstay of treating diabetes.

SUPER TEST OF DIABETES
HbA1C TEST
GLYCOSYLATED (sugar-coated) Hemoglobin Test

Another very important test to know exactly how your sugar is doing is known as the

  • Hemoglobin A1C test, or glycosylated hemoglobin, or how much your organs are getting sugar-coated from the inside.

This is the GOLD STANDARD that we doctors use to see if a person is en route to developing all the complications of diabetes, including heart disease, kidney failure, visual impairment, nerve damage, and blood vessel clogging.
This test tells us much more than even a sugar test done by pin-prick, or even a glucose test done at a medical laboratory. The reason that this test, the HbA1C, is so good is that it tells us how the sugar has been for

  • THE PREVIOUS 3 MONTHS. It is a 3 MONTH test of sugar.

So that gives us a much better information than even a morning fasting blood test done at the laboratory.

Results for this special test are:

HbA1C:

  • Less than 6% is ideal
  • Less than 7 % is good
  • Going higher from 7 % points to inadequate sugar control.
  • More than 8.5 % is very poor control.

Once again, this is the best test to assess Long term sugar control, which means long term protection against all the complications of diabetes. It would be helpful to all concerned if patients themselves started learning the lingo, started learning more about the tests we doctors use to measure sugar control.

The whole point of all this testing is to make sure that your Sugars are as close to normal for as long as possible. This is called

  • TIGHT GLUCOSE CONTROL

This will help protect you, your organs, and give you a longer and healthier life. This is a major message also still to be fully appreciated by people.

In terms of controlling you sugar levels, its important to TAKE THIS MESSAGE TO HEART.

Dr. Shafiq Qaadri is a Toronto family physician and Continuing Medical Education lecturer. www.doctorQ.ca





 






















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