What is diabetes?

Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar levels(Hyperglycaemia)  that results from defects in insulin secretion, or action, or both. Diabetes mellitus was first identified as a disease associated with “sweet urine,” and excessive muscle loss in the ancient world. Elevated levels of blood glucose leads to spillage of glucose into the urine, hence the term sweet urine.

Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin,causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.

Diabetes can often be undiagnosed because, often it may be asymptomatic but, it may present as:

  • Frequent urination
  • Excessive thirst
  • Extreme hunger
  • Unusual weight loss
  • Increased fatigue
  • Irritability
  • Blurred vision
  • Cuts or sores that are slow to heal
  • Itchy skin & increased tendency to develop fungal infections
  • Dry mouth
  • Leg pain
  • Adults over the age of 35 years
  • If you have any of the above symptoms
  • If you have any risk factors:
    • Impaired glucose tolerance or impaired fasting glucose
    •  First degree relative with diabetes
    • Inactive life style or overweight (BMI >25kgm-2)
    • High blood pressure or high Cholesterol levels
    • Cardiovascular diseases
    • Stroke
    • History of having large babies (>3.5kg)
    • Polycystic ovarian syndrome or previous gestational diabetes mellitus

Diagnosis is done by testing your blood which can be done as a fasting blood sample or a random blood sample. A fasting blood sample is obtained following a 10 hour fast while a random blood sample can be obtained at any time. If you are going for fasting blood sugar test, you can still drink water, but not other liquids or foods.
The diagnosis of diabetes mellitus is established by the following criteria:

  1. Fasting plasma glucose >140 mg/dl on at least two occasions.
  2. Fasting plasma glucose >140 mg/dl and 2-hour plasma glucose >200 mg/dl with one intervening value >200 mg/dl following a 75 mg glucose load.
  3. Plasma glucose >200 mg/dl and classic symptoms of diabetes including increased thirst, increased urine output and weight loss.
  1. Take your medication, as prescribed, at the right time.
  2. Go for regular medical check ups.
  3. You need a yearly test to check your eyes for diabetic eye disease
  4. You also need regular tests to check the function of your kidneys.
  5. Get your blood pressure, serum lipid levels also checked
  6. If you are smoking, stop.
  7. Take a healthy balanced diet as adviced by your doctor
  8. Take regular exercise.
  9. Take care of your feet:

Buy shoes that fit your feet, make sure they are not too tight.

Inspect your feet daily especially between toes for any wounds

See your doctor at the first sign of foot ulcer, never ignore.

If you are a diabetic,it is very important that you have a tight blood sugar control throughout because it will prevent the progression of the disease, where your kidneys,heart, brain & nerves are going to be affected.The most effective way to do this is through diet control.

The main principle of an effective diet plan in a diabetic is to maintain a normal level of blood sugar and cholesterol & to maintain a weight appropriate for the height(BMI).

A suitable diet plan for a Diabetic

Breakfast Red rice, Kiribath ,Cereals like green gram,kadalaCerealslike green gram,kadala Strings,pittu or rotti made of kurakkan and red rice flour, a serving of fruit
Lunch Red rice, Green leafy vegetables,vegetables containing a lot of fibre Chicken/fish, a serving of fruits
Snacks at 10a.m & 4p.m Bran crackers or any other biscuit which does not contain sugar, any hot/cold beverage without sugar
Dinner Red rice,Chicken/Fish,Strings,Pittu or Rotti made of Kurakkan flour mixed with red rice flour,Vegetables,  serving of fruits

Weight ideal for the height:

Men-:  5ft- 106lb
6lbs for increase of each inch after  5ft

Females -:  5ft -100lb
5lbs for increas of each inch after 5ft

  • Plasma glucose (preferably via home glucose monitoring records)
  • Glycohemoglobin (minimum quarterly for insulin dependent and twice yearly for non-insulin dependent)
  • Urinalysis (annually)
  • Microalbuminuria or Microalbumin/creatinine level (annually)
  • Serum creatinine (annually)
  • Lipid profile (annually)
  • An annual eye examination (these exams within five years after they are diagnosed).

Services including screening and management of Diabetes is done at the National Diabetes Center, where the general public could walk in without any appointments or referrals.

National Diabetes Center, 50, Sarana Mawatha, Rajagiriya.

Its branches are located at the Teaching Hospital Karapitiya (091-2232176) and 59, Peradeniya Road, Kandy.(081-22234397 )