Renewed hope for diabetic patients

Saturday, 9 March 2019

Renewed hope for diabetic patients, reveals Consultant Endocrinologist, DrManilkaSumanatileke

Diabetes is a common non-communicable disease in which the patient’s blood glucose (sugar) levels are high. Both children and adults are susceptible to this disease. While the wider society is divided on diabetes medication and side effects, there is good news in the research and development front for reversing the disease. It is possible to check the onset of diabetes if it is diagnosed early. The following article was compiled in discussion with Consultant Endocrinologist, DrManilkaSumanatileke (Colombo General Hospital/ Hemas Hospital Thalawathugoda Diabetes and Endocrine Unit (Outpatient) who spoke at length about diabetes and how it can be reversed in some cases.

Types of diabetes

Anyone with a blood sugar level of over 126 milligrams is considered a diabetes patient. There are two Types of diabetes. With Type 1 diabetes, the patient’s body does not make insulin. Type 2 diabetes occurs when the patient’s body does not make enough insulin. Type 1 diabetes is generally triggered when children’s immune system mistakenly destroys pancreatic beta cells, leading to progressively decreasing insulin secretion. Various environmental and genetic conditions can contribute to the onset of Type 1 diabetes. Even though genetics can contribute to the onset of Type 2 diabetes, most often it is caused by lifestyle factors such as lack of exercise and consumption of unhealthy food. Overweight (BMI of over 30) individuals are at a higher risk of Type 2 diabetes.

Treatment

Apart from insulin treatment, there are 11 other drugs that are used to control diabetes. Doctors determine the right kind of medication based on the overall condition of the individual.  However, there is the very real possibility of reversing diabetes without medication. There are numerous treatment options that involve a drug-free approach. Some previously diabetic persons out there have been successfully managing their condition for over five to ten years by sticking to a diet and getting regular exercise. One of the clinical research studies into diabetes management has proven that with a liquid diet of 850 calories per day, along with regular workout, diabetes can be reversed and successfully managed.

Some advanced cases of diabetes require a lengthy hospital stay and insulin therapy to reverse the condition. Modern medication can be used to successfully manage blood sugar levels. Certain diabetes medication is used to flush excess sugar out of the body through urine. While medication can be used to manage diabetes and allow the patient to lead an active life, the disease is not curable.

In the case of individuals who are overweight (A BMI above 35), conducting a bariatric surgery to reduce the size of the stomach can help reverse diabetes by 70 percent. Apart from that, there are numerous other gastrointestinal surgical procedures which could improve diabetic conditions. However, following bariatric surgery, patients will have to stick to a strict diet or risk reversing back to the previous state of health. Similarly, there are number of other ways to reverse Type 2 diabetes without medication.

There is more good news. Researchers have found new methods to reverse even Type 1 diabetes. If caught early, there is a chance that Type 1 diabetes can be treated with immunotherapy to limit beta cell death. One of the most promising strategies that are being researched is to implant beta cells generated from embryonic (fetal) stem cells in to the liver to treat Type 1 diabetes. Medical researchers hope that when blood sugar levels rise, the implants will release insulin to restore them to normal. Research further revealed that in this case, the chances of success diminish after the first five years of the onset of diabetes.

While these new procedures bring hope to diabetic patients, Sri Lankans as a rule are reluctant to commit to such complex procedures which require a great deal of commitment from patients too. Most methods require the patient to be hospitalized for about two weeks. In addition, he or she must stick to a strict diet of soup in the morning and a liquid supplement during the daytime. The patient should lose 15kg before the procedure and replace starchy food with protein. The procedure also involves an exercise regime. Following the procedure, the patient can lead a normal life up to five years without medication as long as he or she sticks to the diet and exercise plan. Patients can switch to a normal diet as long as they methodically change the calorie intake.

Side effects of Diabetes medication

Drug related side effects are common but most of the time mild. There is a common misconception about the relation between diabetes medication and kidney damage. The factual truth is that excessive blood sugar contributes to the deterioration of kidneys. There is no connection between the use of medication and kidney damage. However, if a patient’s kidneys have already sustained damage, drugs such as metformin can cause certain side effects. Other minor side effects of diabetes medication include, nausea, gas, bloating, diarrhea and abnormal weight loss. In such cases, doctors prescribe alternative medication depending on the patient. 

The relation between feet and diabetes

DrManilka explains that we pay little attention to feet. Diabetes can affect nerves and cause poor blood flow leading to developing ulcers or gangrene. If uncontrolled diabetes has affected the nerves on a patient’s feet, he or she may be numb to the pain caused by a cut which can lead to an infection. Sometimes, slow blood flow can weaken the effect of antibiotics which in turn can cause infections to get worse. Patients with uncontrolled diabetes are even at the risk of losing their feet or legs if proper care is not applied.

Diabetic patients should pay extra attention to even small acts such as trimming nails on toes. Even a small cut near toe nails can get infected. Diabetic patients should always keep the spaces between their toes clean and dry to prevent infections. In most cases, cellulitis (a bacterial infection) can escalate in to a major infection. Slow blood flow can impair the effectiveness of antibiotics to cause the patient to lose the infected leg.

 Thalawathugoda Hemas Hospital provides comprehensive and modern care to patients at its Diabetic Centre. The Diabetic centre is well-equipped with the latest technology and a team of highly qualified and experienced consultants provide guidance to patients. Currently, a large number of patients have registered with the Diabetic Centre at Hemas Hospital Thalawathugoda to receive expert care from renowned Endocrinologists.