• Dr. Blaise Ntacyabukura

The fastest growing widespread disease in the world: Diabetes

Updated: Sep 3, 2020

What is diabetes?

Diabetes is a chronic disease affecting the metabolism of glucose, characterized by high glucose level in blood (high blood sugar). Normally, after eating or experiencing a stressful circumstance, our blood glucose level rises but we have Insulin, a hormone secreted by our pancreas, to take that blood glucose into cells to produce energy or for storage.

Sugar (or glucose) is a very important source of energy for cells but also toxic when its levels are elevated in our blood for a prolonged time. Persistently high blood glucose levels damage blood vessels, the heart, eyes, kidneys and nerves, and weaken our body immunity against diseases. According to the World organization of Health (WHO), it is estimated that diabetes alone is affecting 422 million people worldwide, and it is among the leading chronic diseases and causes of deaths.

There are two main types: Type 1 also called diabetes insipidus and Type 2 also called diabetes mellitus. Type 1 is the most common chronic disease of childhood, caused by a deficiency of insulin due to the destruction of its producing cells in the pancreas. The type 2 diabetes on the other hand, is due to insulin ineffectiveness and it affects more the adult population.

Risk factors

  1. Type-1 diabetes:

  • Born as twins

  • Having affected parent/s

  • Family history of type 1 diabetes

  1. Type-2 diabetes:

  • Age ≥45 years

  • The body mass index [BMI] ≥25 kg/m2

  • Family history of people with type 2 diabetes

  • Diabetes mellitus in a first-degree relative

  • Sedentary lifestyle

  • History of gestational diabetes mellitus (Have had diabetes during pregnancy)

  • Hypertension (blood pressure ≥140/90 mmHg)

  • Increased blood lipid levels

  • Polycystic ovary syndrome

How does it present itself?

Irrespective of the type and the causes, diabetes has a classic presentation but the course of symptoms may differ:

Its classic symptoms are:

  • Excessive thirst

  • Increased appetite or hunger

  • Increased urination and

  • Weight loss

Its other symptom includes:

  • Nausea, vomiting and heartburn when the stomach can not empty itself as usual

  • Fatigue or a lack of energy

  • Weight gain from the increased appetite

  • Fruity-smelling breath

  • Problems with the vision

  • Increased susceptibility to infections

  • Slow healing of wounds or cuts

  • Drowsiness especially for kids

  • Tingling and numbness in the feet

  • Feet or face swelling as a result of water retention following kidney failure

How is it diagnosed?

Diabetes has a widely accepted approach to diagnosis. One of the criterias below is sufficient for diagnosis:

  • Having a fasting (after >8 hours without eating) blood glucose ≥126 mg/dL (7 mmol/L) on more than one occasion

  • Random blood glucose ≥200 mg/dL (11.1 mmol/L) and classic symptoms

  • Positive oral glucose tolerance test (OGTT)

  • Having a glycated hemoglobin (A1C) ≥6.5 percent

It is possible that you may have higher than normal blood glucose level according to different circumstances, but also not fulfilling above criteria to be diabetic. In that case, it is said you are in the pre-diabetic phase, a critical stage where all efforts should be used to try to reverse the progress of the disease or delay the symptoms.

How is it Treated?

Diabetes treatment depends on the type of diabetes, its stage and if there is an underlying disease or risk factor. In general, treatment is as follows (combining these options are quite common):

  • Lifestyle change: Healthy foods and drinks and regular exercise

  • Oral medication also known as hypoglycemic drugs

  • Insulin supplementation through injections

As it is a chronic disease, it is strongly advised to set treatment targets and goals of above options with a doctor or nutritionist for better management of diabetes. Via the BYON8 app, a doctor is always available for diagnosis, treatment and personalized treatments or recommendations.


Type-2 diabetes is largely preventable or delayable in case you are predisposed to have it genetically, for example if it is affecting the first or second degree of your family members. There are a number of actions that when carried out with discipline, researchers have proven their effectiveness.

  • Healthy eating and drinking: It means eating fruits and vegetables as half of your plate everytime, and cutting sugared and alcoholic drinks.

  • Regular physical activity that makes you sweat for at least 30 minutes three times a week.

  • Avoiding long term use of medication containing corticosteroids and also

  • Having any underlying medical conditions under control.

What’s the outcome of diabetes?

When diagnosed with diabetes it is important that it is managed properly to avoid outcomes that can have a very negative effect on life and sometimes even fatal complications. According to the WHO and International Diabetes Federation (IDF), nearly 3% of global blindness can be attributed to diabetic retinopathy. Diabetes is also among the leading causes of kidney failure and reduced blood flow and nerve damage in the feet. This can lead to foot ulcers, their associated infections and complications such as limb amputation, as well as severe and life-long health problems.

It is worth mentioning that when the blood glucose level is well controlled and stays in normal range, diabetes will not pose any major limitations in your life. You will be able to do professional sports, successfully carry out your pregnancy and deliver a normal and healthy baby and have a strong immune system. You could do pretty much everything someone without diabetes can do as long as it is managed properly and you are committed to the treatment. It may be hard but possible in every way. It is a matter of mind over body and changing lifestyle behaviors, especially food intake. You can read more in our “beyond the basics” about diabetes.

Until next time - Be well!

Dr. Blaise Ntacyabukura


  1. The World Health Organization (WHO)

  2. The International Diabetes Federation (IDF)

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