Diabetes: What to Expect From a Visit to Your Doctor

Diabetes is a debilitating health condition, and its timely diagnosis and management are essential in preventing long-term complications. More and more people worldwide are being diagnosed with diabetes nowadays.  

According to the International Diabetes Federation (IDF), currently more than 55 million adults between 20 to 79 years of age have diabetes in the Middle East and North Africa region. Moreover, diabetes in UAE is at one of the world’s highest rates of 16.3%. If that is not alarming enough, about 40.7% of adults in this age group with type 2 diabetes mellitus are unaware that they have the condition.²

Hence, the importance of being knowledgeable about this disease and having awareness regarding the difference between type 1 and type 2 diabetes, prevention, early diagnosis, and timely management cannot be emphasized enough.  

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What Exactly is Diabetes?

Diabetes is a group of health conditions in which your body does not make enough insulin, cannot use the insulin produced (insulin resistance), or it’s a combination of both.  

Normally, the carbohydrates you eat in food are broken down into glucose in your digestive system. The insulin—a hormone produced by the pancreas—then helps the cells absorb this glucose from the bloodstream. This glucose in the cells provides energy for carrying out different essential processes in your body.

If there is insufficient insulin production or the cells in your body do not respond to insulin, glucose molecules are not absorbed by these cells, leading to higher-than-normal glucose levels in the blood, which is basically diabetes.

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What are Its Types?

1. Type 1 Diabetes: In this type, your body does not produce insulin to control blood sugar levels. It’s an auto-immune disease, meaning your own immune system attacks the insulin-producing cells in the pancreas. Type 1 diabetes has an onset in childhood or adolescence usually but can also develop in adults. This type is insulin dependent as patients are dependent on insulin injections or pumps to regulate their blood glucose levels.

2. Type 2 Diabetes: In this type, either your body does not produce enough insulin, or the cells do not respond to the insulin produced (insulin resistance). Glucose molecules are not absorbed from the blood by the cells, leading to a rise in their blood levels. Hence, insulin resistance treatment is essential in this type of diabetes. Type 2 diabetes has an onset mostly in adulthood but can also develop in children. This type can be prevented and managed through a healthy diet and exercise, but sometimes patients may need to take medications.  

3. Prediabetes: Sometimes, your blood sugar levels may remain high but are not high enough to be classified as type 2 diabetes. This condition is called prediabetes.  

It’s important to diagnose prediabetes early on to prevent the development of diabetes and its complications.  

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What Long-Term Complications Can Develop From Diabetes?

Diabetes is a disease affecting multiple organs. Its effects are long-lasting and highly debilitating for the patient.  

• Cardiovascular system: High blood pressure, high blood cholesterol, stroke, heart attack.
• Renal system: Diabetic nephropathy (kidney damage) that causes kidney infections and might even lead to kidney failure.
• Nerves: Neuropathy (nerve damage) that causes numbness and tingling in fingers and toes and then eventually spreads.
• Eyes: Diabetic retinopathy (eye damage) that causes cataracts, glaucoma, or even blindness.

• Foot: Diabetic foot (foot damage) that causes poor healing of wounds, sores, and gangrene, which may eventually require amputation.
• Others: Skin infections, dental issues, mental health effects such as depression, etc.  

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How Essential are Timely and Regular Checkups for Diabetes?

The importance of early diagnosis and management of diabetes cannot be emphasized enough. Except for type 1 diabetes, there is a lot that you can do to prevent diabetes as well. As mentioned above, this disease brings with it serious effects on health and complications. Hence, regular, and timely visits to the diabetes doctor are very important if you suspect you have diabetes.  

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What Should I Expect From My Visit to the Doctor?

1. History: Your primary care doctor will ask detailed questions if you have been experiencing the signs and symptoms of diabetes, including those specific to different organs. Some questions would be:

• How long have you been having the symptoms?  
• Have you gotten your blood glucose levels checked before?

• Do you take any medications for your symptoms?
• What does your daily diet typically consist of?
• What do you do for your physical fitness?
• Do you have a family history of diabetes?

2. General physical examination (GPE): Your doctor will then measure your vitals (i.e., heart rate, blood pressure, respiratory rate, height, and weight). Weight control is crucial in the management of diabetes as obesity is a risk factor for diabetes.  

3. Systemic examination: In this, an examination of your different organ systems will be carried out to rule out any complications of diabetes. This will include examining your skin, feet, eyes, and nerves. Foot damage (diabetic foot) is a common complication of diabetes. Diabetes causes damage to your nerves and impairs blood flow, which affects your extremities (arms and legs) the most. Hence, a diabetic foot screening includes checking for your lack of hot, cold, and pain sensation in the foot; presence of sores, infected deep sores (ulcers), blisters, or open wounds; changes in your toenails; development of hard skin (callus) particularly on the soles of your feet.  

4. Lab tests: Based on your history and examination, your doctor will order certain tests to confirm the diagnosis of diabetes and development of any related complications. Some of these are:  

• Fasting and random plasma glucose tests: The first test measures your blood glucose levels, preferably in the morning, after an eight-hour fast. The second test measures the levels at any time, without prior fasting.  
• Glycated hemoglobin test (HbA1C): This test measures your blood glucose levels over the past two to three months.  
• Urinalysis and renal function tests (RFTs): Urine (urinalysis) and blood tests (RFTs) are done to rule out the development of kidney disease as a complication of diabetes. In the urine albumin to creatinine ratio (ACR) test, high levels of albumin in urine indicates early-stage kidney disease and persistently high levels of it are indicative of kidney failure.  

• Lipid profile: Blood cholesterol and triglyceride levels are checked as high levels of these are a complication of diabetes.  

5. Doctor’s remarks: If you are diagnosed with prediabetes or type 2 diabetes, your doctor will suggest lifestyle changes to reverse insulin resistance symptoms, manage and control the progression of disease, and prevent life-long complications.  

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You will be recommended a healthy diet (Mediterranean or Dash diet), walking for at least 30 minutes five times a day, losing weight if you are overweight or obese, avoiding stress, and quitting smoking. In addition, based on your signs and symptoms, your doctor might start you on medications or insulin therapy to control your blood sugar levels.  

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Get Checked Today!

The earlier prediabetes or diabetes is detected and diagnosed, the sooner you can take steps to control it. If you can control your blood sugar levels effectively, the chances of you living a long and healthy life are high. So, why delay your consultation with a doctor?

Contact us today and let us help you book a visit to your primary care doctor today. There is so you can do to achieve your health and wellness goals.

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References:

1. Statistics. Diabetes.org. Accessed May 14, 2022. https://www.diabetes.org/about-us/statistics

2. Alawadi F, Hassanein M, Suliman E, et al. The prevalence of diabetes and pre-diabetes among the Dubai population: Findings from Dubai household health surveys, 2014 and 2017. Dubai Diabetes Endocrinol J. 2020;26(2):78-84. doi:10.1159/000508833

3. Wickham ME, Hohl CM. Relationship between GP visits and time spent in-hospital among insulin-dependent Canadians with type 2 diabetes. Can Fam Physician. 2020;66(2):e69-e77. Accessed May 24, 2022. https://pubmed.ncbi.nlm.nih.gov/32060207/

4. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217-228. doi:10.1001/jama.293.2.217

5. Best diets when you have diabetes. WebMD. Accessed May 24, 2022. https://www.webmd.com/diabetes/ss/slideshow-best-diabetes-diets

6. Diabetes: Types, risk factors, symptoms, tests, treatments & prevention. Cleveland Clinic. Accessed May 24, 2022. https://my.clevelandclinic.org/health/diseases/7104-diabetes-mellitus-an-overview

7. Diabetic feet & skin care information. Cleveland Clinic. Accessed May 24, 2022. https://my.clevelandclinic.org/health/diseases/9492-diabetes-foot-skin-related-complications

8. Pietrangelo A. Types of diabetes: Causes, identification, and more. Healthline. Published May 9, 2022. Accessed May 24, 2022. https://www.healthline.com/health/diabetes/types-of-diabetes

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