The case of diabetes
In 2013 Egypt was ranked 8th highest country in the world in terms of diabetes rates. In 2015 the prevalence of type 2 diabetes (T2D) in Egypt was found in around 15.6% of all adults aged 20 to 79. The World Bank reported an even higher percentage (16.7%). Today, 7.8 million Egyptians suffer from diabetes and this number is expected to double by 2035.
Diabetes is a puzzling disease, and there’s always much to learn about it. It is indeed a relatively sad topic. But let’s be positive and help you take care of yourself, guide you through your treatment and get you over any worries and problems you may face along the way.
What is diabetes?
Some of us might not be fully aware of diabetes, so it’s best to start with a simple definition of diabetes. Diabetes describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or it’s both.
There are mainly 3 types of diabetes:
Type 1 diabetes
In this case the body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. Although the disease’s onset usually begins at the age of 20, it can occur during any age. Approximately 10% of all diabetes cases are type 1.
Type 2 diabetes
In type 2 the body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance). Approximately 90% of all cases of diabetes worldwide are type 2.
This type affects females during pregnancy. According to the CDC, 4.6% to 9.2% of pregnancies may be affected by gestational diabetes. Up to 10 percent of these pregnancies, the mother is diagnosed with type 2 diabetes just after the pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose. Diagnosis of gestational diabetes is made during pregnancy.
Pre-diabetes – there’s only room for right decisions
If you act smart during pre-diabetes, you could save yourself a lifetime of hassles and even prevent diabetes from inflicting you with complications. Many people have blood sugar levels above the normal range, however don’t classify as having diabetes. This is sometimes known as pre-diabetes. If your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased. Check out this fun blood sugar checker tool
It’s very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated.
Who should be tested for Diabetes?
Anyone who has symptoms of diabetes which include:
- Frequent urination particularly at night
- Excessive thirst
- Unexplained weight loss with loss of muscle bulk
- Extreme hunger
- Sudden vision changes
- Tingling or numbness in hands or feet
- Feeling very tired much of the time
- Very dry skin
- Cuts or wounds that heal slowly
Others who don’t necessarily have diabetes symptoms
Some people will not have any symptoms but may have risk factors for diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance and physical inactivity.
Women who have had gestational diabetes have a 35% to 60% chance of developing diabetes in the upcoming 7–20 years.
Testing allows healthcare professionals to find diabetes sooner and work with their patients to manage it and prevent complications (listed below). Testing also allows health care professionals to find prediabetes and help you delay or prevent developing type 2 diabetes. Yes! There are about 50 easy ways you can prevent type 2 diabetes
Diabetes tests & diagnosis
Your healthcare professional can diagnose diabetes, through blood tests.
Do not try to diagnose yourself if you think you might have diabetes. Testing equipment (blood glucose meter) that you can buy over the counter are not accurate enough to diagnose diabetes.
Health care professionals most often ask for some blood tests to diagnose diabetes.
Fasting plasma glucose (FPG) test
For the most reliable results, it is best to have this test in the morning, after fasting for at least 8 hours. Fasting means having nothing to eat or drink except sips of water.
The A1C test is a blood test that provides your average levels of blood glucose over the past 3 months. Other names for the A1C test are hemoglobin A1C, HbA1C, glycated hemoglobin, and glycosylated hemoglobin test. This test doesn’t require fasting. When it comes to using the A1C to diagnose diabetes, your doctor will consider factors such as your age and whether you have anemia or another blood related problem. The A1C test is not accurate in people with anemia.
A1C test result is reported as a percentage, such as an A1C of 7 percent. Higher percentage indicates higher average blood glucose levels.
Random plasma glucose (RPG) test
Sometimes health care professionals use the RPG test to diagnose diabetes when diabetes symptoms are present. You do not need to fast overnight for the RPG test. The test may be taken at any time in the day.
Glucose challenge test
Pregnant women may have the glucose challenge test, the oral glucose tolerance test (OGTT), or both; to test for gestational diabetes. These tests show how well the woman’s body handles glucose.
What are the complications of diabetes if left out of control?
Keeping blood sugar low is important for preventing some problems caused by diabetes, including:
- Eye diseases that lead to weakened vision or blindness
- Kidney disease
- Nerve damage (“neuropathy”) that can cause numbness or pain in the hands and feet
- The need to have toes, fingers, or other body parts removed by surgery (amputation)
Control diabetes with the “ABCs”
What can I do to stay as healthy as possible if I have diabetes?
The most important thing a patient with diabetes can do is controlling his/her “ABCs”:
- “A” stands for “A1C”– A1C to see how your blood sugar level has been during the last few months.
- “B” stands for “blood pressure”– If you have diabetes, controlling your blood pressure is just as important as controlling your blood sugar. High blood pressure puts you at risk of heart attacks, strokes, and kidney diseases.
- “C” stands for “cholesterol”– High cholesterol is another factor that increases your risk of heart attacks, strokes, and other serious problems.
Why are my ABCs so important?
Compared with people who do not have diabetes, people who have diabetes are 2 to 3 times more likely to have a heart attack or a stroke. They can happen at a younger age, which makes them severe, and sometimes deadly. Kidney disease is also a possibility for people with diabetes. By keeping the patient’s ABCs under control, the risk of these problems can be minimized.
What should my ABC levels be?
The levels you should aim for will depend on how severe your diabetes is, how old you are, and what other health problems you have. Ask your doctor what your target diabetes ABC levels should be.
Many people with diabetes aim for:
- A1C levels below 7 percent
- Blood pressure below 140/90,or lower in some cases
- LDL cholesterol level below 100 (LDL is one type of cholesterol, often called the “bad cholesterol” or “lousy cholesterol”)
How can I control my ABCs?
You and your doctor will work together on a plan to keep your ABCs under control. Your plan might include:
- Medicines – Most people with diabetes take medicine every day to control their blood sugar. Apart from having to check blood sugar levels every day, people with diabetes also need medicine every day to treat high blood pressure or high cholesterol, or to prevent future health problems.
- Lifestyle changes – “A person starts to live when he can live outside himself.” – Albert Einstein. Choices you make every day about the food you eat and the way you live can have a big impact on your ABCs and your general health. Here are some things you can do to help keep your ABCs under control and reduce your health risks:
- Make healthy food choices – Eat lots of fruits, vegetables, whole grains, and low-fat dairy products. Limit the amount of meat and fried or fatty food. The Mediterranean cuisine is the number one choice for a person with diabetes. The main element in this cuisine is olive oil which is rich in monounsaturaed fats that are anti-inflammatory and reduce risks of heart diseases and strokes.
- Be active – Walk or workout on most days of the week if possible.
- Lose weight – Controling your weight contributes to cutting the risk of many health problems.
- Avoid alcohol – Alcohol can increase blood sugar and blood pressure.
- Stop smoking – Gradually reducing the rate at which you smoke everyday helps you control yourself and stop it successfully. This definitely eliminates your risks of a heart attack, stroke, and cancer.
Luckily, many of these lifestyle changes can improve your ABCs. For example being active and losing weight can help to control blood sugar, blood pressure, and cholesterol levels.
Introducing Tabibi’s Diabetes Management Program
It is a fully flexible and customizable health management program for patients with diabetes. It aims to help them understand their current health situation, educate them on diabetes and diabetes self-management, help them manage their overall health and provide them with the needed tools and guidelines.
The program offers:
- Initial medical assessment
- Customized health management plan.
- Patient “Diabetes” passport (see below)
It is a handbook that contains health management guidelines. It helps the patient with tracking health activities, acts as a reference to doctors and a reminder for medical follow-ups.
It consists of 4 sections as follows:
Initial medical assessment
- Patient information & social history.
- Past & current medical history.
- Family medical history.
- Physical examination.
- Medication prescription.
- Lab test results & analysis.
Diabetes Health references & guidelines
- General guidelines.
- Weight control.
- Blood glucose control.
- Blood pressure control.
- Tabibi 24/7 scheduled follow-up visits.
- Tabibi 24/7 scheduled lifestyle counseling visits.
- Tabibi 24/7 scheduled diabetes education sessions.
- Specialists’ scheduled follow-up visits.
- Vaccination plan.
- Scheduled lab tests.
Follow-up visits summary
- Physical examination (Results, comments & instructions).
- Medication prescription.
- Lab tests requests (we can bring the lab tests to the clinic or at the comfort of your home).
Membership plan includes:
- Follow-up visits.
- 24/7 consult calls.
- Services Discounts (Tabibi 24/7 & partners).
- Monthly Reports
 Refaat Hegazi, Mohamed El-Gamal, NagyAbdel-Hady, OsamaHamdy, (2015). Epidemiology of and Risk Factors for Type 2 Diabetes in Egypt. Annals of global Health. Volume 81, Issue 6
 World Bank. Diabetes prevalence (% of population ages 20 to 79)
 Association Between Iron Deficiency and A1C Levels Among Adults Without Diabetes in the National Health and Nutrition Examination Survey, 1999–2006