November 14 is World Diabetes Day, and with 1 in 3 Canadians* living with either diabetes or prediabetes, knowledge of how to manage the disease is important. Dr. Sheldon Tobe, nephrologist at Sunnybrook, and Dr. Rahul Jain, family physician at Sunnybrook, provide insight into why it’s important to manage diabetes, tips on how to do that and screening guidelines.
Your body with uncontrolled diabetes
Dr. Tobe says he often describes high blood sugar in the blood vessels as icing sugar that is being sprayed in a room, coating everything in sight and sticking to it.
“The net result is that everything becomes brittle and more worn out and the net effect over years of having high blood sugar in the blood vessels is that everything the blood vessels touch — which is everything in our body — is more likely to become damaged.”
Potential complications from uncontrolled high blood sugar are wide-ranging. Dr. Jain, who is the primary-care representative on the project advisory committee for the Canadian Diabetes Prevention Program (C-DPP), says patients could experience eye disease, foot and leg problems, heart attack, stroke, kidney disease or nerve damage.
“It’s important to properly manage blood sugars early on to reduce the risk of developing these complications, which can be very serious or even life-threatening,” he says.
The importance of screening
“A lot of people don’t have symptoms with diabetes,” says Dr. Jain. “The goal of screening is to catch people early before damage begins.”
For the general population, Dr. Jain says screening should begin at age 40 with a blood test. He says the recommended interval for screening is every three years, although he and Dr. Tobe say patients should speak with their family doctor to determine if and when screening is appropriate.
For those with a family history of diabetes, pregnant people who had gestational diabetes, people with prediabetes or certain cardiovascular risk factors can speak with their doctor about whether earlier and more frequent screening is right for them.
And certainly reach out to your doctor if you’re experiencing increased thirst, frequent urination, blurry vision or increased fatigue because these can be symptoms of diabetes.
A diabetes diagnosis can be overwhelming, but Dr. Tobe says patients can start with changing exercise and eating habits.
“We try to help people build up their muscle and try to keep their calories under control,” he says.
Dr. Jain says to combat that feeling of being overwhelmed, patients can take a step-by-step approach, working with their family doctor and other health-care professionals.
“It’s a journey, it’s a process, and you don’t have to fix everything overnight,” he says. “And education is key.”
Sunnybrook has a diabetes education program, SUNDEC, providing participants with individual and group education sessions and resources to help understand and manage their diabetes. C-DPP also offers individualized health coaching and tools for people at risk of diabetes.
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It’s not your fault
Dr. Tobe says management with nutrition and exercise may not always be enough for patients because diabetes is a progressive disease.
This means doctors may eventually recommend medication to help manage blood sugar levels, or a patient may find themselves crossing the threshold from prediabetes to diabetes. And while it might feel like a failure, Dr. Tobe cautions against that mindset.
“We don’t want [patients] to feel like a failure,” he says. “Some people are just more genetically predisposed. If, unfortunately, despite all your best efforts you’ve crossed that threshold, it’s not your fault. But you must help yourself from progressing further and prevent the downstream complications.”
*Statistic from Diabetes Canada