What is Diabetes?

As one progresses into their 40s and 50s, it's not uncommon to have abnormalities in blood sugar levels pointed out during health check-ups. Subsequently, advertisements for foods and beverages that claim to lower blood sugar levels become more noticeable. Some of you might already be incorporating these so-called health foods and drinks into your daily lives. Here, we aim to introduce diabetes, a condition where persistently high blood sugar levels lead to various health issues, and provide you with accurate knowledge to equip yourself. Early detection and improvements in lifestyle habits are crucial in treating diabetes. If you're alerted to the possibility of diabetes through health check-ups, it's recommended to promptly seek medical attention.

Being overweight is not advisable, but being too thin is also detrimental to longevity. Since diabetes is a lifestyle disease, you might have heard that you need to lose more weight. Indeed, there's extensive awareness campaigns, often in the form of advertisements for health foods and beverages. However, is that really the case? You might be taken aback by the paradoxical discussion introduced earlier, but there's an intriguing topic regarding body weight that's not widely known. Many people perceive that being overweight leads to a shorter lifespan, and those who are slender like models would live longer. Surprisingly, that's not entirely true. Slightly overweight individuals actually tend to live longer. Obesity levels are typically evaluated using BMI (Body Mass Index), calculated as weight in kilograms divided by height in meters squared. For instance, for someone who is 170 cm tall and weighs 65 kg, the BMI would be 65 / (1.7 * 1.7) = 22.5. A BMI of 30 or higher is considered obese, 25 to under 30 is overweight, 18.5 to under 25 is normal, and under 18.5 is underweight. How's your BMI? The Ministry of Health, Labour and Welfare conducted a study evaluating the BMI of Japanese individuals at the age of 40 and their subsequent lifespan. The results revealed that the longest-living individuals were actually those who were slightly overweight, with average lifespans reaching 81.6 years for men and 88.0 years for women. Those considered normal weight lived to averages of 79.9 years for men and 87.9 years for women, while obese individuals lived to averages of 79.4 years for men and 86.0 years for women. Conversely, thin individuals had shorter lifespans, with averages of 74.5 years for men and 81.7 years for women, compared to slightly overweight individuals, indicating a difference of 7.1 years for men and 6.2 years for women. Considering these results, if longevity is the goal, being excessively overweight may not be ideal, but being slightly overweight might actually be beneficial. At least, being thin is not optimal for overall health in the long term, so extreme diets are not advisable. Aim for a BMI around 24, and individuals with a BMI between 22 and 26, without abnormal test results such as blood pressure or blood sugar levels, may not need to force themselves to lose weight.

Nevertheless, diabetes remains a lifestyle disease.

Recently, it has been discovered that genetics play a role in predisposing or protecting individuals from diabetes. Particularly among Japanese people, it's known that there's generally less insulin, the hormone secreted from the pancreas in the abdomen that regulates blood sugar levels, compared to Western populations. This predisposes them to have higher blood sugar levels even with the same dietary intake. Even for individuals with a BMI between 22 and 26 who are slightly overweight, those who are healthy versus those who develop diabetes may have different inherent predispositions. Therefore, those who have developed diabetes or are at risk of developing it should improve their lifestyle habits, even if their BMI is below 26. Specifically, if you lack exercise habits, it's recommended to incorporate aerobic exercises such as walking, jogging, yoga, or dancing into your daily routine.

Remember the symptoms of diabetes

Diabetes often presents with few noticeable symptoms until it has progressed considerably, making it difficult for individuals to self-diagnose unless pointed out during health check-ups. Regular health screenings are strongly recommended for early detection. Additionally, knowing the symptoms of diabetes in advance allows you to recognize them if they appear, enabling you to suspect "Could this be diabetes?" These symptoms include damage to various blood vessels in the body due to prolonged high blood sugar levels. This affects thin blood vessels throughout the body, including around nerves, in the retina of the eyes, and in the kidneys. Neuropathy, retinopathy and nephropathy are the most noticeable diabetic complications, and if blood sugar levels remain high, they typically manifest 10-15 years after the onset of diabetes. It's crucial to be cautious as these complications can lead to numbness in various parts of the body even at rest, loss of vision, renal failure resulting in decreased urine output, and eventually requiring dialysis, significantly reducing the quality of life.

The treatment of diabetes aims to rectify the relative lack of insulin

Insulin, the hormone responsible for lowering blood sugar levels, plays a crucial role in diabetes. As mentioned earlier, insulin is secreted from the pancreas, but there's a limit to the amount that can be secreted per day. When blood sugar levels rise after consuming sugar, insulin is promptly released from the pancreas, returning blood sugar levels to the normal range. However, if you regularly consume high-sugar diets, the relative amount of insulin may become insufficient, making it difficult to keep blood sugar levels within the normal range, resulting in persistently high blood sugar levels. Additionally, even if insulin is secreted, individuals who are overweight or lack exercise habits may have weakened responses in utilizing insulin, resulting in high blood sugar levels (referred to as insulin resistance). To overcome these situations, medications have been developed to stimulate insulin secretion, suppress sugar absorption from meals, improve insulin resistance, and, more recently, increase the excretion of sugar from the body. These medications are increasingly being used in conjunction with dietary and exercise therapy. Some medications also have protective effects on the kidneys and heart, so the choice of oral medication should be based on evaluating the condition of various organs in patients. If blood sugar management remains difficult, insulin injections may be necessary at regular intervals.

Diabetes is a complex disease, and there's been significant progress in developing treatment methods for this national epidemic in recent years. It's anticipated that treatment methods will continue to be updated gradually. Therefore, if you're already undergoing diabetes treatment, it's advisable to regularly review your oral medications at medical institutions. Of course, even if you haven't developed diabetes yet, equip yourself with correct knowledge and prevent this lifestyle disease to lead a healthy life every day.