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Diabetes Mellitus: Causes, Signs, and Management Strategies

May 9, 2025 | by Dr. Kenneth A.O

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Diabetes mellitus is a chronic health condition that impairs the body’s ability to regulate blood glucose, commonly known as blood sugar. Glucose is a vital source of energy for cells, and insulin—a hormone produced by the pancreas—helps facilitate this process. When the body either doesn’t produce enough insulin or cannot effectively use it {insulin resistance}, glucose accumulates in the bloodstream. This long-term imbalance can lead to severe complications, including nerve damage, kidney failure, and cardiovascular disease.

The seriousness of diabetes became clear during a recent hospital visit. “How are you feeling, Mr. Jack?” I asked my 65-year-old patient, who has type 2 diabetes. “I’m fine… but why am I here?” he replied. His family rushed him to the emergency room after he suddenly collapsed at home. “Did you eat before your insulin shot?” I asked. “No, but I usually do,” he admitted. “That’s likely the cause,” I explained. “Insulin without food can dangerously lower your blood sugar.”

According to the World Health Organization (WHO), more than 420 million people globally are living with diabetes, and the number continues to rise, particularly in low- and middle-income countries, including many in Africa: https://iris.who.int/

Causes of Diabetes Mellitus

The causes of diabetes are multifactorial, often involving a combination of genetic predisposition and environmental triggers. Type 1 diabetes is primarily autoimmune, where the immune system attacks insulin-producing beta cells in the pancreas. Lifestyle factors like diet, physical inactivity, obesity, and stress largely influence Type 2 diabetes, which accounts for over 90% of all cases.

Other causes include

  • Gestational diabetes during pregnancy due to hormonal changes
  • Certain medications like corticosteroids
  • Endocrine disorders such as Cushing’s syndrome

Professor Jean Claude Mbanya, a leading Cameroonian endocrinologist and past president of the International Diabetes Federation (IDF), emphasizes the need for culturally contextual prevention strategies in Africa, where urbanization and dietary shifts are accelerating diabetes incidence: Jean Claude Mbanya – IDF

Type 1 vs. Type 2 Diabetes Mellitus

Doctors often diagnose Type 1 diabetes in children and adolescents. This autoimmune condition requires lifelong insulin therapy.

Type 2 diabetes is usually diagnosed in adults, involves insulin resistance, and is often preventable or manageable with lifestyle changes. Alarmingly, younger populations are increasingly being diagnosed due to rising obesity rates.

Early Symptoms of Diabetes Mellitus

Symptoms of diabetes can be subtle or mistaken for other conditions. Common early warning signs include:

  • Excessive thirst and frequent urination
  • Fatigue
  • Unexplained weight loss
  • Blurred vision
  • Slow-healing wounds
  • Increased hunger

Ignoring these signs can lead to delayed diagnosis and complications.

How Insulin Works

Insulin allows glucose to enter cells for energy production. In diabetes:

  • Type 1: The body produces little or no insulin.
  • Type 2: The body cells become resistant to insulin’s effects.

This dysfunction leads to hyperglycemia (high blood sugar), which damages blood vessels and organs over time.

Risk Factors for Diabetes Mellitus

Risk factors include:

  • Family history of diabetes
  • Obesity, especially abdominal fat
  • Sedentary lifestyle
  • Age over 45
  • High blood pressure or cholesterol. Read also Lower Blood Pressure Naturally
  • Ethnic background (e.g., African, Hispanic, South Asian descent)

According to a 2023 study in The Lancet Diabetes & Endocrinology, African populations show a genetic predisposition to insulin resistance, making lifestyle interventions critical: The Lancet Diabetes & Endocrinology

Complications of Diabetes Mellitus

Uncontrolled diabetes can affect nearly every system in the body:

  • Eyes: Diabetic retinopathy can lead to blindness
  • Kidneys: Diabetic nephropathy is a leading cause of kidney failure
  • Nerves: Peripheral neuropathy causes numbness, pain, and foot ulcers
  • Heart: Increased risk of heart attacks and strokes

Diagnosing Diabetes Mellitus

Common diagnostic tools include

  • Fasting Blood Sugar: ≥126 mg/dL
  • HbA1c Test: ≥6.5%
  • Oral Glucose Tolerance Test: ≥200 mg/dL after 2 hours

Early detection through routine screening is vital, especially in at-risk populations.

The Science Behind Blood Sugar Control

Blood sugar control helps prevent complications. Key metrics:

  • HbA1c levels reflect average blood sugar over 2–3 months
  • Self-monitoring with glucometers

A 2022 study in Diabetes Care revealed that patients maintaining HbA1c below 7% had significantly reduced risks of microvascular complications: Diabetes Care Journal

Management and Prevention of  Diabetes Mellitus

  • Weight management
  • Routine physical activity (150 minutes/week)
  • Medication adherence
  • Diabetes self-management education (DSME)

Programs like Kenya’s “Changing Diabetes® in Children” have shown measurable improvements in health outcomes through culturally adapted care.

Nutrition and Diabetes Mellitus

Best foods for Diabetes Mellitus
Diabetes Mellitus-Friendly Meal of Ofada Rice, Fish, and Broccoli

Personalized Diabetes Plan

Symptoms Of Diabetes Mellitus
Regular Physical Exercise Is An Important Component In The Management Of Diabetes Mellitus

No one-size-fits-all plan exists. Key components include

  • Aerobic and strength training. Read also Exercise Without a Gym
  • Personalized medication regimens
  • Regular monitoring and goal-setting with a healthcare team

Living Well with Diabetes Mellitus

causes of Diabetes Mellitus
Mindful Breathing & Stress Management Are Useful Tools In The Management of Diabetes Mellitus

Myths vs. Facts About Diabetes

  • Myth: Only overweight people get diabetes
    • Fact: Many people with Type 1 or even Type 2 are of normal weight
  • Myth: Diabetics can’t eat sugar
    • Fact: Moderation is key—total dietary pattern matters more
  • Myth: Insulin is a last resort
    • Fact: Insulin may be necessary early in Type 2 management for some

Research Perspectives on Diabetes

The International Diabetes Federation projects that diabetes cases in Africa will increase by 129% by 2045. This surge is linked to:

  • Urbanization
  • Poor access to healthy foods
  • Cultural stigmas around insulin and chronic illness

Community-based screening, public education campaigns, and collaboration between governments, NGOs, and traditional health systems are showing promise.

Final Thoughts 

Diabetes is a global epidemic with unique implications for African populations. Understanding its causes, recognizing early symptoms, and applying scientific and culturally relevant strategies for prevention and management are key to turning the tide. Whether you’re living with diabetes or supporting someone who is, education, empowerment, and early action are the most powerful tools we have.

What strategies are you trying out this week? Comment, and let’s share in your success story.

This post is for educational purposes only; consult your doctor before making any medical decision.

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