How physical inactivity, smoking, increase your risk of diabetes

Physical inactivity and smoking are some of the factors that could increase one’s risk of diabetes, a medical expert, Prof. Jibril Mohmmed El-Bashir, has said.

He said emotional stress, diet, medication and genetic factors were some of the other factors that put people at risk of diabetes.

He stated this during his presentation titled ‘Diabetes and Its Complications in Africa’ at the virtual training session of the Africa Disease Reporting Fellowship (ADReF) for journalists reporting health in Africa.  The fellowship is organized by the Africa Diseases Prevention and Research Development Initiative (ADRAP).

El-Bashir, who is a Professor of chemical pathology and metabolism, said that diabetes is a group of metabolic diseases characterized by increased levels of glucose in the blood resulting from defects in insulin (a hormone that regulates the level of sugar in the blood) secretion, insulin action, or both.

He said the types of diabetes are: Type 1 diabetes (Insulin-dependant diabetes), Type 2 diabetes (non-Insulin-dependant diabetes), gestational diabetes mellitus and diabetes mellitus associated with other conditions or syndrome.

He further said clinical manifestations of diabetes include fatigue and weakness, sudden vision changes, tingling or numbness in hands or feet, dry skin, skin lesions or wounds that are slow to heal and recurrent infections.

Explaining physical inactivity as a risk factor, Prof. El-Bashir said prolonged television watching is associated with a significantly increased risk of type 2 diabetes. 

He said that men who watched TV more than 50 hours per week had a nearly threefold increase in the risk of type 2 diabetes compared with those who spent less than one hour per week watching TV.

He further said several dietary factors have been linked to an increased risk of diabetes, such as low vitamin D consumption; early exposure to cow’s milk or cow’s milk formula; or exposure to cereals before 4 months of age.

He said, “Consumption of red meat, processed meat, and sugar-sweetened beverages is associated with an increased risk of diabetes.”

On smoking, he said several large prospective studies have raised the possibility that cigarette smoking increases the risk of type 2 diabetes.

He said, “In a meta-analysis of 25 prospective cohort studies, current smokers had an increased risk of developing type 2 diabetes compared with nonsmokers.

“A definitive causal association has not been established, a relationship between cigarette smoking and diabetes mellitus is biologically possible based upon several observations.”

He said smoking increases the glucose concentration after an oral glucose challenge.

“Smoking may impair insulin sensitivity. Cigarette smoking has been linked to increased abdominal fat distribution and greater waist-to-hip ratio that may have an impact on glucose tolerance,” he added.

The expert said medications were also a risk factor for diabetes, adding that there are drugs known to antagonize the effects of insulin such as adrenal corticosteroids and oral contraceptives.

He also said that physiologic or emotional stress causes prolonged elevation of stress hormone levels which raises blood glucose levels, placing increased demands on the pancreas.

He added that genetic factors may play a part in the development of all types of diabetes, noting that autoimmune disease and viral infections may be risk factors in Type I diabetes mellitus.

“Exposure to cow milk and cereal before four months can increase diabetes in children, that is why breast milk is better. Some hypertensive drugs also increase concentrates of plasma glucose level concentration in the blood,” he said.

He however outlined ways to manage diabetes mellitus as: nutritional therapy, exercise, education monitoring and medications.

While noting that diabetes is highly prevalent, he said prevention, lifestyle changes and management of diabetes were important because of the complications of the disease such as diabetic retinopathy (an eye disease caused by the high blood sugar from diabetes), erectile issues and psychological issues.

Other complications, according to the expert, are heart-related issues, kidney failure, skin infections, psycho-sexual dysfunction, depression, poor quality of life, premature death and costs, among others.

Another expert, Prof. Felicia Anumah, a consultant endocrinologist, said Nigerians need to know how to live right.

She said type 2 diabetes which accounts for more than 90 percent of cases of diabetes in the country is preventable.

Also, Prof Sunny Chinenye, a consultant endocrinologist at the University of Port-Harcourt Teaching Hospital, said local studies and the situation on the ground have shown that 11.2 million is the actual burden of the diabetes in the country contrary to the 3.6 million persons earlier estimated to live with the disease.

Prof Chinenye who is also a past president of the Diabetes Association of Nigeria (DAN) said out of the 11.2 Nigerians living with the disease, about 40 percent are not even diagnosed.

He said there is a need for the integration of detection and management of diabetes at the primary healthcare level in the country, adding that tertiary health facilities are overwhelmed, with his hospital recording an average of 150 diabetes patients per week.