‘How’s your sugar?’
I had never realised how big sugar is in this part of the world. Tinned fruit has added sugar, the juices have added sugar, heck, even the milk has added sugar. Owing in part to its American imports, Barbados certainly has a sweet tooth.
Sat in clinic with me today was a lady whose life had been devastated by sugar. Her left leg had been amputated some years ago, and her vision was starting to decline due to damage to the vessels in her eye. She had diabetes mellitus, a condition where the amount of sugar in the blood goes uncontrolled – often due to being overweight. It translates roughly as ‘sweet urine’, after the sugary quality urine takes on when glucose levels climb too high. This was a hallmark sign used by early physicians (and perhaps some stranger ones today) in diagnosing diabetes.
How does this happen? As we touched on in an earlier post, sugar in the blood needs to be held in a delicate balance by hormones in order for the body to function normally. The reason it’s there at all is as an energy source: and so if levels decline, individuals can become drowsy and lose consciousness. However, when levels are too high (hyperglycaemia), damage to blood vessels can occur. This causes a host of problems depending on which blood vessels are affected.
For our patient, the vessels in her leg had become so damaged by poor sugar control that its tissues were no longer receiving blood properly, and so the leg needed to be removed so that it didn’t start to decay. Now, her eyes were at risk: the tiny vessels supplying the back of her eye (the retina) were starting to leak, causing dangerous swelling on a part called the macula. If the swelling persists, she will lose vision permanently.
All of these problems are made a lot better with improved control of diabetes, which can be achieved by lifestyle changes like losing weight, eating less refined sugary products and exercising more, as well as adherence to medication. This will lay the groundwork for the treatment of this lady’s eyes with a laser, which will hopefully plug the leaky vessels and reduce the dangerous swelling (a process called photocoagulation).
It’s definitely something I’ll be keeping in mind the next time I’m eyeing up one of the island’s many sweet treats. No-one wants to be facing the question: ‘How’s your sugar?’