New Where There Is No Doctor 

It happens in every corner of the world: a routine blood test yields the surprising news that you have diabetes. Diabetes doesn’t necessarily present symptoms right away, and someone whose diabetes has been progressing undiagnosed may find her life turned upside down by having to adopt new eating habits, begin new routines of self-care, and figure out how to afford the cost of new medicines.

Communities have responded to these circumstances in many creative ways that don’t require a huge investment. Shared community kitchens give families the opportunity to make their own meals instead of relying on prepared foods — and offer a place for a healthy cooking class or that can be shared. School programs can offer children the chance to learn about nutrition early and participate in growing, cooking, and eating healthy food. Community gardens provide people with low or no cost vegetables. Hesperian’s New Where There is No Doctor contains a detailed chapter on diabetes.

What is Diabetes?

When we digest food, it puts sugar into our blood. This sugar is called glucose and our bodies use it to get the energy we need. Sweet things turn into glucose but other foods do too, especially starchy foods such as rice, maize, yam, potato, and bread or other foods made from wheat.

Diabetes means having too much sugar in your blood. With diabetes, The most common type of diabetes is called Type 2 diabetes. Type 2 diabetes is mainly caused by not enough activity, eating unhealthy foods—especially processed, packaged foods—and increased stress and inequality in our lives. Diabetes is a “chronic” disease, which means it can get better or worse, but it never completely goes away.

To live healthier with diabetes, it is very important to control the amount (level) of sugar in your blood. Diabetes is dangerous because high blood sugar can cause problems such as blindness, loss of limbs, loss of ability to have sex, stroke, or even death. When you keep your sugar levels down,

these problems can mostly be avoided, and you can have a productive and healthy life. This is called “managing” diabetes.instead of giving us energy, the sugar builds up in the blood and causes damage to the body.

Can you be healthy with diabetes?

Medicines and medical care cannot cure diabetes. But people can be healthy with diabetes if they learn about the disease and take care to manage the disease themselves. The most important things to do are to eat healthy food, get exercise, keep your teeth and gums clean, take care of your feet, find ways to reduce stress, and get enough rest. In some cases, medicine is needed too.

Signs of diabetes

Early signs of diabetes are often hard to recognize. Sometimes there may be no signs at all. Many people have diabetes without knowing it.


  • Thirst 
  • Frequent urination
  • Blurred vision
  • Lack of energy or gets tired easily
  • Slow-healing wounds
  • Feet that feel numb
  • Repeated yeast (candida) infections for women

These signs are common to many health problems, so you cannot tell if a person has diabetes from these signs alone. Get a blood test to know for sure (see pages 10 to 12).


When blood sugar levels get too high, they cause:

  • Severe thirst
  • Extreme weakness and sleepiness or confusion
  • Hunger
  • Weight loss even if the person is eating enough

A person with these danger signs should be tested and treated fast. A person can die from very high blood sugar levels if not treated. See High blood sugar (hyperglycemia), page 32.

Problems caused by unmanaged diabetes

If diabetes is left untreated over months or years, high sugar levels can damage organs, nerves, and blood vessels. This causes serious problems in the body that can cause permanent harm or even death.

High amounts of sugar in the blood can cause nerve damage. Many people with higher levels start to feel pain in their feet or their feet go numb. Higher levels also cause problems with blood circulation that can make wounds on the skin heal slowly. The person may get tired quickly. High blood sugar levels can damage the eyes and kidneys, causing them to function poorly or stop working at all.

To download a pdf of the entire chapter.

Billie Nicholson, Editor
April 2019

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