Healthy Lifestyle

What is Diabetes?

Diabetes is a disease in which the body produces too little of ineffective insulin. Insulin is a hormone that comes from a gland below the stomach, called the pancreas.

When the food you eat is digested, most of it break down into a sugar called glucose, which is absorbed into the blood.

In a normal person, insulin helps the blood glucose enter the body cells to be used for energy.

In a diabetic person with ineffective, too little or no insulin, the glucose cannot enter the body cells. It builds up in the blood, giving rise to a high blood glucose level which is the main sign of untreated or uncontrolled diabetes.

Types of Diabetes

The two main types of diabetes are Type 1 diabetes and Type 2 diabetes.

Type 1 Diabetes

This type of diabetes is usually found in children and young adults. The insulin-producing cells in the pancreas are destroyed, and the body produces practically no insulin.

You have a higher risk of developing Type 1 diabetes if your parent or sibling is a diabetic.

Type 1 diabetes can only be controlled with daily insulin injections, as well as proper diet and exercise.

The warning symptoms of Type 1 diabetes include:

• nausea and vomiting
• extreme thirst with frequent urination
• extreme hunger with rapid weight loss
• tiredness and irritability

These symptoms usually occur suddenly. Prompt treatment is necessary. See you doctor immediately if you have these symptoms.

Type 2 Diabetes

This is the most common type of diabetes in Singapore. Insulin is produced by the body, but it may not be enough or it may not work effectively.

More and more Singaporeans are getting Type 2 diabetes because of changes in lifestyle which increase the risk of getting diabetes. The risk factors of Type 2 diabetes are:

• Lack of exercise and being overweight
  Type 2 diabetes is more common in people who do not exercise regularly and who are overweight.
• Family history
  The risk of a person getting Type 2 diabetes is increased if one’s parent, grandparent or sibling is diabetes, and even higher if both parents are diabetes.
• Age
  In Singapore, Type 2 diabetes commonly affects those over 40 years of age.
• Ethnic group
  Type 2 diabetes is more common in Indians than in Malays or Chinese. But the number of people with Type 2 diabetes is increasing in all three ethnic groups.
• High blood pressure, high blood cholesterol and smoking
  Studies have shown that people with high blood pressure, high blood cholesterol levels and smokers have an increased risk of getting Type 2 diabetes.

Diabetes can sometimes develop during pregnancy, or it can become worse in diabetic woman during pregnancy. A woman who has diabetes during pregnancy is also at higher risk of developing Type 2 diabetes later in life.

Type 2 diabetes can often be controlled with proper diet and exercise alone. For some, tablets are needed to stimulate the production of more insulin, or to improve the action of ineffective insulin. In severe cases, insulin injections are needed.

Persons with Type 2 diabetes often have no warning symptoms. Some only discover they have the disease after a routine blood test, or when they develop complications.

If warning symptoms occur, they may include:

• fungal infection and itching of the genital area
• thirst with frequent urination
• unexplained weight loss
• blurred vision or a change in vision
• numbness or tingling of hands or feet
• slow healing of wounds
• tiredness and irritability

These symptoms usually occur gradually. See your doctor as soon as possible. Early treatment improves the chances of preventing or delaying complications.

Complications of Diabetes

Untreated or uncontrolled diabetes leads to serious complications.

A persistent high blood glucose level damages the small and large blood vessels in the body, particularly in the eyes, kidneys, nerves, heart and brain. Blood flow to the various organs and tissues is reduced or even cut off, causing damage.

If the nerves in the hands and feet are affected, there is a loss of feeling. Such diabetics often injure themselves without realising it. The wounds are slow to heal and become infected easily.

Complication of diabetes are:

• coma or loss of consciousness
• blindness
• high blood pressure
• kidney disease
• heart disease
• stroke
• gangrene or decay of the limbs, which may require…
• amputation

Is there A Cure?

There is no cure for diabetes at present. But the disease can be controlled with lifelong treatment.

Good control of blood glucose level will help prevent or delay the complications of diabetes, and enable a diabetic person to live a normal life.

Prevention

At present, it is not possible to prevent Type 1 diabetes. However, Type 2 diabetes, which is often associated with being overweight, may be prevented by:

• Maintaining a healthy weight
  Excess fat prevents insulin from working properly.
• Eating a balanced diet
  Take the correct number of servings from each of the basic food groups for your age and level of activity. Avoid too much sugar, salt, fat and high-cholesterol foods.
• Exercising regularly
  This uses up blood glucose and body fat, improves blood circulation and strengthens the heart. It helps to control weight and improves insulin action.
• Not smoking
  If you’re a smoker, stop now. Ask your family doctor for advice on quitting. If you are a non-smoker, don’t start.

Sweet dilemma - to eat or not to eat?

What is Diet?

Diet is a cornerstone of diabetic treatment. Dietary modification for a diabetic can only be achieved with the full participation of patient. Planing for diabetic meals should be individualized, particularly in multi-ethnic population. Doctors refer patients to dietitians for dietary counselling, assessment of current eating habits and development of appropriate meal plans.

The following are only general recommendations. If you or your loved one is diabetic, see your doctor for specific dietary advice.

Diabetic diet guidelines

Diabetic need to ensure that amount of food they eat each day matches the amount of insulin they have in their bodies. At the same time, the food they consume should provide enough energy for the performance of their daily activities. For this, they need to:

• Plan their meals with their doctor or dietitian.
• Eat at regular times each day.
• Eat the right amounts for their energy needs.
• Aim to keep their weight within the healthy range.

Eating properly helps in the treatment of diabetes. It is important for diabetic to have the right amounts of carbohydrates, proteins, vitamins and minerals in their diets. The American Diabetes Association has set nutrition guidelines for people with diabetes. Their daily energy consumption should be comprised of 50-60% carbohydrates, 30% fat and 10-20% proteins.

What kind of carbohydrates should I consume?

Carbohydrates are the main source of energy for the body. There are two main groups: starches and simple sugars. Both are broken down to form glucose, which is used to provide energy. Starches are complex carbohydrates, which are absorbed slowly and do not raise blood sugar levels quickly, especially when taken as foods containing fibre. Diabetics should include foods like rice, wheat, noodles, bread, chapattis and beans in their diet. Simple sugars like glucose and sucrose should be avoided because they cause weight gain and are associated with poor control of glucose. Avoid carbonated drinks that contain simple sugars - there are about 6 teaspoons of sugar for every can of soft drink.

Can cutting down fat reverse diabetes?

Research suggests some benefit of a low fat intake in reversing the risk of developing diabetes. Type 2 diabetes occurs when the body becomes resistant to the effects of insulin, which is important for processing sugar. A high-fat diet keeps the insulin level in the blood inappropriately elevated. Thus, diabetics should avoid eating saturated fats like animal fats, coconut and palm oil, all of which raise blood cholesterol levels. Fish or poultry should replace red meat. Skin and visible fat from meat and poultry should be removed before and after cooking. Cream, cheese, egg yolks, salad dressings and organ meats should be avoided.

How does fibre help control diabetes?

High-fibre diets improve the control of blood sugar by reducing the need for insulin or other medications. In addition, they help prevent diabetic complications such as high blood cholesterol and atherosclerosis. Fibre delays the emptying of stomach and slows down the absorption of glucose in the intestine. Thus, a diabetic should increase his/her intake of high-fibre foods such as dried beans, lentils, unpolished cereals, fruits and vegetables like bitter gourd, cabbage, and leafy vegetables.

Is sugar still a taboo?

Previously it was thought that sugar caused a quick, large spike in a person’s blood sugar level. New research suggests that this is not the case. Thus, table sugar is no longer prohibited though diabetics should stick to artificial sweeteners whenever possible. These substances sweeten the palate without raising blood sugar levels.