Healthy Lifestyle

What is Diabetes?

The body breaks down carbohydrates that are found in food and converts them to glucose, which is the major source for food for the body cells. Diabetes is a condition wherein the body does not respond to, or is missing a hormone called insulin. This hormone helps the tissues and organs of the body to use glucose from the blood. When there is a shortage of insulin in the body, glucose or blood sugar level builds up in the bloodstream.

Diabetes can be diagnosed through a fasting blood glucose test. There are two types of diabetes:

Type 1:

Previously known as insulin-dependent diabetes mellitus (IDDM), which is the deficiency of insulin in the body. This develops mainly in adolescence and early adulthood.

Type 2:

Previously known as non-insulin dependent diabetes mellitus (NIDDM) which is the resistance of the body to insulin. This develops mainly in adults, and is frequently associated with obesity, hypertension and high levels of cholesterol.

Symptoms of Diabetes

Early Symptoms:

• Excessive thirst
• Frequent urination

Advanced Symptoms:
Type 2 diabetes may be asymptomatic in its early stage

• Sudden weight loss (mainly type 1)
• Tingling or numbness in legs, feet or fingers
• Slow healing of cuts
• Weakness and fatigue
• Nausea and vomiting

Diabetes is one of the leading causes of kidney failure in Singapore. Diabetes damages blood vessels throughout the body, affecting the kidneys, eyes, skin, nerves, muscles and heart. The co-existing high blood pressure is an important risk factor for diabetics to develop kidney failure. In addition, the presence of protein in the urine is a significant factor that leads to kidney failure among diabetics. Finally, the level of control of blood sugar also affects the development of complications in all organs of the body. Thus, it is crucial to control diabetes well, manage high blood pressure and reduce the amount of protein in the urine through regular drug therapy.

Symptoms of diabetes developing kidney disease

Early Symptoms:

• Protein in the urine
• High blood pressure
• Increased need to urinate, especially at night

Advanced Symptoms:

• Morning sickness, nausea and vomiting
• Weakness, pallor and anaemia
• Itching

Among diabetics, who are most at risk of progression to kidney disease?

• People who are overweight.
• People with a family history of diabetes and kidney disease.
• Patients over 40 years old with NIDDM.
• Patients with IDDM even before 40 years of age.
• Patients with poor control of diabetes.
• Patients with high blood pressure, urinary protein or high cholesterol.

How can diabetics retard the progression to kidney disease?

Treatment of diabetic kidney disease involves slowing its progression to irreversible kidney failure by:

• Controlling high blood pressure.
• Controlling blood sugar levels.
• Regular visits to a doctor.
• Taking medication to decrease protein in the urine.
• Controlling blood cholesterol.
• Treating urinary tract infections.
• Taking medication as prescribed.
• Increasing intake of high-fibre diet.

Some facts about diabetes

Introduction to Type 2 Diabetes

• Food is digested in the stomach and broken down to sugar.
• Sugar is absorbed in the bloodstream.
• The pancreas produced a hormone, called insulin. Insulin acts like a key, it helps to open up “doors” of the body cells (muscles, fatty tissues, liver) so that sugar can enter and be used or stored in these cells as energy.
• Diabetes occurs when insulin is not working properly at the body cells or when there is insufficient insulin production. This causes sugar to accumulate in the blood.

How to Manage Type 2 Diabetes

1. Monitor your blood glucose levels - Regular monitoring will reveal whether you are in control of your diabetes.
2. Medication - Take medicine as advised by your doctor.
3. Regular exercise - Undertake at least 30 minutes of physical activity daily.
4. Healthy diet - Eat high fibre foods, fruits and vegetables, reduce fat intake.

Insulin Sensitizer - The Hope for Type 2 Diabetes

• Currently, there is no cure for diabetes.
• Conventionally oral medicine available, treat mainly the symptom of high blood sugar.

The good news is that there is now a new breakthrough oral medicine that treats insulin resistance.

The Glitazones A new class of oral medicine

• Treats Insulin Resistance, by sensitizing the body cells to its own insulin and improve absorption of blood sugar.
• Does not overwork the pancreas over time.
• Reduces the risk factors that could lead to heart diseases (eg. High blood pressure, high cholesterol).
• Convenient dose regimen - Once-daily dosing, no need to take with meals.
• Minimal side effects.

The 1998 National Survey showed that 62% of Singaporeans with Type 2 Diabetes were unaware that they had the disease.

Who is at risk and how often should you be tested?

• Age 30 years and above with any of the risk factors
  • Obesity (*BMI > 27kg/m^2)
  • High blood pressure
  • Relative with diabetes
  • Suffered diabetes
  • Coronary heart disease

Test every 1 - 3 years

• Age 40 or above

Test every 3 years

If you or someone you know is in the risk group, ask your doctor to screen for diabetes.

Insulin Resistance: The Root Cause of Type 2 Diabetes

• Insulin Resistance is a condition whereby the body cells become less sensitive to insulin. This condition acts as a barrier for sugar to enter the cells.
• Initially, the pancreas will produce more insulin to overcome insulin resistance. Over time, the pancreas loses its function function of insulin production, causing blood sugar levels to rise. Hence the onset of Type 2 Diabetes.

Why is Insulin Resistance a Concern?

Beside diabetes, Insulin Resistance also cause heart diseases.

Diabetes Complications

Heart Diseases
1 in 3 diabetics in Singapore suffer from heart problems (eg. Heart attacks, stroke, high blood pressure)

The estimated cost is $7000 per year for managing heart diseases and diabetes.

Blindness (or Retinopathy)
1 out of 5 diabetics in Singapore are in danger of losing their sight!

Kidney Failure
2 out of 5 diabetics in Singapore require kidney dialysis.

The estimated cost of managing kidney dialysis is $12,400 per year!

Amputation
Over 700 amputations are performed annually in Singapore due to diabetes.

Diabetics are at risk of long-term infections and gangrene leading to amputation!