Unravelling Diabetes Mellitus

The rate of diabetes is rapidly increasing in many countries worldwide

Different types of diabetes

In 2014, an estimated 440,000 Singaporeans were diagnosed with diabetes, and the number is projected to increase to 1 million by 2050.

Diabetes mellitus is a condition where the body is unable to properly use and store sugar (glucose) in the cells, resulting in blood sugar level persistently rising higher than normal.

Type 2 diabetes (which accounts for 90 to 95 percent of all cases of diabetes) occurs because the body does not produce enough insulin and is also unable to use insulin properly (due to insulin resistance from being overweight
or obese). Insulin is the hormone (chemical messenger) produced by the pancreas and it helps blood sugar to enter the cells in the body. Type 2 diabetes usually occurs in people who are over 40 years of age, overweight or obese, and have a family history of diabetes.

Type 1 diabetes (5 to 10 percent of all cases of diabetes) is due to little or no production of insulin by the pancreas. It mainly occurs in children and adolescents, although it can occur at any age. Persons with Type 1 diabetes need lifelong treatment with insulin injections.

Gestational diabetes is a type of diabetes that occurs in the late second or third trimester of pregnancy. High blood sugar level in pregnancy can pose risks for both the mother and the unborn baby. Gestational diabetes usually resolves after pregnancy. However, having had gestational diabetes increases the risk of the mother eventually developing Type 2 diabetes.

Symptoms of diabetes

The symptoms of having high blood sugar level include:

  • Increased thirst and urination
  • Tiredness or fatigue
  • Blurred vision
  • Unexplained weight loss
  • More frequent infections
  • Slow-healing cut and soresHowever, many individuals with diabetes may not have any of the above-mentioned symptoms at all. They may only find out that they have diabetes during health screening or when they see a doctor for other conditions and have blood tests done.

Urgency of seeking treatment

High blood sugar level over time can lead to a host of complications in the body including:

■ Heart attack
■ Stroke
■ Blindness
■ Kidney failure
■ Nerve damage and blood vessel disease that may require amputation
■ Impotence in men

Controlling blood sugar levels will reduce the risk of the development and/or slow down the progression of these complications.

Is there a cure?

With so much research and advances in the treatment of diabetes, it is tempting to think that someone must have discovered a cure for diabetes by now. Unfortunately, the reality is that there is currently still no cure for diabetes. Only few individuals with very mild Type 2 diabetes may be able to achieve remission with lifestyle changes alone.

Many overweight or obese persons with Type 2 diabetes will see their blood sugar levels return to normal without the need for medications after weight-loss (or bariatric) surgery. However, up to 50 percent of these people will eventually need blood sugar-lowering medications over the years as some weight is regained after the surgery.

Diabetes management

For most people, when first told that they have diabetes, their reactions may range from denial to despair. It is natural to feel lost or helpless for a period of time after receiving the unwelcome news. It will be helpful if you can talk to a family member or a friend about the illness. Freeing up your mind and heart is definitely better than bottling up the confused thoughts and frustrated feelings.

To overcome diabetes and to live life confidently with the condition, you must have a positive mindset and be willing to make lifestyle changes. Improving your blood sugar
levels by modifying your diet, exercising regularly, taking medications regularly, and checking blood sugar levels as instructed by the doctor. Having encouraging family members and/or friends who will support you on your journey with diabetes is very important as well.

Living with Type 2 diabetes

Here are some tips for those with Type 2 diabetes:

• Opt for good food choices–reduce the intake of refined carbohydrates (such as white rice, refined breads, noodles) and choose instead complex carbohydrates (such as brown rice, black rice, sweet potatoes, quinoa).

• Exercise regularly–start with 20 to 30 minutes once a week and gradually increase to at least three times a week.

• Be more active physically – instead of sitting down all the time, try walking more often. Take the stairs when you can instead of the lift or stand while working at your desk, if you can.

• Watch your weight–ensure that you are in a healthy weight range.

• Take medications as instructed by your doctor regularly. Types of medications available:

There are many different medications (in the form of tablets as well as insulin injections) currently available to help control blood sugar level in people with diabetes. The different tablet medications lower blood sugar level by targeting the different reasons for high blood sugar level in a person with diabetes.

Majority of individuals start off with tablet medication(s) when they are first diagnosed with Type 2 diabetes. Depending on the blood sugar level and the degree of overall blood sugar control (measured by HbA1c), more tablet medications

may be added to improve diabetes control. Blood sugar management should be achieved in conjunction with lifestyle changes, ie. diet modification, regular exercise, and weight reduction if overweight or obese.

As insulin production from the pancreas continues to decrease with increasing years of Type 2 diabetes, up to 40 percent of individuals may need insulin injections by the time they have 10 to 15 years of diabetes.

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