Overview
Diabetes means having too much sugar in the blood. The food we eat is broken down into glucose. In a normal person, insulin (manufactured by an organ called the “pancreas”) acts on cells throughout the body to stimulate uptake, utilization and storage of glucose. People who are diabetic do not produce enough insulin or the insulin produced does not work well. As a result, sugar builds up in the blood, causing diabetes.
Diabetes is one of the top 10 chronic diseases. Diabetes can affect people of any age. 90 percent occur in people over 40 years of age. The risk factors include:
- Family history of diabetes
- Being overweight
- Sedentary lifestyle
- Above 40 years old
- Past history of diabetes during pregnancy
- Type 2 diabetes is more common in Indians and Malays
- Impaired glucose tolerance or impaired fasting blood glucose level (pre-diabetes state)
- Viral infections that have damaged the pancreas
There are two main types of diabetes.
Type 1 Insulin-Dependent Diabetes: This is the less common type and usually occurs in young people. The pancreas is not able to produce insulin. When there is no insulin, the body is unable to store glucose in the cells. This causes the blood glucose to build up and leads to an impairment in metabolism.
Type 2 Non-Insulin Dependent Diabetes: About 80percent belong to this group. The body produces insulin but this is not effective. The cells are resistant to the insulin, hence blood sugar rises.
Some women develop diabetes during pregnancy. This is called gestational diabetes and usually resolves after the birth of the child. In some women gestational diabetes predisposes the person to diabetes.
There is currently no cure for diabetes. However, diabetes can be controlled and its complications can be prevented.
Some diabetics do not present with any symptoms and is only picked up during a routine health check with the GP. Some may experience one or more of the following symptoms:
- Frequent passing of urine
- Excessive thirst
- Weight loss despite eating well
- Tiredness and weakness
- Delayed healing of wounds
- Skin Infections
- Numbness and reduced sensation in the hands or feet
- Blurred vision
If you are over 40, check your blood glucose at least once a year. If you have any of the above risk factors or signs and symptoms consult your GP.
Uncontrolled diabetes may lead to complications. These can be classified into two main groups- acute and chronic complications:
| Acute Complications |
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When there is not enough insulin to convert glucose into energy, the body uses fat as an energy source and this results in production of ketones which is harmful to your body. This is a serious condition and requires immediate medical attention. The symptoms include thirst, passing large amounts of urine, nausea, vomiting and abdominal pain.
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| Hypoglycaemia |
This occurs if a diabetic does not eat after taking diabetic medication, does not eat before exercise, or if the diabetic medication dosage is too high. You need to recognise the symptoms early and quickly consume food that is high in such as plain sugar, sweets, honey, soft drinks, or glucose tablets. The symptoms include irritability, confusion, tremors, profuse perspiration, rapid heartbeat, and feelings of hunger.
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Persistently high blood glucose levels can cause poor blood flow to many organs. This may lead to many serious complications such as blindness, high blood pressure, heart attack, stroke, kidney failure, impotence, infections with poor healing, numbness of hands and feet, and delayed healing of wounds.
- Diet modification
- If diet modification and diet planning do not control your diabetes, your GP will prescribe tablets
- Insulin injections may be added to help improve blood sugar control
- Well balanced healthy diet - take small frequent meals that consist of low fat, sugar but contain enough complex carbohydrates (e.g. wholemeal bread, brown rice, pasta, noodles). Also include in your daily diet different groups of food such as vegetables, lean meat, fish or fruits
- Maintaining a healthy weight
- Take your diabetic medication as prescribed
- Know your blood pressure level. Maintain blood pressure below 130/ 80 mmHg
- Know your cholesterol levels. Maintain desirable levels as advised by your doctor
- Go for yearly feet screening with a podiatrist
- Go for annual eye screening with an eye specialist
- Exercise regularly - this enhances insulin action and helps your body use glucose more efficiently
- Quit smoking - smoking increases the risk of heart disease, especially in a diabetic
- Home blood glucose monitoring - learn how to monitor your own blood glucose level and take necessary action when required
Should your condition require specialist attention your GP doctor may make an appointment with Raffles Hospital. Alternatively please visit our Family Medical Centre at Raffles Hospital for a consultation.