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Diabetes Mellitus

What is Diabetes?

Diabetes is one of the chronic diseases which poses a large problem in many countries in the world. In Malaysia, a survey in 2011 has indicated that there are more than 3 million Malaysians with diabetes..

Diabetes is a condition when your blood sugar level is higher than normal. It is one of the main risk factors for heart attack and stroke.

Diabetes occurs when the pancreas in the body does not produce insulin or the body cannot use its own insulin effectively. The food we eat is turned into sugar in our body. Insulin is used to bring the sugar in the blood stream into the cells and tissues where it is used for fuel.

When there is a lack of insulin, the sugar cannot be transported into the cells and tissues and hence the amount of sugar in the body is raised.

This will harm the cells that need glucose for fuel and also harm certain organs and tissues exposed to the high glucose level.

Types of diabetes

There are two main types of diabetes :

  • Type 1 – Diabetes or Insulin Dependent Diabetes Mellitus
    • usually occurs in children and young adults.
    • unable to produce insulin, characterised by an absolute lack of insulin.
  • Type 2 – Diabetes or Non-Insulin Dependent Diabetes Mellitus
    • most common type of diabetes and accounts for more than 90% of all people with diabetes.
    • common in older people and who are overweight.
    • characterised by relative, lack of insulin or resistance of tissues to insulin

However there is another group of people who are at the borderline of becoming diabetic, known as the Impaired Glucose Tolerance or IGT group.

What are the warning signs of diabetes?

Diabetes, in particular type 2 diabetes is often a silent disease in the beginning. However the commonly experienced symptoms are :

  • Excessive thirst
  • Fatigue
  • Weight loss
  • Blurred vision
  • Muscle weakness
  • Itching

Other symptoms include :

  • Prolonged skin infections
  • Delayed wound healing
  • Urinary symptoms e.g. frequent urination
  • Itchiness at the private part
  • Numbness

Do not depend on the presence of symptoms to know you are diabetic. Get tested at your nearest healthcare facility.

Who are at higher chance to get diabetes?

Anybody at any age can get diabetes. However, the following increase your chances of getting diabetes :

  • Age 35 years or older. The older you are, the greater your risk of diabetes.
  • Overweight/obese. The more overweight you are, the greater your risk of diabetes.
  • Impaired glucose tolerance (IGT).
  • Family history of diabetes.
  • History of diabetes during the last pregnancy.
  • History of big baby (birth weight 4.0kg or more).
  • Hypertension.
  • Physical inactivity – sedentary lifestyles.
  • Nutritional factors – high intake of fatty food and low intake of dietary fibre poses a risk for diabetes.
  • High fat level/high cholesterol.

If you think that are you are at higher chance of getting diabetes, contact your nearest healthcare facilities.

Complications of diabetes

Diabetes is a chronic condition and can affect many organs depending on blood sugar control. Without proper management it can lead to various complications such as cardiovascular disease, kidney failure, blindness and nerve damage. Emergency conditions :

  • Hypoglycaemia is when your blood sugar level is very low in the blood. You will experience headache, feeling giddy, poor concentration, tremors of hand and sweating. You can faint or have a seizure if your sugar level is too low.
  • Diabetic Ketoacidosis is a serious condition when your sugar level is very high (this usually means there is complete lack of insulin or a relative lack of insulin). It can also be precipated by infective stress, trauma , using medication or following medical admissions like stroke and heart attack. You will experience drowsiness and unconciousness.
  • Hyperglycaemia is when your blood sugar level is very high. You will experience drows iness and may become unconscious.

Prolonged high blood sugar (chronic)

  • This causes long term damage to :
    • Eye
      • Cataract, bleeding in the eyes leading to blindness
    • Nerve
      • Numbness or loss of feeling in the hands and feet which can result in injuries without realizing it. Foot ulcer and gangrene can result from this and may lead to need for foot amputation to prevent spread of infections to the rest of the body.
    • Brain
      • Stroke
    • Kidney
      • Kidney failure
    • Heart
      • Heart attack

The good news is that good control of diabetes will help prevent or delay the above complications.

What should I do if I’m diabetic?

Good diabetes control means keeping your blood sugar levels close to normal. This can be achieved by a combination of the following :

  • Control your diet
    • Take a well-balanced diet as excessive food will increase your blood sugar level
  • Do Physical Exercise
    • Exercise lowers blood sugar and helps insulin work more effectively. Exercise will also help you to lose weight.
  • Medication
    • If you are a type 1 diabetes you will require insulin injections.
    • If you are a type 2 diabetes, you may require oral hypoglycaemic drugs to lower your blood sugar and some may need insulin injections.

Even if you are diabetic, you still can lead a normal and active life.

You can take care of yourself

  • General self care :
    • Skin Care
      • Bathe everyday
      • Dry all parts of the body thoroughly
      • Treat cuts and scratches at once
      • See your doctor if wounds do not heal after 2- 3 days.
    • Foot Care
      • Wash your feet everyday
      • Dry the feet well especially between the toes
      • Examine your feet daily for any cuts, scratches, blisters, sores or any change in colour
      • Trim your toe nails straight across
      • Change your socks every day
      • Do not walk barefoot
      • Always wear soft shoes that fit well, outdoors.
  • Self monitoring
    • You are encouraged to do Self Blood Glucose Monitoring (SBGM). Regular blood glucose monitoring is the only way to know how well you control your diabetes.
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  • Dental Care
  • Regular eye-check-ups
  • Avoid alcohol
  • Stop Smoking

What I should do to avoid getting diabetes?

Diabetes can be prevented by practising a healthy lifestyle :

  • Eating healthily helps to control blood sugar levels, maintain body weight, control high cholesterol, reduce high blood pressure, and prevent heart disease.
  • Exercise helps improve fitness, burn calories and thus reduce body fat and control your weight. Exercise lowers blood sugar and helps your body to utilise blood sugar efficiently.
  • Studies show obesity is associated with diabetes. Maintain your ideal body weight.

Support groups

  • Persatuan Diabetes Malaysia (PDM)
  • National Diabetes Institute (NADI)
  • National Kidney Foundation (NKF)
  • EMKAY (Yayasan EMKAY)

Click here to evaluate your health risk!!!

Last reviewed : 26 April 2012
Writer : Dr. Fatanah Ismail
Reviewer : Dr. Sunita a/p Bavanandan