Diabetes - General Information

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Diabetes is a condition which results when a person's body doesn't make any insulin, enough insulin, or doesn't use insulin the right way. Insulin is a hormone made in the pancreas gland that helps your cells use blood sugar for energy. When insulin is in short supply, the glucose (sugar) in the blood can become dangerously high. Someone who is diabetic may have to take insulin by injection, or pills by mouth to help the body secrete more of its own insulin or make better use of the insulin it does secrete. Some diabetics, however, require no medication. All persons with diabetes must follow a controlled diet and exercise regularly to prevent their blood sugar from getting too high.

Types Of Diabetes - There are many forms of diabetes.

The 3 most common types are:

Type 1

5-10% of all diabetics.

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

Type 2

90 - 95% of all diabetics. This form of diabetes usually develops in adults aged 40 years and older and is most common in adults over age 55. Unfortunately, as more children and adolescents become overweight, Type 2 diabetes is becoming more common in young people. The body produces insulin but it may not be enough or it may not work effectively.

Gestational Diabetes

2-5% of all pregnancies. This refers to diabetes first detected during pregnancy. Though it usually disappears after delivery, the mother is at increased risk of getting Type 2 diabetes later in life.

Who Gets Diabetes?

Anyone can get diabetes but the following factors may put you at higher risk of developing it:

Increasing age

In Singapore, Type 2 diabetes commonly affects those over 40 years old.

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 of diabetes

Type 1 & Type 2 diabetes have a genetic link. Your risk increases if your grandparent, parent or sibling suffers from diabetes.

Prior history of gestational diabetes
Delivering a baby over 4 kg (9 lbs)
Impaired glucose tolerance

Refers to a pre-diabetes state where levels of blood glucose concentration are above the normal range but below those that are diagnostic for diabetes.

Ethnic Group

For unknown reasons, Type 2 diabetes is more common in Indians and Malays.

How Can I Tell If I Have Diabetes?

Type 1 Diabetes

People with Type 1 Diabetes Usually Have Obvious Symptoms And Signs:

Increased thirst and urination
Constant hunger
Weight loss
Extreme tiredness
Blurred vision
In severe cases, lapsing into coma

Type 2 Diabetes

Most people with Type 2 diabetes may not be able to tell that they have diabetes. No early symptoms appear and the disease is only diagnosed several years after its onset, sometimes when complications are already present.

When their blood glucose gets very high (usually when the person is sick or under a lot of stress), signs may include:

Increased thirst
Frequent urination
Blurred vision
Dry, itchy skin
Poor wound healing

Is Diabetes Dangerous?

Untreated or uncontrolled diabetes can lead to serious complications.

The 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 people often injure themselves without realising it. The wounds are slow to heal and become infected easily.

The Complications of Diabetes are:

Coma or loss of consciousness
Eye disease & blindness
Kidney failure
Heart disease
Stroke
Nerve damage with loss of feeling or tingling sensations
Foot ulcers and amputations
Impotence

How Is Diabetes Treated?

Diabetes is a chronic disease. It can be managed but not cured.

However, 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 person with diabetes to live a normal life.

For Type 1 diabetes, treatment includes a carefully planned diet and exercise, home blood glucose monitoring and multiple daily insulin injections.

For Type 2 diabetes, treatment includes diet control, exercise, home blood glucose monitoring and in some cases, oral medication and/or insulin.

People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too low or too high.

Can I Prevent Diabetes?

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. Find out the healthy weight for your height and commit yourself to losing weight.

Adopting Healthy Eating Habits

Have regular and balanced meals everyday. Pay special attention to your food portion and frequency.
Include at least 2 servings of fruit, 2 servings of vegetables and 1 serving of whole grains in your daily meals.
Choose and prepare foods with:
less fat, especially saturated fat
less sugar
less salt and sauces.

Use the Healthy Diet Pyramid as a guide to planning your meals and to help you eat a balanced diet.

There are 4 Main Food Groups:

Rice and alternatives
Fruit
Vegetables
Meat and alternatives.

Your daily meals should include the largest servings from the rice and alternatives food group. This includes rice, noodles, pasta, cereal, porridge, chapatti, naan, idli, thosai, biscuits and potatoes. You may have heard people saying that these foods are fattening.

This is not true. It is the added fat and sugar that you need to be careful about. When choosing foods from this group, select more of the wholemeal and unrefined grain products.

Placed on the second level of the Pyramid are the Fruit and Vegetables food groups.

When Consuming These Foods:

Eat fruit with skin on, if the skin is edible.
Choose brightly-coloured fruit and vegetables as they contain more nutrients than the pale-coloured types.
Don't overcook the vegetables.

Meat & alternatives food group, placed on the third level of the Pyramid includes meat, poultry, fish, seafood, milk & milk products, beans & bean products, nuts and seeds.

When Choosing Foods from This Food group:

Use lean meat, skinless poultry and low fat milk & milk products.
Replace meat with beans, beancurds, lentil or dhal in your meals occasionally.
Choose fresh-cooked meat instead of preserved, canned or barbequed meats.

Placed at the tip of the pyramid is - fat, oils, salt and sugar which you should only use in small amounts.

Choose foods from all the four food groups and eat the recommended number of servings everyday.

Exercising Regularly

Engaging in regular physical activity is good for the prevention of diabetes. It uses up blood glucose and body fat, improves blood circulation and strengthens the heart.

Thus, it helps to control weight and improves insulin action. Walking, swimming, dancing, cycling and bowling are all good ways to exercise. Cleaning your house or gardening is also a form of physical activity.

If you have not engaged in a regular and vigorous physical activity before, check with your doctor.

Use the F.I.T.T. formula as a guide to help you plan an effective exercise programme.

To estimate your MHR, subtract your age from 220. For e.g. if you are 35 years old, your MHR is 220 - 35 = 185 beats per minute (bpm). 55-69% of this MHR is 102 - 128 bpm.

Do You Have Diabetes?

If you have any of the risk factors or any of the signs and symptoms of diabetes and especially if you have a family history of diabetes, consult your doctor to have your blood glucose checked.

If you are 40 years of age or older, see your family doctor for a blood glucose check. Repeat the test at least once every three years.

Diabetes-Risk Test

Are You at Risk?

Use the questionnaire below to assess your risk of getting diabetes. If you answered YES to any of the questions, you are at risk and should be tested for diabetes earlier or more often.

Do you have a grandparent, parent or sibling suffering from diabetes?
Are you overweight or obese (body mass index of 25 - 29.9 or 30+ respectively)?
Are you physically inactive (i.e. work out less than 3 times per week for at least 20 minutes per day)?
Are you the mother of a child who was over 4 kg (9 lbs.) at birth?
Do you have any of the symptoms of diabetes or have high blood pressure and/or high cholesterol?
Do you belong to Malay or Indian ethnicity?

Courtesy : Health Promotion Group of Singapore

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