Diabetes Related Q & A

1. I have same of the Symptom of diabetes such as thirsty frequent urination feeling hungry relating of the skin, but my fasting blood sugar is 5.5 and after breakfast is 6.6.

What May Be The Reason for These Symptoms?

A. These symptoms can have other causes besides Diabetes. Your blood tests show that it is not likely that Diabetes is the cause for your symptoms.

You should consult a Doctor who will ask you more questions, and may do other blood tests on your thyroid gland or on your calcium levels.

2. My cousin 64, highly overweight and suffering from chronic arthralgia, hypertension cardiovascular disease and Diabetes.

For last few months he is having occasional cramps in the leg while asleep.

Do You Think It Could Be Due to Diabetes? If So Why It Should Happen?

A. Leg cramps can occur in people with or without Diabetes, but are often more common in Diabetes patients.

It can be from the poor circulation, or from early damage to the nerves - both of which are more frequent in Diabetes.

3. It Is Said That Diabetic Patients Stand Bigger Chance of Suffering Renal Failure? Is It Correct? How?

A. It is correct that Diabetic patients have a very serious risk of renal damage and renal failure. Poorly controlled Diabetes leads to more renal infections. Hypertension (very common in Diabetics) may damage the kidney more easily. There is also problem with the blood vessels in the kidneys of Diabetics which lead to renal damage.

5. I have diabetes and I try to keep it controlled with diet exercise and oral anti-diabetics. Now I have got some teeth to extract and the dentist asks me to go there after controlling Diabetes.

Should I Take Insulin? I am 38 and is in good health.

A. If your diabetes is not controlled well enough by the diet, exercise and oral drugs - then you should start on Insulin. To assess if your diabetes control is good enough, the glycated Haemoglobin should be measured (Hb A1c). This gives a very good assessment of your diabetes control for the past 6 to 8 weeks.

6. It Is Reported That Once a Day Insulin Has Come to The Market.

How efficient is it? How it maintains sugar level for 24 hours at a stretch?

A. For some patients with Type 2 Diabetes on oral drugs, adding once a day insulin is enough to improve Diabetes control. But for the Type 1 Diabetic (truly Insulin Dependent) more than once a day is necessary.

You are probably referring to the new long acting insulins, Glargine (and Detemir - which should be available next year). These have been very popular in Europe, but are seldom used alone in Type 1 diabetics.

7. What Causes Gestational Diabetes? Is There Any Way to Know Who's Most Likely to Develop Gestational Diabetes?

A. Gestational Diabetes is the term for Diabetes that is discovered for the first time during pregnancy. During pregnancy, the mother and fetus require more insulin than in the normal non-pregnant state, and when this requirement is not met, the mother becomes diabetic. Screening for likely Gestational Diabetes is recommended in mothers who are relatively older, fatter, have a family history of Diabetes; or have a poor obstetric history.

8. What is Glycaemic Index. Why It Is Necessary to Determine Gi Of A Diabetic Patient to Be Operated Upon?

A. The glycaemic index for any food substance is the measurement of how much the blood sugar increases when a fixed quantity of that food is eaten. So the Glycemic index of 100 gm of ice-cream is much higher than 100 gm of whole meal bread. Patients with Diabetes should generally eat food with a lower glycemic index.

9. It is reported that alternated insulin intake such as insulin pills, insulin patches, inhaler, month spray etc. has been marketed.

How Useful and Effective Are These?

A. Insulin still is only marketed in injectable form. All these other forms of insulin are still in the experimental stages, and it may be several years before any of them become available.

10. Why Doctors Advise Diabetic Patients to Cut Carbohydrate Intake Considerably?

A. Diabetic patients should take a healthy balanced diet, take regular exercise, and maintain a healthy weight. The carbohydrate content should be about one-third of the total calorie intake.

11. Does Diabetes Run in The Family?

A. Yes - Diabetes tends to run in the family, and this is only partly genetic for most people, because people in the same family tend to have the same eating habits and exercise habits.

Submitted By:
Professor Lee Kok Onn
MB, MD, FRCP, FRACP
Head, Division of Endocrinology
Department of Medicine, National University Hospital

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