Many Malaysians are still oblivious as to how diabetes is diagnosed.
Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders in which the pancreas no longer produces enough insulin, or the cells stop responding to the insulin that is produced, resulting in glucose in the blood that cannot be absorbed into the cells of the body.
This causes excessive urine production, excessive amounts of sugar in the blood and urine, thirst, hunger and weight loss, among others.
Left untreated or poorly controlled, diabetes can lead to further health complications, even death.
Diabetic patients have two to three times higher risk of stroke and chronic kidney disease, 10 times higher risk of foot ulcers – every 30 seconds a lower limb or part of a lower limb is being amputated, and one in 14 patients are at risk of becoming blind due to damage to the eyes (diabetic macular oedema).
According to data from the International Diabetes Federation, every eight seconds, someone dies as a result of diabetes.
However, 50% of type 2 diabetes cases are preventable.
You may have heard that eating too much sugar causes diabetes. Or maybe someone told you that you have to give up all your favourite foods when you’re on a diabetes diet.
Here are the facts to dispel some of the fiction surrounding diabetes.
If you have diabetes mellitus, you can never eat sweets.
The cells in your body require glucose as it is the energy source of life. It is a common myth that if you have diabetes, then you must avoid sugar. Eating more sweets doesn’t cause diabetes, and the amount of sugar you can consume will depend on the type of diabetes you are suffering from.
In the case of type 2 diabetes, you must keep everything in moderation as there should be a portion of sugar along with vegetables, whole grains and lean protein as what is recommended in the Ministry of Health’s quarter-quarter half diet.
However for type 1 diabetes (autoimmune condition and patients are insulin-dependent), the dose of your next insulin depends on the sugary carbohydrates you have consumed.
Reading food labels is good way to control what you are eating and it’s best to avoid anything that has more than 8gm of sugar per serving.
Glycemic index is a number which allows you to differentiate the slower-acting “good carbs” from the faster-acting “bad carbs”. Opting for food items that have a low glycemic index is also another way to help keep your blood sugar in check.
Only obese people are likely to suffer from diabetes.
This myth is partially true as having metabolic syndrome (a cluster of conditions that occur together i.e. increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglyceride levels) increases your risk of heart disease, stroke and type 2 diabetes.
Other factors like genes, age and ethnicity play a major role in determining one’s risk of potential diabetes, which is prevalent among Indians (24.9%), Malays (16.9%) and Chinese (13.8%). If you are genetically predisposed to diabetes genes, it might be harder to avoid the disease, despite keeping yourself trim.
People with diabetes always need insulin and taking insulin means you have failed in managing the disease.
People with type 1 diabetes usually need insulin for life. However, type 2 diabetes can be managed with oral medication and/or insulin, along with a healthy diet and regular exercise.The point is to get your blood glucose levels within normal targets (fasting 4.4–7.0 mmol/ L and post-meal 4.4 -8.5 mmol/L).
As type 2 diabetes is a progressive illness, the majority of those afflicted will eventually need insulin over time, and this should not be regarded as a failure.
Insulin injections hurt and can cause dangerously low blood sugar.
Using small, fine needles and changing them after every three injections can prevent a painful situation. Learning the right technique and regular monitoring of blood glucose can prevent hypoglycemic episodes such as anxiety, shaky hands, sweating and an urge to eat.
Recognising the symptoms and consuming simple life savers like a sweet drink or 15gm of carbohydrates can quickly reverse the situation.
Insulin is difficult to take and causes weight gain.
Currently, it is very easy to self-administer insulin, which is available in the form of portable pen injectors. It doesn’t require refrigeration once opened, and there are various regimes which can be adjusted according to the individual’s needs. It can also be used discreetly, some just once a day.
Insulin therapy itself does not induce weight gain but some patients with type 2 diabetes may gain weight (which may be transient) after starting insulin therapy because if they are responding to the treatment, the body begins to process blood glucose more normally, leading to weight gain.
This is one reason unexplained weight loss can be an early symptom of diabetes.
Oral medications are better than insulin.
Oral medications such as metformin, are very safe and great when it comes to lowering blood glucose levels. However not all patients respond well to just oral medications, especially those who have poorly controlled diabetes, kidney impairment or failure, or heart failure as a result of the complication of diabetes. This group of patients will benefit from insulin more as it is fairly safe.
You cannot exercise if you have diabetes.
Incorporating exercise in your daily routine is an excellent way to help control diabetes. The five best exercise recommended for diabetes are:
- Brisk walking – 150 minutes a week and/or at least 90 minutes a week of vigorous aerobic activity, plus at least two sessions per week of resistance exercise.
- Tai Chi – provides significant improvement in blood glucose control while increasing vitality, energy and mental health
- Yoga – helps incorporate fluid movements that build flexibility, strength and balance. It lowers stress and improves nerve function, leading to an increased state of mental health and wellness. Yoga also improves blood glucose levels due to improved muscle mass.
- Dancing – remembering dance steps is a form of brain exercise. As a physical activity, dancing promotes weight loss, improves flexibility, lowers blood glucose and reduces stress. A mere 30 minutes of dancing will result in a 70kg adult burning up to 150 calories.
- Swimming – stretches and relaxes the muscles and doesn’t put pressure on the joints, which is great for those with diabetes. Studies shows that swimming improves cholesterol levels, burns calories and lowers stress levels.
All in all, shedding 5% to 10% of your body weight can help slow or stop the progression of type 2 diabetes.
You cannot get pregnant if you are diabetic.
A diabetic woman can get pregnant. It is also possible for her to deliver healthy babies if there is a tight control over the blood glucose levels before and during pregnancy. During pregnancy, diabetic patients will be treated with insulin. This does not cause any harm to the baby.
Therefore, its recommended that you take enough precautions before conception, as poorly controlled diabetes can result in your baby having birth defects, some of them lifelong conditions.
High blood sugar levels can harm your baby in the first few weeks of pregnancy, even before you discover you are pregnant!
You will need dialysis if you are diabetic.
For a diabetic patient, kidney impairment is a long term complication. As we know, diabetes is a progressive disease, hence the blood vessels of the kidneys are damaged over time and they cannot filter the blood as they used to.
If left untreated for long, there are high chances of kidney failure. In such cases, you will require dialysis to clean your blood stream. However, if you can control your diabetes properly, this risk can be delayed for quite some time.
There are many diabetic patients who never had to resort to dialysis in their lifetime.
It’s possible to “cleanse” diabetes with detoxes, traditional medicines or supplements.
There is no cure-all diabetes cleanser. While it’s tempting to fall prey to these products that claim to act as a “wonder drug”, there’s no scientific proof of their effectiveness.
On the contrary, in view that herbal supplements are not regulated by the United States-based Food and Drug Administration, it is difficult to know the exact content in each tablet.
These therapies might result in long term side effects such as kidney failure. It’s best to stick with well-researched medicines that have been prescribed by your doctor and put your money to good use by spending it on healthy food.
Dr Shalena Nesaratnam is a consultant physician and endocrinologist. For more information, email firstname.lastname@example.org. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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