'Will diabetes drugs damage my internal organs?'

Misperceptions or false information about diabetes can adversely affect a patient's management of their condition, resulting in potentially avoidable complications. — AFP

Quitting sweet and starchy foods will make it easier to control blood sugar levels, but is unlikely to be sufficient to control diabetes by itself.

It is not fake news that the number of people with diabetes is increasing.

In 2000, there were 151 million people with diabetes worldwide.

That number is expected to reach or exceed 552 million people by 2030.

According to the 2019 National Health and Morbidity Survey (NHMS), there were an estimated 3.9 million adults aged 18 and above with diabetes – that’s about one in five Malaysian adults.

Nearly half (49%) of these people had never been examined for or diagnosed with diabetes prior to the survey.

It is important to detect the disease early as patients can start to manage it earlier and potentially prevent or delay the serious complications of diabetes.

These complications can affect multiple organs in the body, including the heart, nerves, eyes and kidneys.

There are a multitude of sources that claim to provide information about diabetes.

However, not all of them are accurate.

The fear is that any misrepresentations or false information may lead to suboptimal treatment of the condition, and even potential harm to patients.

Here are some of the common questions I have been asked by my diabetic patients:

Is it true that the more expensive the blood glucose-lowering medication or drug is, the better it is?

Not necessarily so. There are good medications that are cheap as well, but the choice of medication is always individualised.

This means that there are some medications that are better for certain groups of patients.

For example, there are medications that are more suitable for overweight or obese patients, and some that are more suitable for patients who have a history of heart disease or stroke.

To get the best advice on the most suitable medication, you can consult an endocrinologist, who is a medical doctor specialising in hormone-related diseases.

The endocrinologist will take a proper medical history and conduct a complete examination before giving you the required advice.

Do diabetic medications like metformin damage the internal organs?

This is a common misconception among the public, that medications hurt or damage the internal organs.

It is not the price of the drug that determines how well it works, but how suited it is for the individual's condition. — Photos: Filepic

This has unfortunately led to many patients stopping essential medications by themselves, without the knowledge or against the advice of their doctors.

The truth is that poorly-controlled diabetes is what leads to damage to the internal organs, e.g. kidney failure.

Medications like metformin actually help to control blood glucose levels, thus preventing deterioration of the internal organs.

This is why it is important to detect diabetes early and start treatment as soon as possible.

When the diabetes is too advanced and the internal organs have already been damaged, some medications may no longer be suitable for the patient, thus limiting their treatment options.

Can I increase the dose of my diabetes medications on my own and reduce the dose when my blood glucose is stable?

It depends on the type of medication.

For example, if a patient is on insulin treatment, the dose of insulin can be adjusted based on the carbohydrate content of their meal and increased if necessary.

However, it is imperative to get advice and education from your doctor before making such decisions.

Do I need to take the blood glucose-lowering drugs for the rest of my life?

Type 2 diabetes mellitus is a chronic disease, and the ability of our pancreas to carry out its normal functions will deteriorate with increasing age (like all our other organs).

Therefore, it is likely that a patient with type 2 diabetes will need to be on long-term treatment.

Are health products better than blood glucose-lowering drugs?

Blood glucose-lowering drugs have gone through years and years of extensive non-clinical and clinical research, and safety testing, before being approved to treat patients with diabetes.

On the other hand, many “health products” do not have robust or established research data on their long-term health benefits.

If you wish to take such a product, it should be with the mindset that it is a complementary supplement, and not the sole treatment for your diabetes.

If in doubt, please consult your endocrinologist for more advice.

Can I eat as much sugar-free food as I like?

At the end of the day, balanced meals are the key to a healthy diet.

It is crucial to watch the quantity of food you take in and maintain a healthy weight.

Advice from a trained dietician can be helpful in guiding your food choices.

Will taking insulin for a long time cause stroke or blindness?

No. Insulin is one of the treatment options for diabetes.

If the disease is well-controlled, the risk of developing complications from diabetes is reduced to a significant degree.

In fact, it is poorly-controlled diabetes that leads to complications like stroke or blindness.

Can I control my diabetes by quitting sweets and starchy foods?

One of the ways diabetes mellitus can be controlled – in addition to medications – is by controlling your diet.

It will be easier to control your blood glucose levels if you reduce your intake of unhealthy sweets and carbohydrates.

However, there are various factors that contribute to poor or inadequate control of diabetes.

Thus, it would be best to regularly consult your endocrinologist to get an individualised opinion on the best management plan for your condition.

Dr Chooi Kheng Chiew is a consultant endocrinologist. For more information, email [e-mail]. 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.