Female doctor do blood sugar test for elder patient
DIABETES is the highest risk factor that contributes to Covid-19 fatality.
According to Pantai Hospital KL consultant physician and endocrinologist and diabetes specialist Dr Shalini C. Sree Dharan, patients with diabetes mellitus suffer increased severity of the effects of Covid-19.
Diabetics’ high glucose level reduces their recovery from infections, including Covid-19, says Dr Shalini.
“They require hospitalisation and even intensive care because of their underlying diabetes condition.
“They are prone to inflammation as their high glucose level predisposes them to infections. This is worsened due to their weakened immune system.
“The high glucose level reduces their recovery from infections, including Covid-19,” she said.
Even without Covid-19, people with diabetes are susceptible to health complications, she added.
Data from a 2015 study showed that:
> 50%-80% of diabetics die of cardiovascular disease.
> 44% of new kidney failure cases are observed in diabetics.
> 16% of diabetics aged over 65 years die of stroke.
> 29% of diabetics aged over 40 years have diabetic retinopathy.
Coronary artery disease accounts for two-thirds of deaths associated with diabetes, says Dr Lee.
Dr Shalini was one of the three speakers at a recent webinar titled “Oh My Sweetheart! Who is the Culprit? Heart, Kidney or Pancreas?” organised by Star Media Group, and supported by pharmaceutical company Boehringer Ingelheim.
To a question by moderator Douglas Lim, the actor and comedian, fellow speaker Dr Lee Zhen-Vin said a diabetic was two to four times at risk of developing heart disease.
The Universiti Malaya Medical Centre and Universiti Malaya Specialist Centre consultant interventional cardiologist also said that coronary artery disease accounted for two-thirds of deaths associated with diabetes.
Citing the National Cardiovascular Disease Database, Dr Lee said about 50% of patients admitted to hospital for heart attacks had diabetes, while the Malaysian National Heart Failure registry indicated that 59% of patients admitted for heart failure had diabetes.
He said coronary angiograms showed that diabetics were likely to suffer more severe disease, and often times involving multiple arteries.
“Diabetes can lead to heart failure either directly, or through the process of worsening of coronary artery disease.
“The bigger problem is that people with diabetes are also more likely to have other conditions that raise the risk of heart disease.
“This includes high blood pressure and high levels of blood cholesterol,” he said.
We are in the world’s top five for diabetes as the cause of kidney failure, says Dr Yew.
Dr Lee highlighted that a 2019 survey revealed that close to five million people in Malaysia were prediabetic and this was a major problem as the increment in risk of developing cardiovascular diseases started at the stage of prediabetes.
Mahkota Medical Centre consultant nephrologist and physician Dr Yew Shiong Shiong said the kidney was not spared by diabetes.
“Unless patients go for a blood or urine test, they probably don’t know that their kidneys are damaged,” he said, adding that most times the signs and symptoms would only show when up to 90% of the kidney is damaged.
“For Malaysia, we are currently among the world’s top five for diabetes as the cause of kidney failure,” he added.
Dr Yew said each year there were 7,000 to 8,000 new dialysis patients in Malaysia, and 66% of their kidney failure was due to diabetes.
“Diabetes can cause heart problems which can cause death. In the case of kidney failure, you don’t die as fast but you need dialysis for many years,” he warned.
In a question-and-answer session, Dr Shalini said there was no absolute cure for diabetes but with intensive lifestyle and dietary restrictions resulting in weight loss, patients might experience diabetes remission.
Dr Yew advised diabetics to accept that they have the disease, have a good diet and adopt a healthy lifestyle, besides keeping up with medication.
Dr Lee highlighted the importance of understanding the disease and its complications.
He advised people to go for blood tests and check for diabetes regularly, ensure that their blood pressure is optimal, maintain good cholesterol levels and for smokers to quit.
The “For Your Sweetheart” campaign is a nationwide public awareness and education campaign organised by the Malaysian Endocrine and Metabolic Society (MEMS) and Malaysian Diabetes Educators Society (MDES), supported by Boehringer Ingelheim, to educate the public, especially those living with diabetes, about the link between diabetes and heart diseases, and to highlight on the importance of its early detection which saves their lives. For more information, go to www.foryoursweetheart.my
Free diabetes screening is ongoing until December 2021, and everyone is encouraged to register for the free screening at the campaign microsite.
