"Malaysia has the highest rate of diabetes in Asia and one of the highest in the world, probably next to Saudi Arabia, with 2.5 million Malaysians suffering from diabetes"
Datuk Dr Mustaffa Embong, National Diabetes Institute (Nadi) executive chairman.
What is Diabetes?
Diabetes is a chronic disease that occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces.
Insulin is a hormone made by the pancreas, that acts like a key to let glucose from the food we eat pass from the blood stream into the cells in the body to produce energy. All carbohydrate foods are broken down into glucose in the blood. Insulin helps glucose get into the cells. Not being able to produce insulin or use it effectively leads to raised glucose levels in the blood (known as hyperglycaemia). Over the long-term high glucose levels are associated with damage to the body and failure of various organs and tissues.
Types of Diabetis
|Type 1 diabetes|
It is usually caused by an auto-immune reaction where the body’s defence system attacks the cells that produce insulin. People with type 1 diabetes produce very little or no insulin. The disease may affect people of any age, but usually develops in children or young adults. People with this form of diabetes need injections of insulin every day in order to control the levels of glucose in their blood.
|Type 2 diabetes|
also known as adult-onset diabetes, and accounts for at least 90% of all cases of diabetes. It is characterised by insulin resistance and relative insulin deficiency, either or both of which may be present at the time diabetes is diagnosed. The diagnosis of type 2 diabetes can occur at any age. Type 2 diabetes may remain undetected for many years and the diagnosis is often made when a complication appears or a routine blood or urine glucose test is done. It is often, but not always, associated with overweight or obesity, which itself can cause insulin resistance and lead to high blood glucose levels.
|Gestational diabetes (GDM)|
a form of diabetes consisting of high blood glucose levels during pregnancy. It develops in one in 25 pregnancies worldwide and is associated with complications to both mother and baby. GDM usually disappears after pregnancy but women with GDM and their children are at an increased risk of developing type 2 diabetes later in life. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery.
Risk FactorsThe risk factors for type 1 diabetes are still being researched. However, having a family member with type 1 diabetes slightly increases the risk of developing the disease. Environmental factors and exposure to some viral infections have also been linked to the risk of developing type 1 diabetes. Several risk factors have been associated with type 2 diabetes and include:
- Family history of diabetes
- Unhealthy diet
- Physical inactivity
- Increasing age
- High blood pressure
- History of diabetes during pregnancy
- Poor nutrition during pregnancy
People with diabetes have an increased risk of developing a number of serious health problems. Consistently high blood glucose levels can lead to serious diseases affecting the heart and blood vessels, eyes, kidneys, nerves and teeth. In addition, people with diabetes also have a higher risk of developing infections. In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation.
Maintaining blood glucose levels, blood pressure, and cholesterol at or close to normal can help delay or prevent diabetes complications. Therefore people with diabetes need regular monitoring.
Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially.
- Increased thirst
- Frequent urination
- Extreme hunger
- Unexplained weight loss
- Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin)
- Blurred vision
- Slow-healing sores
- Frequent infections, such as gums or skin infections and vaginal infections
Type 1 diabetes cannot be prevented. However, it is advisable for Pre-diabetic, type 1 Diabetes, Type 2 Diabetes and Diabetes in pregnancy to follow the recommendations for a healthy diet for the general population:
Choosing water, coffee or tea instead of fruit juice, soda, or other sugar sweetened beverages.
Eating at least three servings of vegetable every day, including green leafy vegetables.
Eating up to three servings of fresh fruit every day.
Choosing nuts, a piece of fresh fruit, or unsweetened yoghurt for a snack.
Limiting alcohol intake to a maximum of two standard drinks per day.
Choosing whole-grain bread, rice, or pasta instead of white bread, rice, or pasta.
Choosing unsaturated fats (olive oil, canola oil, corn oil, or sunflower oil) instead of saturated fats (butter, ghee, animal fat, coconut oil or palm oil.
** Regular screening for early detection and prevention of diabetes and its complication is highly recommended
Treatment of diabetes
Diabetes knowledge, treatment, and prevention strategies advance daily. Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self- management is integral to the treatment of diabetes. Treatment must be individualized and must address medical, psychosocial, and lifestyle issues.
|Treatment of type 1 diabetes|
Lack of insulin production by the pancreas can make type 1 diabetes difficult to control. Treatment requires a regimen that includes a carefully calculated diet, planned physical activity, home blood glucose testing and multiple daily insulin injections.
|Treatment of type 2 diabetes|
Treatment includes diet control, exercise, home blood glucose testing, and in some cases, oral medication and/or insulin. Approximately 40% of people with type 2 diabetes require insulin injections.
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