UNDERSTANDING DIABETES MELLITUS

 by Ms Lavanya a/p Balakrishnan_KPJ Penang Pharmacist, Pharmacy Services. 

A recent survey showed that an estimated 3.9 million Malaysians aged 18 and above are suffering from diabetes, said Health Minister Datuk Seri Dr Adham Baba. Nearly one in five Malaysian adults has diabetes and the prevalence rate spike from 13.4% in 2015 to 18.3% in 2019. During the launching of the National Health and Morbidity Survey (NHMS) 2019, the Health Minister said non-communicable diseases (NCD) such as diabetes and their risk factors are on the rise.

What Is Diabetes?

People with type 2 diabetes mellitus are unable to make enough insulin to meet the body’s needs or are unable to normally respond to the insulin they produce. When this happens, sugar levels build up in the blood. Over time, complications of high blood sugar may damage your eyes, kidneys, nerves and blood vessels.

Risk Factors for Diabetes

You are at risk of developing diabetes if you are:

●       Overweight

●       45 years old and above

●       Having family history of diabetes

●       Having Less physical activity

●       Having Poor diet control (high sugar and carbohydrate intake)

Signs & Symptoms of diabetes

If you have some of these signs and symptoms, your doctor may suspect you have diabetes mellitus:

●       Increased thirst

●       Increased hunger

●       Fatigue

●       Increased Urination, especially at night

●       Blurred vision\

Consequences of diabetes

Once diabetes mellitus is diagnosed, immediate lifestyle and diet modifications need to be done to control blood sugar level. Oral medications and insulin can also be initiated if blood sugar are very high. Nevertheless, patients with uncontrolled blood sugar levels over the years may develop complications that are related to diabetic tissue damage. About one in five people diagnosed with type 2 diabetes, eventually will develop retinopathy conditions where it impairs vision. So annual eye examination is very crucial for everyone with diabetes.  Besides, diabetes affects the nerves in the feet and legs, commonly known as diabetic neuropathy. It is generally mild and associated with a loss of feeling which goes unnoticed. Combined with poor circulation, neuropathy can lead to foot injury, foot infection and foot ulcers. In addition, diabetic nephropathy is also associated with type 2 diabetes. It affects kidney functions by reducing the ability to filter, and may cause protein to leak in the urine. So it is encouraged to take an annual protein urine analysis to monitor kidney function.

Two main ways to monitor blood glucose

Check HbA1c                                        

The haemoglobin(Hb) A1c test is a more accurate and meaningful test for determining overall diabetes control. It reflects the average blood sugar value over the last two to three months. The ideal goal for people with diabetes is less than 7%.

Self- Monitoring of Blood Glucose

It is a valuable tool in managing diabetes. All diabetic patients are recommended to have self-monitoring devices to make obtaining and monitoring normal levels of blood glucose at all times is achievable.

Treating type   2 diabetes

Diabetes does not have to affect your wellbeing, prevent you from doing things or interfere with your job. Unfortunately, diabetes is forever but when it is properly managed you can have a healthy life and protect yourself against negative long term effects. There is presently no cure for diabetes, but it can be treated in three ways by controlling diet and exercise, oral medications and lastly insulin injections. 

 Simple steps to maintain good management of type 2 diabetes

●       Regular Exercise                    

●       Proper Healthy Diet

●       Stop Smoking & Alcohol

●       Comply to medications

●       Test your own blood sugar regularly

REFERENCES:

1. National Health and Morbidity Survey 2019. Available at http://www.iku.gov.my/nhms/. Accessed February 2021.
2. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care.2020;43(Suppl 1):S1-S212.
3. Ministry of Health Malaysia. Clinical Practice Guidelines: Management of diabetic foot (2^nd edition). 2018.
4. Ministry of Health Malaysia. Clinical Practice Guidelines: Management of Diabetes Mellitus (6^th Edition). 2020

** Importance of Annual Health Screenings: Health screenings can be a routine visit to the doctor but these routine visits can be of utmost importance in maintaining your health.

**Do Healthy Individuals Need Full-Body Checks? : As counter-intuitive as it may seem, anyone, however healthy they might be, need regular health check-ups. Medical experts suggest that a full-body screening is essential for everyone, however old or fit they might be.

For Medical Screening you can do an appointment with our wellness centre ( +6045486688 ext: 1709) or  Internal medicine clinic (General Physician) (Internal medicine for Health screening) 

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