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Diabetes
What is Diabetes?
Diabetes is a chronic condition characterised by raised blood glucose level over a prolonged period of time). Diabetes occurs when the pancreas loses its ability to produce enough insulin (a hormone that regulates glucose), or when the body does not respond to insulin action (also known as “insulin resistance”).
When blood glucose level increases after we eat, the pancreas secretes insulin to help body cells convert glucose into energy or to store it. In diabetes, instead of the glucose being converted to energy, glucose remains in the bloodstream and leads to a higher-than-normal blood glucose level.
Diabetes increases the risk of cardiovascular diseases (heart diseases and stroke), which are often associated with high blood pressure, high cholesterol levels and obesity.
There are two main types of diabetes:
- Type 1 diabetes occurs when no insulin is produced, most commonly caused by an abnormal immune reaction in the body that damages the insulin-producing cells. It is the most common cause of diabetes in young people and children. People with this type of diabetes require daily insulin injection to survive.
- Type 2 diabetes occurs when the body does not respond to insulin action. Disease onset is usually gradual as the insulin-producing cells slowly die off from working overtime to overcome the “insulin resistance”. While type 2 diabetes usually appears after age 40, it may also appear much younger in the setting of obesity or strong family history and can be exacerbated by unhealthy diet and lack of physical activity.
Other types of diabetes:
- Gestational diabetes mellitus (GDM) occurs in 2-5% of pregnant women who are not previously diagnosed with diabetes, and is often associated with type 2 diabetes later in life.
- Steroid-induced diabetes mellitus is caused by prolonged or high dose steroid use for other unrelated conditions. Usually occurs in people who are already at high risk for type 2 diabetes.
The most common symptoms include (usually more than 1 symptom occur):
- Frequent urination day and night
- Thirst, even after drinking plenty of water
- Constant hunger
- Weight loss despite normal appetite
- Feeling tired or weak constantly
- Itchy skin / rash around the genitals
- Blurred vision
- Numbness in the hands and feet
- Poor wound healing
For all types of diabetes:
- Maintain a balanced and healthy diet: avoid food high in fats and cholesterol, increase intake of fruits and vegetables, and watch your sugar consumption
- Exercise regularly
- Maintain a healthy weight
Type 1 diabetes:
- Usually require multiple doses of insulin injection daily
Type 2 diabetes:
- Treatment would involve oral medications in the early stages
- A weight reducing injection may be added if you also have obesity
- Insulin may be required in later stages or if you develop kidney diseases or have underlying liver diseases
Gestational diabetes:
- Usually with multiple doses of insulin
- Close monitoring and frequent insulin adjustment may be required as you progress in the pregnancy
- Treatment can usually be stopped after delivery, but regular screening for type 2 diabetes is usually recommended
- Early check-up is recommended for subsequent pregnancies
Steroid-induced diabetes:
- Usually require insulin, but both oral medications or insulin may be used depending on severity
- Treatment needs to be adjusted with changes in dosage of the steroid
- Eye complications including diseases of the retina, cataracts and glaucoma. Blindness may result in severe cases.
- Kidney disease. Dialysis or kidney transplant may be required in end-stage kidney failure.
- Nerve diseases such as numbness and pain in legs, toes and fingers. Complete loss of sensation may result in affected limbs.
- Foot diseases including blisters and non-healing wounds. Gangrene may result, in which case amputation may be required.
- Heart and blood vessels diseases such as coronary heart disease, stroke or diseases of the arteries in the legs, which may result in gangrene.
- Susceptibility to infections (especially bacterial and fungal skin infections).