Diabetes Decoded

TYPE 1, TYPE 2 AND STEREOTYPES BUSTED

Diabetes is a long-term condition in which the blood glucose levels of a person remain persistently higher than normal. It occurs when the pancreas does not produce enough insulin or when the body cannot effectively use insulin. Insulin is a hormone produced by the pancreas that allows your body cells to use blood glucose (sugar) for energy. People with diabetes are unable to fully use the glucose in their bloodstream due to either lack of insulin in the body or ineffective use of insulin.

There are two types of diabetes. Type 1 diabetes occurs mainly in children and young adults when the body produces little or no insulin. Type 2 diabetes is usually found in adults and it happens when the body does not use insulin properly (insulin resistance) or does not produce enough of it.


SINGAPORE SNAPSHOT

According to the National Health Survey 2010, Type 2 diabetes is the most common form of diabetes in Singapore. Amongst developed countries, Singapore is second only to USA in terms of diabetes prevalence. Figures from the National Health Survey 2010 reveal that 11.3%, or 1 in 9 Singapore residents (Singapore citizens and Permanent Residents) aged 18 – 69 years were affected by diabetes.

There are two groups of risk factors for diabetes – modifiable, where measures can be adopted to mitigate the risk; and unmodifiable, referring to factors that cannot be changed. Modifiable risk factors for diabetes include unhealthy diet, physical inactivity, obesity, high blood pressure and high cholesterol levels. Unmodifiable risks factors include family history of diabetes, increasing age and history of gestational diabetes (for women).

Individuals with these modifiable and/or unmodifiable factors are at higher risk of getting diabetes than the general population.  An individual is at risk of developing Type 2 Diabetes if he or she:

  • Has a parent or sibling with diabetes
  • Has a Body Mass Index (BMI) of 23.0 kg/m2 or higher
  • Has an inactive (sedentary) lifestyle
  • Has high blood pressure
  • Has abnormal blood cholesterol/lipid levels
  • Has a history of gestational diabetes
  • Is 40 years old and above
  • Has impaired glucose tolerance or impaired fasting glucose

SERIOUS COMPLICATIONS

Undiagnosed or poorly controlled diabetes can lead to serious complications. These include coronary heart disease such as angina and heart attack, stroke, eye disease, kidney disease, foot disease such as numbness, ulcers and even gangrene and amputation, and nerve disease, which can lead to problems such as impotence and diarrhoea.

Based on figures from the National Registry of Diseases, in 2014, about 1 in 2 heart attack cases had diabetes; 2 in 3 new kidney failure cases were due to diabetes; and 2 in 5 stroke cases had diabetes. There are over 1,500 amputations per year due to complications arising from diabetes, which is roughly 4 per day.


HERE’S THE GOOD NEWS… 

The good news is, Type 2 diabetes may be prevented or its onset delayed through the adoption of healthy lifestyle habits, mainly through exercise and diet. The importance of regular exercise cannot be overstated. We’re not talking about making the gym your second home or pounding the pavement every day at dawn. We’re talking about small incremental increases in physical activity, built into daily life, which can result in significant health benefits.

Eating a healthy diet is of paramount importance in the prevention and management of diabetes. A reduction in the intake of refined carbohydrates such as white rice, noodles and bread, saturated fats, sugar and high-calorie foods will generally lower the risk of diabetes, diabetic complications and a whole host of other health problems.

When eating in, it’s a good idea to go for healthier options under the Healthier Choice Symbol (HCS) programme. When eating out, seek out the healthier meal options that are available at more than 1,500 food and beverage outlets island- wide under HPB’s Healthy Dining Programme. In general, maintaining an ideal weight range for your height, race and body type is a good way to minimise your risk of developing diabetes, or manage your condition once it has been diagnosed.


TELLTALE SIGNS

Common symptoms of diabetes include:

  • Frequent thirst despite drinking lots of water
  • Constant hunger
  • Constant tiredness
  • Itchy skin especially around the genital area
  • Passing excessive urine during the day and night
  • Weight loss despite a good appetite
  • Poor healing of cuts and wounds

Any of these symptoms are cause for concern and should not be ignored. If you suspect that you may be at risk of developing diabetes for any reason, you should see a GP immediately.


SCREEN FOR SEEN AND UNSEEN SIGNS

In addition, regular health screening for diabetes is recommended once every three years for those aged 40 years or older. Regular health screening and follow-up with a doctor can help in early detection and better management of diabetes, which results in better health outcomes. At-risk individuals, such as those with a family history of diabetes, or who are overweight (BMI ≥ 23), should go for regular screening even if they are below 40 years old.

Screening for diabetes is available either at GP clinics and polyclinics. Subsidies for screening are available under HPB’s Screen for Life at participating Community Health Assist Scheme (CHAS) GP clinics. Eligible individuals with a Health Assist or Pioneer Generation (PG) card can benefit from the fully subsidised screening for chronic diseases under Screen for Life.


FIGHT THE GOOD WAR BY LIVING WELL

As you can see, there is much that can be done to prevent diabetes by modifying one’s lifestyle with regular exercise and healthy diet. For those at-risk individuals who are genetically pre-disposed to diabetes, the good news is that it can be managed.

A diagnosis of diabetes comes with a simple prescription to adopt a healthy lifestyle. And that’s good advice for all of us, at-risk of diabetes or not.


Information supported by Health Promotion Board.

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