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Is Diabetes just about sugars?

Type 2 diabetes is a problem in the way the body regulates and uses sugar (glucose) for energy.

Insulin is a hormone produced by the pancreas that lowers the blood sugar level. Being overweight and inactive are key contributing factors.

Type 2 diabetes is caused by problems of:

1. The body's response to insulin (sugar-regulating hormone).

a. Cells in muscle, fat and the liver are resistant and do not respond to insulin. Hence, cells cannot take in sugar from the blood, resulting in a constantly high blood sugar level.

2. The production of insulin by the body.

a. The pancreas cannot produce enough insulin to lower blood sugar levels to a healthy range.

Overtime, high blood sugar levels lead to diabetes, which is incurable.

Prediabetes means you have a higher than normal blood sugar level.

Table showing the different fasting sugar level and HbA1c levels for normal, pre-diabetes and diabetes

Table showing the different fasting sugar level and HbA1c levels for normal, pre-diabetes and diabetes

At the stage of early diabetes or prediabetes, it is still curable, which is why it is so important that you consistently go for health check-ups in order to find out how well you are managing your blood sugar levels.

Risk factors for diabetes and prediabetes

  • Family history (risk increases if your parent or sibling has type 2 diabetes).
  • Age (risk increases after 45 years old).

Lifestyle

  • Weight (risk increases with BMI of 23.0 and above).
  • Inactivity/Sedentary lifestyle.
  • Diet
    • Red meat, processed meat, sugar-sweetened beverages increases risk of prediabetes.
    • Fruits, vegetables, nuts, whole grains, olive oil lowers risk of prediabetes.
  • Smoking.

Pre-existing medical conditions

  • Obstructive sleep apnea
    • It is a sleep-related breathing disorder which shares common risk factors with diabetes such as obesity.
  • High cholesterol/ Abnormal blood lipid levels
    • Low levels of “good” cholesterol and high levels of “bad” cholesterol and fats.
  • Pregnancy-related risks
    • A history of gestational diabetes (diabetes developed during pregnancy) or giving birth to a baby weighing more than 4 kilograms increases risk.
  • Polycystic ovary syndrome (PCOS)
    • It is a condition in which the ovaries produce an abnormal amount of male sex hormones (androgens) that are usually present in women in small amounts.
  • Acanthosis nigricans
    • It is a skin condition that causes skin discolouration.
  • High blood pressure (higher than 140/90 mmHg)
    • Hypertension and diabetes share common causes such as obesity and insulin resistance.

Early signs and symptoms

  • Increased thirst
  • Frequent urination
  • Increased hunger
  • Unintended weight loss
  • Fatigue
  • Blurred vision
  • Sores that heal slowly (include picture)
  • Frequent infections
  • Numbness or tingling in the hands or feet

Prediabetes:

  • Does not usually have any signs or symptoms.

How a diagnosis is made

There are various tests which can be used to diagnose diabetes and pre-diabetes, the most common of which are the fasting plasma glucose test (FPG) , hemoglobin A1C test and Oral Glucose Tolerance Test. How is a diagnosis made? It is made based on the patient meeting at least one of the below criteria.

Table showing the various tests to diagnose pre-diabetes and diabetes Table showing the various tests to diagnose pre-diabetes and diabetes

Results of Testing and Follow-up measures

Even if the screening test for diabetes yields a negative result, you should continue to have follow-up screenings with your doctor regularly (every 3 years or so) or as recommended by your doctor.

Medication may be prescribed, and your doctor will encourage you to follow a exercise regimen and to eat healthier.

Ascertaining the type of diabetes you have

​​There are different types of diabetes: Type 1 and Type 2.

Type 1 diabetes is usually diagnosed during childhood, and occurs because the body is unable to produce insulin (the hormone that helps to manage your blood sugar levels). Type 2 Diabetes is diagnosed during adulthood, and is more common in patients who are overweight.

Importance of early screening

Early screening is important as it helps to identify individuals who are likely to have diabetes, yet do not present with symptoms. The early diagnosis of diabetes can help to reduce the long-term and drastic complications of diabetes, such as kidney failure, strokes, vascular disease and so on, as the patient will be in a position to take action quickly and manage the symptoms before they progress into worse complications.

Did you know that with the current technology, even diabetes can be reversed, or cured? In the past, many patients used to think that diabetes was a “death sentence”, and they would have to be on medication for the rest of their lives. However, that is no longer the case, and it is possible to reverse diabetes with strict diet and exercise control. The chances of reversing prediabetes are even higher, which is why you should go for regular screenings. With the results from these tests, your healthcare provider can help you make simple changes to your diet and lifestyle in order to turn things around in the long run.

Complications of diabetes

If diagnosis and treatment of diabetes is delayed, there will be more diabetes complications, further emphasising why early screening is important.

Hands and legs (peripheral vascular/arterial disease (PVD/PAD))

This disease affects the circulatory system, usually leading to problems with the feet and legs. It is caused by narrowing and blockage of blood vessels outside the heart.

Diabetes

  • Affects the blood vessel lining, affecting blood flow. This causes less oxygen to reach the body parts.
  • Increases chances of blood clotting, which may cut off blood supply.
  • Increases insulin (sugar-regulating hormone) resistance, which is a risk factor for PVD.

This causes decreased or absent blood flow which may result in:

  • Amputation (loss of a limb)
  • Slow wound healing
  • Pain or discomfort which limits movements
  • Severe pain in the hands or legs
  • Stroke

Nerves (mostly at legs or feet)/ Diabetic Neuropathy

As many as 50% of people with diabetes have diabetic neuropathy. Depending on which nerve is affected, it may cause you to lose your sense of touch or affect your sight etc.

Diabetes

  • Affects blood flow which damages the nerves, causing you to lose your sense of touch.
  • Causes high blood sugar level causes wounds to heal slower.

Kidney (diabetic nephropathy)

Diabetes may lead to kidney failure, which is a life-threatening condition. At that point, the only treatment options are dialysis or kidney transplant.

Diabetes

  • Damages the blood vessels in your kidneys that filter waste from your blood, leading to kidney damage and causing high blood pressure.

Eye (diabetic retinopathy)

Diabetes can affect the eyes and one’s vision, potentially leading to blindness.

Diabetes

  • Results in high blood sugar level which disrupts blood flow, which may affect one’s vision and increases the risk of other serious conditions such as cataracts and glaucoma.

Stroke (life-threatening)

Stroke happens when blood vessels in the brain are damaged.

Diabetes causes

  • High blood sugar level which increases chances of blockage of blood vessels carrying blood to the neck or brain, cutting off blood supply to the brain.

Having a stroke could lead to permanent injury to the brain or death. It is a life-threatening condition.

Heart (coronary Artery Disease (CAD) and heart attack)

Diabetes may damage or block major blood vessels in the heart. A complete blockage cuts off blood supply to the heart, causing heart attack.

Diabetes:

  • Causes high blood sugar level, insulin (sugar-regulating hormone) resistance and high cholesterol and fats in the blood which may block or damage major blood vessels in the heart.
  • Shares common risk factors with CAD, such as high blood pressure and obesity.

Feet (common)

Diabetes may cause damage to the feet due to damage of:

  • Blood vessels
    • Poor blood flow to the feet may cause tissue damage.
  • Nerves
    • Lack of feeling in the foot may lead to cuts and wounds being left untreated, causing infection and gangrene (permanent death of tissues).

Skin conditions

Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. Certain types of fungus are naturally found in our bodies, but too much can lead to problems in diabetics.

Diabetes can cause skin conditions due to the damage of:

  • Blood vessels
    • Poor circulation can cause itchiness especially in the lower legs.
  • Nerves
    • Nerve fibers in outer layer of skin may be damaged due to diabetes, causing itchiness.

Hearing impairment

Diabetes can cause hearing problems due to the damage of:

  • Nerves
    • Small blood vessels and nerves in the inner ear can be affected by diabetes, resulting in hearing loss.

Hearing loss is twice as common in people with diabetes compared to those without it at the same age. Even prediabetes has a 30% higher rate of hearing loss.

Alzheimer's disease

It is possible that Type 2 diabetes can increase the risk of dementia, including Alzheimer’s diseases. Although there are theories behind the possible connection of these disorders, none has yet been proven.

For more information or if you require a medical consultation, please contact My Healthcare Collective here.