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By THERESA BELLE
DESPITE the notorious reputation
diabetes has garnered over the
years, many remain unaware
of how dangerous it can be.
The idea that diabetes is not
dangerous as many people have
it could not be further from the
truth. This disease can lead to
serious complications and there
is no such thing as mild diabetes,
says Emeritus Prof Datuk Dr
Mustaffa Embong, executive
chairman of the National Diabetes
Institute (Nadi) and consultant
diabetologist/endocrinologist at
Nadis Diabetes Resource Centre
DCenters.
The disease is closely associated
with metabolic syndrome
increased blood pressure,
abnormal cholesterol level, high
blood sugar level and excess body
fat around the waist.
This cluster of conditions
increases ones risk of developing a
non-communicable disease such as
diabetes, which is caused by the
bodys inability to regulate blood
glucose levels due to insulin
insufficiency or resistance.
Warning signs
Diagnosis of the pre-diabetic
condition helps address the growth
in number of diabetics by
identifying the condition at the
earliest stage. Using simple blood
tests, doctors are able to determine
whether or not a patient is
borderline diabetic.
There is also the now popular
HbA1c (glycated haemoglobin) test,
which is able to provide an average
sugar level reading of the past
two to three months, as opposed to
the fasting plasma glucose test that
only measures glucose
concentration in the blood at
that point in time.
Those at the pre-diabetic stage
are still able to delay or prevent the
onset of diabetes with proper
management of lifestyle factors.
This is a crucial period in
INSULIN is a pancreatic hormone
that converts glucose into energy,
thus controlling the level of blood
sugar in the body.
When insulin, which is
produced by beta cells, is
insufficient or unable to function
optimally, this conversion process
is interrupted and the level of
sugar rises beyond the healthy
range. This is how diabetes
comes about.
Although the basic mechanism
is general, diabetes cases vary
from one individual to the next
due to different root causes and
degrees of environmental impact.
Hence, follow-up treatment and
control measures may also differ.
People react differently to
medication, which is why every
case is dealt with individually
some need to have insulin
introduced into the system while
others may need to reduce it.
A balance of lifestyle changes
and medication is needed for
diabetics to be in the best of
health and a very small
percentage of people can
depend on only one or the
other, says Dr Lim Siang Chin,
endocrinologist and physician
at Mahkota Medical Centre.
Risk-free living
diabetes management as there
is no way to cure the disease
pre-diabetes diagnosis can be
considered a final warning for
high-risk individuals to make
significant changes.
According to Siah Guan Jian,
senior diabetes educator at the
National Heart Institute (widely
known by its Bahasa Malaysia
acronym IJN), preventive measures
are vastly similar to diabetes
control methods.
Diabetes prevention and
management rely on blood sugar
management, so we generally
advise high-risk patients to
improve their diet by cutting down
on sweet, fatty and cholesterol-rich
foods, eat regular meals in small
portions, and exercise regularly,
she says.
Being obese places one at great
Education, guidance
AS the premier non-government
organisation dealing with diabetes
in the country, the National
Diabetes Institute (Nadi) is
dedicated to spreading the word
on and assisting with prevention
and optimal management of
diabetes, its complications and
associated diseases.
This non-profit organises
activities and sessions aimed
at promoting early detection
and elevating best diabetes
management practices through:
l Talks, road shows,
exhibitions and counselling
sessions
l Screening for diabetes
and risk factors
It is important to understand and get the right treatment for your type of
diabetes.
Getting your eyes checked regularly will go a long way in preventing diabetes-related eye complications.
Exploring effects
Dr Pall Singh.
Elevating treatment
As with almost all other diabetic
Unhealthy lifestyle
habits such as constant
overeating can increase
ones risk of developing
diabetes.
Managing neuropathy
MOST people take foot care for
granted. To the diabetic, however,
caring for the feet is a serious
matter with unfortunate
consequences if neglected.
In diabetics, prolonged high
blood sugar level damages nerve
cells and causes tingling, impaired
sensitivity, numbness or pain.
Most often, this affects the
nerves to the feet as they are the
longest in the body. Loss of
sensation in the feet means that
sores or injuries may go unnoticed
and become ulcerated or infected.
Eventually, amputation of the
toe, foot or even lower leg may be
necessary if treatment is no longer
possible.
According to the World Health
Organization, diabetic neuropathy
is the most common complication
of diabetes. It has been implicated
in 50% to 75% of non-traumatic
amputations.
Treating or slowing
down neuropathy
Neuropathy can be treated or
slowed down by providing nerve
cells with the nutrients that they
need to function properly,
especially vitamins B1, B6 and B12.
While a healthy person usually
has a sufficient supply of these
vitamins in the body, diabetics
often experience deficiency. The
longer a person has diabetes, the
worse this is and the more severe
the nerve damage becomes.
Therefore, diabetics need to
ensure that they get sufficient
amounts of these vitamins in their
diet or via a health supplement.
Neurobion is a health
supplement brand that has been
trusted for more than 50 years
and offers diabetic patients the
synergistic benefits of vitamins B1,
B6 and B12.
It has been clinically proven to
help manage diabetic neuropathy.
It nourishes your nerve cells to
help improve nerve function and
relieve nerve pain.
On top of that, Neurobion can
Discretion in management
importantly, minimising or
eliminating refined sugar in foods
and drinks.
Prevention, control
Lifelong monitoring
The majority of those who seek
consultation at IJNs Diabetes Care
Centre are existing patients with
some type of heart disease who
must address their risk of
developing diabetes complications.
According to Siah, diabetes
educators advise patients from
pre-diabetic stage onwards
because the aspects of diabetes
care are wide ranging and
all-encompassing.
Patients are prescribed oral,
subcutaneous insulin injection or
pump insulin replacement therapy
based on their bodys ability to
regulate and neutralise sugar
Consultation and guidance provided at IJNs Diabetes Care Centre ensure patients are aware of how the disease
works so they can better understand management measures.
The number of people living with diabetes is continually rising. Leading an active lifestyle as a family can prevent you
and your loved ones from developing this disease.
seven seconds.
The Diabetes Atlas calculated
that diabetes caused about 1.19
million deaths in South-East Asia,
about 54% of which were of people
under the age of 60.
However, the region has the
lowest diabetes-related
expenditure per person with
diabetes, totalling only US$7bil
(RM30.15bil).
Compared to the US$310bil
(RM1.335 trillion) total expenditure
by countries in North America and
the Caribbean, which have a total
population that is about half that of
South-East Asia, this is a dismal
figure.
What is more worrying is that
in this region, almost half of
the people with diabetes are
undiagnosed. This means that the
overall figures of people living with
diabetes and those who die from it
are actually higher.
Also, it means that people who
remain undiagnosed do not get the
treatment and medication required
to manage the disease.
The latest IDF Diabetes Atlas
with new global figures will be
released on Nov 12 and will be
made available on www.idf.org/
diabetesatlas
HIGH blood
DIABETES
SUGAR LEVELS
DIABETES
1. CHINA
Worlds
is the
rd most populous
country
2. INDIA
3. DIABETES
4. USA
Global healthcare
expenditure
US
in
IS SPENT ON
DIABETES CARE
HEALTHY EATING
and physical
activity
DIABETES poses
a THREAT to
GLOBAL
SUSTAINABLE
DEVELOPMENT
COULD
PREVENT
UP TO
70%
of type 2
DIABETES
IS AN
IMPORTANT
PART OF
EFFECTIVELY
M A N AG I N G
type 1
DIABETES
Early diagnosis
Symptoms of diabetes include
Specialised facility
The Mahkota Diabetes Centre
aims to provide diabetic care
services as a precautionary
measure to battle the condition.
It also strives to educate patients
on the common diabetic symptoms,
highlight the importance of a
regular full body screening and
inspire people to lead healthier
lifestyles.
A full body screening helps
Keep active
DIABETES is a lifelong disease with no
cure. However, daily care can help to control
blood sugar level and manage complications
arising from diabetes.
Diabetes has a negative impact on red
blood cells and causes thickening of the
blood. This increases the resistance of blood
flow and causes poor blood circulation that
lead to high blood pressure and high
cholesterol.
Diabetes sufferers are twice as likely to
suffer from heart attacks and stroke
compared to healthy adults and the average
life expectancy of diabetes sufferers may be
reduced by up to 12 years.
Due to poor blood circulation and low
body oxygen, diabetes can cause severe
damage in the nerves especially in the arms
and legs.
Diabetes can also affect vision when it
damages the tiny blood vessels in the retina,
which causes it to leak fluid or bleed, leading
to distorted vision and blindness.
Diet and lifestyle can help to minimise the
health complications associated with
diabetes. Keeping track of carbohydrate
consumption, increasing fibre intake and
maintaining a healthy balanced diet helps in
controlling blood sugar levels.
Regular exercise such as brisk walking
and swimming for about 30 minutes a day
helps to strengthen the heart and lungs and
help with weight loss.
As many of these health complications
occur due to poor blood circulation, it is
important to improve blood circulation and
body oxygen level.
Owell BIO-Ge Titanium Health Accessories
are specifically designed to improve blood
circulation and body oxygen levels using
Germanium (BIO-Ge) health minerals.
Each necklace, bracelet and timepiece
contains BIO-Ge health minerals that help
to minimise health complications associated
with diabetes through the positive hole effect
and far infrared rays.
Owells BIO-Ge
Titanium Heath
Accessories are
designed to improve
blood circulation,
minimising the
complications caused
by diabetes.
Healthy
sweet life
IN the process of supporting
their loved ones to ensure that
they stay healthy and happy,
caregivers of diabetes patients
often end up doing the opposite.
Caregivers tend to want to
take charge of what patients
should or should not eat. For
instance, sweetened beverages
and sweet delights such as
cakes, cookies and desserts are
commonly banned from the
diabetics diet.
Often, it reaches the extent of
over-controlling what diabetes
patients eat. However, should
they be deprived entirely of
sweet delights?
Overwhelmed after learning
that they are sick, some patients
undergo stages of depression
before accepting the reality of
the disease.
Caregivers should help smooth
out the transition by making the
necessary changes, especially
diet modification, gradually.
Abrupt changes not only
frustrate patients but also make
them lose hope in managing
their blood sugar levels.
Sugar craving
Patients who have long been
taking sweet food habitually
will find it difficult to give up
muffins, puddings and cakes in
their diet.
As a result, they might eat
these forbidden foods behind
their caregivers back.
This has become the common
complaint of most caregivers
who think they have been taking
good care of the patients diet,
yet the sugar level of their
loved one does not respond
accordingly.
Preference for sweetness is
not acquired within a day or
two. Our body learns and
responds to sweet food from the
time we were first exposed to it.
The more we are exposed to
sweetness, the higher the dose of
sweetness required to satisfy our
taste buds the next time. This is
termed sugar addiction.
Sweetness from food sends a
signal to the body that food or
energy supply is en route. If we
decide to remove sweetness or
sugar totally from our diet, our
body would automatically think
that nothing is being fed to the
body, causing the body to fight
back by requesting for more
food.
Alas, food craving ensues
and the vicious cycle of
uncontrollable behaviour
towards sweet food and sugar
spike starts all over again.
Understanding calorie
Although sugar is often
accused of being the culprit of
diabetes, medical practitioners
can tell you that sugar is not the
Life-saving knowledge
A MAJOR part of preventing diabetes is
knowing what to look out for.
At the current rate of diabetes prevalence,
the World Health Organization projects that
it will be the seventh leading cause of death
by 2030. In 2014, the worldwide statistic for
adult deaths caused by diabetes was 9%,
placing the disease in the top 10 leading
causes of death.
Understanding treatment
Diabetes may be gaining notoriety around
the world, but according to Siah Guan Jian,
Risk factors
l Family history of diabetes
l High blood pressure
l High cholesterol level
l High blood triglyceride and low HDL
(high-density lipoprotein) levels
l Pre-diabetes diagnosis
l Obesity, especially excessive fat in
abdominal area
Symptoms
Frequent thirst and urination Kidneys
are forced to work harder in filtering excess
glucose, which exits the body in the form of
urine along with other liquids.
You urinate more because of this
increased nephrogenic action, which in turn
Exercise is
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convenient
with the
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T13 treadmill.
l FlexSelect cushioning
The adjustable treadmill
cushioning offers two different
modes superior impact
reduction and joint comfort as
well as a surface that likens to
running on road.
l Convenient usage
Fold your treadmill up and
out of the way for convenient
cleaning and storage.
A hydraulic dampening spring
does the heavy lifting for you,
making it easy to fold your
treadmill and save precious
floor space.
Impressive features
What to include
Complex carbohydrates and fibre-rich
foods should make up the main part of your
meals. These are not so easily broken down
to blood glucose and will keep you fuller for
longer without causing a high glucose spike.
Examples are fruits, vegetables and
wholegrain products.
Since it is common for Malaysians to
include white rice and bread as well as foods
with high sugar content such as breakfast
cereals in their diet, diabetics should find
healthier alternatives such as brown rice,
wholewheat or wholegrain bread and rolled
oats.
A diabetic diet should also include good
fats that contain monounsaturated and
polyunsaturated fats as these can help lower
cholesterol levels if taken sparingly. Foods
with good fats include almonds, walnuts,
avocados and olive oil.
What to avoid
Diabetics should learn to avoid foods high
in saturated fats, trans fats and cholesterol as
these accelerate the development of clogged
Attention
to the feet
DIABETICS are highly prone to foot
complications due to diabetic neuropathy,
which is nerve damage that can cause
numbness of the feet.
According to Dr Harikrishna K. R. Nair,
head of the Wound Care Unit at the
Department of Medicine, Hospital Kuala
Lumpur, approximately 1.5 million diabetics
suffer from foot complications yearly, and in
many cases, their infected wounds are left
untreated. In fact, diabetic foot ulcers are
the most common foot wound among
Malaysians.
Dr Nair explains that there are three types
of nerve damage: sensory, autonomic and
motor neuropathy.
Sensory neuropathy is characterised by
numbness of the feet or insensate feet or
abnormal sensations such as pins and
needles, autonomic neuropathy is
characterised by dryness of skin, which can
lead to cracks, while motor neuropathy
involves the gradual weakening of muscles
that eventually waste away.
Muscle atrophy can increase pressure on
the skin, causing it to break and form a
wound, he says.
Besides that, the compromised immune
systems of diabetics can make them more
susceptible to infection and vascular
abnormalities can interrupt blood supply
to the feet as blood vessels are damaged.
These patients can be helped as long as
the infected wound does not develop into
gangrene, after which point not much can be
done to save the affected area the foot or
part of it has to be amputated. This calls for
greater caution and care among those living
with diabetes.
Diabetics must ensure their feet are
always clean, wear proper footwear, and
tend to any wound immediately to prevent
infection. Wounds must be thoroughly
Save
a limb
Managing diabetes
Physical activity
Being physically active usually
lowers blood glucose levels as the
muscles use more sugar as energy
and the body becomes more
sensitive to insulin.
People with diabetes should
accumulate 30 to 45 minutes a day,
three to five days a week exercises
such as walking, jogging,
swimming, skipping, bike riding
and brisk walking.
Medicines
If medicines are prescribed,
ensure compliance and proper
coordination of meals and
medicines.
Some medicines are meant to
be taken before meals and some
after meals. Always speak to a
pharmacist for any inquiry
regarding medicines.
Those who are on insulin
should learn the proper injection
technique and timing of injection
as well as ascertain the correct
dose of insulin.
Consult a healthcare provider if
your blood sugar level is too high
or too low.
Blood sugar monitoring
This is another important part
of the diabetes management plan.
Keeping track of the numbers will
guide people with diabetes on
making the proper choices in their
diet and lifestyle as well as
medicines.
The HbA1c test shows your
average blood sugar level over the
past two to three months.
Therefore, it is important to
routinely check with the
HbA1C test and discuss your
results with a healthcare
provider.
Maintain
thorough foot
care to keep
diabetic
complications
at bay.