Some 3.6 million Malaysians are suffering from diabetes, the highest rate of incidence in Asia and one of the highest in the world. By 2025, seven million Malaysian adults are likely to have diabetes, a worrying trend that will see diabetes prevalence of 31.3% for adults aged 18 years and above. Launched in 1991 by the International Diabetes Federation and the World Health Organization (WHO), World Diabetes Day falls on November 14th. Each year, World Diabetes Day carries a particular theme. In 2019, the theme was Family and Diabetes. This year, the theme is The Nurse and Diabetes.
Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.
Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time, this leads to serious damage to many of the body’s systems, especially the nerves and blood vessels. Here, we answer important questions on diabetes.
How many types of diabetes are there?
Apart from gestational diabetes, there are two main types of diabetes: Type 1 and Type 2. If an individual has Type 1 diabetes (also known as juvenile diabetes or insulin-dependent diabetes), this means they have an autoimmune condition where cells in the pancreas that produces the hormone called insulin are attacked and destroyed by the body’s immune system. We all need insulin as it helps absorb glucose from our blood into our body’s cells. We then use this glucose for energy. Without insulin, the glucose level in your blood gets too high. Most times, Type 1 diabetes prevails in childhood or adolescence, but it can also happen to adults.
Over 90% of individuals are diagnosed with Type 2. People with Type 2 diabetes do not produce enough insulin, or their body doesn’t fully respond to insulin effectively. This is known as insulin resistance.
Although many symptoms of Type 1 and Type 2 diabetes are similar, they present themselves in very different ways. In reality, people with Type 2 diabetes won’t have symptoms for many years but instead, the symptoms tend to develop slowly over the course of time. In fact, some people with Type 2 diabetes have no symptoms at all and don’t discover their condition until complications develop.
Did you know that Type 2 diabetes has escalated to 20.8% in adults above the age of 30, affecting 2.8 million individuals in Malaysia? Researchers aren’t sure why some people become insulin resistant and others don’t, but several lifestyle factors contribute to this including excess weight and inactivity. Other genetic and environmental factors may also contribute. In addition, diabetes varies among the major ethnic groups in Malaysia, with Asian Indians having the highest number of individuals with Type 2 diabetes followed by Malays and Chinese.
What are the symptoms of diabetes?
Both types of diabetes, if not controlled, share many similar symptoms, including:
- frequent urination
- feeling thirsty and drinking a lot of fluids
- feeling hungry
- feeling fatigued
- blurry vision
- cuts or sores that don’t heal quickly
More serious cases of diabetes cases can cause blindness, kidney failure, heart disease and other serious conditions. Before diabetes is diagnosed, there is a period where blood sugar levels are high but not high enough to be diagnosed as diabetes. This is known as prediabetes. It’s estimated that up to 70% of people with prediabetes go on to develop type 2 diabetes. Fortunately, progressing from prediabetes to diabetes isn’t inevitable.
What are some ways to prevent diabetes?
1. Get involved in physical activity
There are many benefits to regular physical activity. Exercise can help you:
- Lose weight
- Lower your blood sugar
- Boost your sensitivity to insulin — which helps keep your blood sugar within a normal range
Research shows that aerobic exercises and resistance training can help control diabetes. The greatest benefit comes from a fitness program that includes both.
2. Move more each day
Now, think about the most sedentary people you know. Can you honestly say they’re on their feet for a total of three hours a day? Probably not. Find ways to be more active each day! Try to be active for at least 30 minutes, 5 days a week. Walking is a great way to get started and you can do it almost anywhere at any time. Bike riding, swimming, and dancing are also good ways to move more. You’ll feel better overall, and shed some extra pounds as well.
3. Get plenty of fiber
While most carbs break down into sugar, fiber stays intact as it passes through your digestive system. Eating fiber along with other carbs helps you feel fuller for longer. It may help you reduce your risk of diabetes by improving your blood sugar control, lower your risk of heart disease as well as promote weight loss by helping you feel full. Whole-food carb sources all naturally contain fiber These include fruits, starchy vegetables, legumes, and whole grains. For a start, have a big vegetable salad with low-calorie salad dressing when eating out.
4. Quit smoking
Smoking 16 to 20 cigarettes a day or more can increase a person’s risk of developing diabetes to more than three times that of non-smokers. The exact reason for this isn’t well understood yet. It may be that smoking directly decreases the body’s ability to utilize insulin. Moreover, it has been observed that after smoking, blood sugar levels increase. Finally, there is also an association between smoking and body fat distribution; smoking tends to encourage the “apple” body shape, which is a risk factor for diabetes.
5. Limit your alcohol intake
Too much alcohol can lead to weight gain and may increase your blood pressure and triglyceride levels. Men should have no more than two standard glasses a day and women should have no more than one.
6. Rethink your drink
Unless you are a true water lover, you may be getting some extra, unneeded calories through sweetened soft drinks, sodas, iced tea, coffee, juice, and energy, and sports drinks. In fact, sugary drinks are the number one source of added sugars in our diet. Try to increase your water intake gradually by drinking water instead of juice and regular soda. If you drink whole milk, try changing to 2% milk. It has less fat than whole milk. Once you get used to 2% milk, try 1% or fat-free (skim) milk. This will help you reduce the amount of fat and calories you take in each day.
7. Control your blood pressure
About 25% of people with Type 1 diabetes and 80% of people with Type 2 diabetes have high blood pressure. Even a small reduction in the sodium in your diet can improve your heart health and reduce blood pressure by about 5 to 6 mm Hg if you have high blood pressure. The effect of sodium intake on blood pressure varies among groups of people. In general, limit sodium to 2,300 milligrams (mg) a day or less. However, a lower sodium intake — 1,500 mg a day or less — is ideal for most adults.
Most people can also manage their blood pressure readings with regular exercise, a balanced diet, and by keeping a healthy weight. In some cases, you might need medication prescribed by your doctor.
8. Get regular check-ups
A regular blood glucose screening is highly recommended if you’re 45 years or older, an overweight adult of any age, with one or more additional risk factors for diabetes, such as a family history of diabetes, a personal history of prediabetes, or an inactive lifestyle. Share your concerns about diabetes prevention with your doctor. He or she will appreciate your efforts to prevent diabetes and may offer additional suggestions based on your medical history or other factors.
Living a sweet life is in your control as you have power over many of the factors that influence diabetes, which is pretty empowering. Start with small steps, be mindful of your eating habits and adopt other lifestyle behaviours that promote healthy blood and insulin levels. Remember, with early detection and awareness, you can take steps to prevent or delay the onset of diabetes.