Not-so-sweet facts on diabetes Diabetes is a common disease in Malaysia. According to the 3rd National Health and Morbidity Survey (NHMS), more than 10% of Malaysian adults above 18 years old have this disease. this is doubled the number in a survey done 10 years ago.

Diabetes is a condition where the amount of glucose (a type of sugar) is too high in our blood, and our body cannot use it properly for our own good. it is easily diagnosed through a simple blood test.

Diabetes can happen when our pancreas does not produce enough insulin (Type 1 diabetes), or the insulin does not work properly (Type 2 diabetes).

Insulin is a hormone produced by pancreas to help sugar in our blood enter our body cells. the cells need sugar as fuel for energy to support all the vital function of our body.

In diabetes, our body cannot utilise the sugar properly and sugar is built up in the blood.

In Type 1 diabetes, the pancreas does not produce any insulin. the insulin-producing pancreatic cells have been destroyed by a process called autoimmune mechanism (the immune system is producing antibodies that destroy the pancreatic cell).

No one knows for sure why it happens, but this may be triggered by virus or bacteria infection.

Type 1 diabetes normally happen in childhood but can strike at any age, especially before age 40. Since the body does not produce insulin, the only treatment is replacement with insulin through injection.

Type 2 diabetes develops when the body does not produce enough insulin or the insulin is not working properly. this is known as insulin resistance.

Type 2 diabetes accounts for more than 95% of all the diabetic cases in Malaysia and normally occurs after the ages of 25 to 30.

It can be treated with dietary modification and exercise. In some cases, the patient may need medication or insulin.

Symptoms

The main symptoms include passing urine more often than usual, especially at night; unusual thirst or the need to drink lots of water; extreme hunger; tiredness all the time; weight loss; frequent infection; slow healing of cuts and wounds; and blurred vision.

We cannot prevent Type 1 diabetes. however, certain risk factors predispose a person to Type 2 diabetes. these include having a close relative with the disease; being overweight; having a waist circumference of 31.5 inches or more for women and 35 inches or more for men; and suffering from hypertension or heart disease.

Women with polycystic ovary syndrome and are overweight as well as those with a history of diabetes during pregnancy are at greater risk of developing the disease.

If not treated promptly and optimally, uncontrolled diabetes can cause damage to the blood vessel in our organ and, subsequently, the following complications:

> Heart attack and strokes: People with diabetes are two to four times more likely to have heart disease and they are five times more likely to suffer a stroke.

> Kidney disease and kidney failure: Diabetes is the most common cause of kidney disease in Malaysia. many of them require dialysis later in their life.

> Eye disease and blindness: Blood vessels in the eye can become blocked, leaky or grow haphazardly. this damage if left untreated can damage vision.

> Nerve damage: this can lead to numbness, weakness and impotence.

> Blood vessel damage: This can also lead to non-healing ulcer of limbs and later amputation.

Many patients do not like the idea of taking medication for the long term but in the case of diabetes, it is for life. Some think that medications can damage their kidney or liver.

The fact is that if medications are not taken as instructed, kidney and other organ failure will occur.

Diabetes is a serious disease. if not treated properly, complications can occur and death is a possibility.

However, taking too much sugar does not cause diabetes. it is the weight gain caused by high sugar that precipitate a person to develop Type 2 diabetes.

So, a balanced diet and regular exercise are very important. these help to prevent and control the disease.

Dr Gan Ing Earn is a consultant gastroenterologist and internalmedicine physician. any queries on health-related matters can bedirected to gastro.gan@gmail.com.