Diabetes in Malaysia

There are nearly 1.2 million people in Malaysia have diabetes. Diabetes is actually a general term for a number of separate but related disorders. These disorders fall into two main categories:
1. Type 1, which usually occurs during childhood or adolescence, (24,ooo Malaysians are suffering from Type 1 ) and
2. Type 2, the most common form of the disease, usually occurring after age 30. ( 98% of 1.2 million Malaysian are suffering from Type 2)

Type 2 diabetes is a life-long disease marked by high levels of sugar in the blood. It occurs when the body does not respond correctly to insulin, a hormone released by the pancreas.

Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move glucose (blood sugar) into cells, where it is used for energy.
If glucose does not get into the cells, the body cannot use it for energy. Too much glucose will then remain in the blood, causing the symptoms of diabetes.

In this article I will be focusing on type 2, which is usually accompanied by obesity and insulin resistance.
Insulin resistance means that insulin produced by your pancreas cannot get inside fat and muscle cells to produce energy. Since the cells are not getting the insulin they need, the pancreas produces more and more. Over time, abnormally high levels of sugar build up in the blood. This is called hyperglycemia. Many people with insulin resistance have hyperglycemia and high blood insulin levels at the same time. People who are overweight have a higher risk of insulin resistance, because fat interferes with the body's ability to use insulin.

Type 2 diabetes usually occurs gradually. Most people with the disease are overweight at the time of diagnosis. However, type 2 diabetes can also develop in those who are thin, especially the elderly.
Family history and genetics play a large role in type 2 diabetes. Low activity level, poor diet, and excess body weight (especially around the waist) significantly increase your risk for type 2 diabetes.

Other risk factors include:
1. Age greater than 45 years
2. Previously identified impaired glucose tolerance by your doctor
3. High blood pressure
4. HDL cholesterol of less than 35 mg/dL or triglyceride level of greater than 250 mg/dL
5. History of gestational diabetes

Often, people with type 2 diabetes have no symptoms at all. If you do have symptoms, they may include:
1. Increased thirst
2. Increased urination
3. Increased appetite
4. Fatigue
5. Blurred vision
6. Frequent or slow-healing infections
7. Erectile dysfunction

Type 2 diabetes is diagnosed with the following blood tests:

1. Fasting blood glucose level -- diabetes is diagnosed if higher than 126 mg/dL on 2 occasions.
Random (non-fasting) blood glucose level -- diabetes is suspected if higher than 200 mg/dL and accompanied by the classic symptoms of increased thirst, urination, and fatigue (this test must be confirmed with a fasting blood glucose test).

2. Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours.
The first goals are to eliminate the symptoms and stabilize your blood glucose levels. The ongoing goals are to prevent long-term complications and prolong your life. The primary treatment for type 2 diabetes is exercise and diet .

DIET AND WEIGHT CONTROL.

Meal planning includes choosing healthy foods, eating the right amount of food, and eating meals at the right time. Learn how much fat, protein, and carbohydrates you need in your diet. Your specific meal plans need to be tailored to your food habits and preferences. (see low glycemic weight management)
Managing your weight and eating a well-balanced diet are important. Some people with type 2 diabetes can stop medications after intentional weight loss, although the diabetes is still present.

REGULAR PHYSICAL ACTIVITY

Regular exercise is important for everyone, but especially if you have diabetes. Regular exercise helps control the amount of glucose in the blood. It also helps burn excess calories and fat so you can manage your weight.
Exercise improves overall health by improving blood flow and blood pressure. It decreases insulin resistance even without weight loss. Exercise also increases the body's energy level, lowers tension, and improves your ability to handle stress.

FOOT CARE

People with diabetes are prone to foot problems. Diabetes can cause damage to nerves, which means you may not feel an injury to the foot until a large sore or infection develops. Diabetes can also damage blood vessels, which makes it harder for the body to fight infection.
To prevent injury to the feet, a person with diabetes should adopt a daily routine of checking and caring for the feet as follows:

1. Check your feet every day, and report sores or changes and signs of infection.
Wash feet every day with lukewarm water and mild soap, and dry them thoroughly.
2. Soften dry skin with lotion or petroleum jelly.
3. Protect feet with comfortable, well-fitting shoes.
4. Exercise daily to promote good circulation.
5. See a podiatrist for foot problems, or to have corns or calluses removed.
6. Remove shoes and socks during a visit to the health care provider to remind them to examine your feet.
7. And Stop smoking because it worsens blood flow to the feet.

The risk of long-term complications from diabetes can be reduced. If you control your blood glucose and blood pressure, you can reduce your risk of death, stroke, heart failure, and other complications.

Possible Complications are:

Emergency complications include diabetic coma.

Long-term complications include:
1. eye disease
2. kidney disease
3. nerve damage
4. Peripheral vascular disease (damage to blood vessels/circulation)
5. High cholesterol, high blood pressure, atherosclerosis, and coronary artery disease

You may be suffering from diabetes if you have:
1. Trembling
2. Weakness
3. Drowsiness
4. Headache
5. Confusion
6. Dizziness
7. Double vision
8. Lack of coordination
These symptoms can rapidly progress to emergency conditions (such as convulsions, unconsciousness, or hypoglycemic coma).

Prevention ( I would like to stress PREVENTION IS BETTER THAN CURE)

Everyone over 30 should have blood glucose checked at least every 3 years. Regular testing of random blood glucose should begin at a younger age and be performed more often if you are at particular risk for diabetes.
Maintain a healthy body weight and keep an active lifestyle to help prevent the onset of type 2 diabetes. (listen to audio on how to maintain healthy weight loss here)