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Vol 21, No. 04, April 2017   |   Issue PDF view/purchase
Understanding Diabetes

Diabetes is a long-term condition in which the blood glucose levels of a person remain persistently higher than normal. It occurs when the pancreas does not produce enough insulin or when the body cannot effectively use insulin.

Insulin is a hormone produced by the pancreas that allows your body cells to use blood glucose (sugar) for energy. Food is converted into glucose before it is absorbed into our bloodstream. The pancreas then releases insulin to move the glucose from the bloodstream into the body cells for use or storage. People with diabetes are unable to fully use the glucose in their bloodstream due to: lack of insulin in the body and ineffective use of insulin

Age and family history of diabetes increases one's risk of diabetes; unhealthy diet and lack of exercise are major factors for diabetes in Singapore.

Although uncontrolled Diabetes can lead to serious complications, the risk of developing Diabetes can be reduced or delayed by leading an active and healthier lifestyle.

There are 3 major types of diabetes:

Type 1 Diabetes

  • no insulin is produced due to damaged pancreatic cells
  • usually diagnosed in children or young adults although it can occur at any age
  • insulin is needed for treatment
  • complications may be sudden and life-threatening

Type 2 Diabetes

  • insulin produced is not enough or effective (insulin resistance)
  • occurs more frequently in people over 40 years old, particularly those who are overweight and physically inactive
  • more younger adults and children are developing Type 2 Diabetes
  • can be controlled with proper diet and exercise but is usually supplemented with oral medication
Gestational Diabetes Mellitus (GDM)
  • Occurs in about 2-5% of all pregnancies. Women who were not diagnosed to have diabetes previously show high blood glucose levels during pregnancy.
  • needs specialized obstetric care to reduce serious complications to the unborn baby

The common symptoms of diabetes are:
  • frequent thirst despite drinking lots of water
  • constant hunger
  • constant tiredness
  • itchy skin especially around the genital area
  • passing excessive urine during day and night
  • weight loss despite good appetite
  • poor healing of cuts and wounds

In the long run, uncontrolled diabetes can lead to the following complications:

  • coronary heart disease such as angina, heart attack
  • stroke
  • eye disease
  • kidney disease
  • foot disease such as numbness, ulcers and even gangrene
  • nerve disease which can lead to problems such as impotence and diarrhea

Who is at risk?

  • You are at risk of developing Type 2 Diabetes if you:
  • have a parent or sibling with diabetes
  • have a Body Mass Index (BMI) of 23.0 kg/m2 or higher
  • lead an inactive (sedentary) lifestyle
  • have high blood pressure
  • have abnormal blood cholesterol/lipid levels
  • have a history of gestational diabetes
  • are 40 years old and above
  • have impaired glucose tolerance or impaired fasting glucose

What are some of the common myths of Diabetes?

  1. Myth: I feel fine, so I don't think I have diabetes.

    Fact: Many people do not know they have diabetes until complications set in. The damage from diabetes, such as heart disease, stroke and nerve damage, may take years to show.

  2. Myth: No one in my family has diabetes so my chance of getting it is small.

    Fact: Although family history of diabetes is one of the risk factors, leading an unhealthy lifestyle and being overweight or obese can also increase your risk of getting diabetes.

  3. Myth: I have Type 2 Diabetes, but it's not serious as it's milder than Type 1 Diabetes.

    Fact: All types of diabetes are serious. If not well controlled, the high blood glucose level can lead to serious complications like nerve damage, foot ulcers and amputation, kidney failure, heart disease, stroke and blindness.

  4. Myth: I am already taking medication for my diabetes, so I do not need to exercise at all.

    Fact:Regular physical activity helps lower your blood glucose level and improves insulin action. It also lowers your risk of heart disease and improves your overall health. If you have not exercised for a long time, consult your doctor before starting any exercise plan.

  5. Myth: If I have diabetes, I will eventually lose my limbs and my sight.

    Fact: Diabetes is a serious medical condition, but complications like kidney failure, blindness, nerve damage, foot amputation and heart disease may not occur if you keep your diabetes under control with lifelong treatment and healthy lifestyle changes.

  6. Myth: Only fat people get diabetes.

    Fact: Diabetes can happen to anyone but being overweight or obese increases your risk of developing Type 2 Diabetes. Other factors like family history and unhealthy lifestyle practices also increases your risk.

  7. Myth: Diabetes can be cured.

    Fact: Diabetes is a lifelong condition. It cannot be cured BUT through proper management, it can be well controlled.

  8. Myth: Too much sugary foods can cause diabetes.

    Fact: People are generally more aware of the sugars coming from sweetened drinks but many are less aware of the effects of refined carbohydrates on our blood sugar level. According to the 2010 National Nutrition Survey, we consume nine times more sugar from starchy carbohydrate in rice and noodles than sugar from cane sugar in sugary drinks.

  9. Myth: I have diabetes. I should not eat fruits because I'm trying to control my blood sugar level.

    Fact: Fruits can raise the blood sugar level as they contain carbohydrates. However, they must still be included in your diet as they are a good source of vitamins, minerals and fibre. Check with a Dietitian on the amount you should eat or refer to letsbeatdiabetes.sg on making healthy food choices and using My Healthy Plate as a guide to plan your meals.

  10. Myth:I have diabetes. I can't eat sweets or chocolates.

    Fact: People with diabetes can include foods with added sugars (e.g. sweets, cakes and chocolate) in their meal plan. However, it is advisable to limit the intake of such foods as they are usually low in nutritional value, and may be high in fat. Talk to a Dietitian on how you can incorporate these foods in your diet or refer to letsbeatdiabetes.sg on making healthy food choices and using My Healthy Plate as a guide to plan your meals.

  11. Myth: I should only eat a little rice, noodles and bread to keep my diabetes under control.

    Fact: We do not advocate cutting out staples from our diets as a balanced diet must comprise foods from various food groups so that our body receives the nutrients it requires. Replacing as little as 20% of a typical bowl of white rice with brown rice can reduce the risk of diabetes.

  12. Myth: I am on diabetes medication, so I can eat what I want.

    Fact: Poor eating habits will still affect blood glucose control and increase your risk of complications. To manage diabetes properly, take your medicine as prescribed and follow your personalised meal plan.

      The information above are adapted from the materials provided by Health Promotion Board (HPB).

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