Diabetes Mellitus is a health condition where a person’s blood glucose (also known as blood sugar) levels are too high. Glucose comes from the food you eat (especially carbohydrates) and is what fuels your body cells, but a hormone called insulin is needed to use the glucose for energy. When somebody has Diabetes Mellitus, it means that their body does not make enough insulin, or is unable to use the insulin which it produces. In some cases, it could even be a combination of both.

Since the glucose is not used, it builds up in the blood and eventually causes harm to the person with Diabetes Mellitus.

Type 1 Diabetes

Type 1 diabetes is believed to be an autoimmune condition. It causes the insulin producing beta cells in the pancreas to be destroyed, preventing the body from being able to produce enough insulin to adequately regulate blood glucose levels.

Because type 1 diabetes causes the loss of insulin production, it therefore requires regular insulin administration either by injection or by insulin pump.

Type 2 Diabetes

Type 2 diabetes happens when the body doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. This means glucose stays in the blood and isn't used as fuel for energy.

Type 2 diabetes is usually associated with obesity and is more common than type 1 diabetes. It is a serious medical condition that needs medication in order to keep blood sugar levels under control.

Gestational Diabetes

Gestational diabetes happens when women have hyperglycemia (high blood glucose levels) during pregnancy and this condition can occur at any stage of pregnancy, but is more common in the second half.

Gestational diabetes can cause problems for both mother and baby during and after birth. But the risk of these problems happening can be reduced if it's detected and well managed.

It is important to schedule a doctor’s appointment as soon as possible to get a proper diagnosis in the event that the key symptoms of Diabetes Mellitus are present.

• Tiredness and lethargy
• Excessive thirst and urination
• Increase appetite
• Weight change
• Blurring of vision
• Dry mouth
• Itchy skin
• Prolonged healing
• Sexual dysfunction
• Numbness and tingling in hands and feet

Urine tests are actually considered to be inaccurate and are not used for the diagnosis of diabetes. Instead, diabetes is diagnosed via blood tests such as:

• Oral Glucose Tolerance Test (OGTT)
• HbA1c (aka haemoglobin A1c test or glycated haemoglobin test)
• Fasting Plasma Glucose (FPG)
• Random blood sugar test

If not diagnosed early and treatment is not received in time, the build-up of glucose in the blood eventually causes the following health complications:

• Heart - heart attack
• Brain - stroke
• Kidneys - kidney failure
• Eyes - blindness
• Legs - amputation, infected legs
• Nerves - numbness or pain or burning sensation
• Skin - infection
• Sexual dysfunction
• Infertility

Treatment for diabetes is multidisciplinary, those affected with diabetes need to manage their condition in a number of ways to keep their health in check and avoid complications.

• Food management -timing for food, portion of food, early intake of food
• Exercise - 3 to 4 times a week for at least 30mins
• Medications - tablets and injections
• Surgery - weight reduction surgery
• Avoid diabetogenic drugs – such as steroids (unless advised by doctor)

Ultimately, diabetes management plans should be discussed in detail with the attending doctor to make sure that it is personalized to the patient’s needs and existing health concerns.

Aside from the treatment, diabetes management also requires additional care to be taken for the patient’s health and wellbeing:

• Education for patients and their care-takers
• Toes and feet hygiene need to be carefully maintained
• Consistent home blood sugar and blood pressure monitoring
• Regular follow-ups (consultations and blood tests)
• Regular eye checks
• Support from family and friends can make a lot of difference for those affected
• Support groups to share experiences and learning

Credits:

Dr Lim. Soo San,

Consultant Physician & Endocrinologist, Pantai Hospital Cheras

Dr. Mariam George

Resident Medical Officer, Pantai Hospital Kuala Lumpur