Diabetes is a serious complex condition which can affect the entire body and would require daily self-care as it can affect one’s quality of life. It is a condition when the body is unable to maintain healthy levels of glucose in the blood. With unhealthy levels of glucose in the blood, it can lead to long term and short-term health complications.
There are three main types of diabetes:
Type 1 Diabetes
It is an auto-immune condition that is usually diagnosed in children or young adults. In type 1 diabetes, the pancreas no longer produces insulin and daily insulin injections are necessary. This type of diabetes is not linked to any modifiable lifestyle factors and cannot be prevented.
Type 2 Diabetes
This is a progressive condition usually found in people aged above 40 years who are overweight and have a sedentary lifestyle. Type 2 diabetes can be usually kept under control with proper lifestyle management and oral medications. Type 2 diabetes is the most common type of diabetes.
Gestational Diabetes
Gestational Diabetes occurs during pregnancy and is diagnosed when higher than normal blood glucose appears during pregnancy. It needs to be managed due to the risk to the development of the unborn baby. The maternal blood glucose would usually return to normal levels after birth. But there is an increased risk of the woman developing type 2 diabetes later in life.
Diabetes is the fourth most common condition of polyclinic attendances in 2014. In 2016, 1 in 9 Singaporeans have diabetes and 1 in 3 Singaporeans are at risk of developing diabetes. Due to our aging population, this number is estimated to grow to 1,000,000 by 2050. Malays and Indians have a higher prevalence of diabetes as compared to the Chinese.
- 40 years and above
- Family history of diabetes
- High blood pressure
- History of cardiovascular disease
- Elevated levels of cholesterol
- History of gestational diabetes
- Overweight/ obese
- Sedentary lifestyle
Diabetes is not fatal in the short term, but undiagnosed or poorly controlled diabetes may lead to disabilities and diseases that could affect a person’s quality of life. Complications develop quickly when diabetes are poorly managed. Some complications related to diabetes can also lead to disability and if severe, death.
Common complications caused by uncontrolled diabetes include:
- Kidney damage (nephropathy)
- Eye damage or blindness (retinopathy)
- Nerve damage (neuropathy)
- Amputation
- Heart attack or stroke
- Skin conditions
- Tooth decay and gum diseases
The first line to manage well the condition is by lifestyle modifications. Eating a well-balanced meal is crucial in diabetes control. Sugar and refined carbohydrates are digested and enter the bloodstream quickly. For proper glucose control, the type of carbohydrates we consume is important, and one can use the Glycemic index to help them select the right type of carbohydrate.
The glycemic index (GI) Is a measure of how fast the blood glucose level rises after eating a particular carbohydrate. High GI food contains carbohydrates that are digested and absorbed rapidly into the bloodstream while low GI food contains carbohydrates that breaks down slowly and absorbed gradually into the bloodstream. When possible, consider choosing low GI food types like wholemeal pasta, rolled oats and brown rice vermicelli. Low GI food gives a better long-term blood glucose control and may even protect healthy people against diabetes and cardiovascular diseases.
Other ways to manage the condition are:
- Keep your BMI below 23kg/m2 (Learn to calculate your BMI here)
- Have regular meal timings
- Eat a balanced diet, choose more whole grains, fruits and vegetables, and to reduce the intake of foods that are high in sugar and saturated fat
- Limit alcohol as alcohol can interfere with glucose control
- Lead an active lifestyle by exercising for at least 150 minutes per week, 30 minutes per session for 5 days per week
- Quit smoking – Smoking can worsen the narrowing of blood vessels. It can reduce the blood flow to many organs, leading to serious complications
- Self-monitoring of blood glucose
It is important to maintain your blood glucose within healthy levels advised by your doctor. In some cases, patients may be too strict in maintaining the blood glucose or due to certain situations like missing your meals or overdosing of medicines that lead to a dip in blood glucose levels. When low blood glucose level (hypoglycemia) happens, you may experience:
- An irregular heart rhythm
- Fatigue
- Pale skin
- Shakiness
- Anxiety
- Sweating
- Hunger
- Irritability
- Tingling sensation around the mouth
All these symptoms are important in telling your family members, caregiver and you that the blood glucose level is low. As hypoglycemia worsens, signs and symptoms may include:
- Confusion, abnormal behavior or both, such as the inability to complete routine tasks
- Visual disturbances, such as blurred vision
- Seizures
- Loss of consciousness
One of the easy ways to remember how to help bring up your glucose level is via the 15-15-15 method. Eat 15grams of carbohydrate and wait 15 minutes. This will allow the body sufficient time to absorb the carbohydrate consumed. The following food can provide you with approximately the 15grams:
- Half a cup (approximately 120ml) of fruit juice or soda
- 1 tablespoon of honey or sugar
- Diabetes in Singapore. (n.d.). Retrieved from https://www.healthhub.sg/a-z/diseases-and-conditions/626/diabetes.
- The GI Values of Common Foods. (n.d.). Retrieved from https://www.healthhub.sg/live-healthy/1330/the-gi-values-of-common-foods.
- (n.d.). Retrieved from https://www.ndss.com.au/about-diabetes/.