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Singapore’s war on diabetes: How can I prevent it from happening to me?

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For all those of you who spend more time scrolling your Instagram feed than watching the news, here’s the low-down on our country’s diabetes situation: Singapore has declared a War on Diabetes (WoD) in 2016 to rally the nation to tackle rising diabetes. If you’re thinking diabetes won’t happen to me, think again.

infographic showing the expected number of Singaporeans having diabetes condition, 1 million Singaporeans by 2050Source: HealthHub

Fact: Singapore has the second highest proportion of diabetics among developed nations (the United States claims the top spot). It is estimated that some 400,000 Singaporeans have diabetes and one of three are not even aware that they have it.

In neighbouring Indonesia, it is estimated that nearly 16 million adults have diabetes. A study by Indonesia’s National Institute of Health Research and Development found that more than half of diabetes cases in Indonesia remains undiagnosed.

It’s because diabetes does not show any initial symptoms until it has already wreaked havoc in the body and caused something to malfunction. Too much sugar in the blood can cause a whole lot more harm than you think. People with diabetes have a much higher risk of developing problems affecting the eyes, kidneys, heart, brain, feet and nerves. In this guide, we cover everything you need to know about diabetes – what is it, how to prevent it, who are at high risk getting diabetes and what are the subtle signs to watch out for.

“What is diabetes?”

Illustrations showing how Type 2 diabetes affects the bodyType 2 diabetes (Source: HealthHub)

Diabetes mellitus, or diabetes as we know it, occurs when we have excess glucose in the blood and our body is unable to break it down. We get glucose whenever we eat or drink carbohydrates and we need glucose because it’s what gives us our energy.

Blood glucose is essential for the proper functioning of brain cells as well. Low blood sugar can lead to central nervous system breakdowns and cause the person to experience:

  • Dizziness/Weakness
  • Confusion
  • Tremors

We also need a hormone called insulin that is produced by our pancreas. Insulin is the one responsible for breaking down the glucose in our blood and transporting it into our cells, thereby converting it into energy.

But if you are diabetic, this natural system malfunctions.

If you have Type 1 diabetes, your body can’t make any insulin at all. If you have Type 2 diabetes, it means your body either does not make enough insulin or your body has developed an insulin resistance.

Both conditions results in excess glucose building up in the blood since it cannot be converted into energy. And when your high blood sugar is left untreated, it can cause irreversible damage to your nerves and organs.

“Types of Diabetes”

So the two main types of diabetes are mentioned above – Type 1 and Type 2. Type 2 diabetes mellitus is the most common form of diabetes – up to 90% of diabetic people belong to this category.

pregnant woman undergoing diabetes check as they are more vulnerable to get gestational diabetesTest for gestational diabetes

In addition, there is also another type called gestational diabetes which is diabetes developing during pregnancy. It is usually diagnosed 24 to 28 weeks into pregnancy via an Oral Glucose Tolerance Test blood test.

To summarize, the three main types of diabetes can be categorised into:

  1. Type 1 diabetes: The body can’t produce insulin. Usually because the pancreas undergoes an autoimmune attack by the body itself and loses ability to make insulin. Unfortunately, this condition is genetically inherited. Type 1 diabetics have to rely on insulin medications for survival every day.
  2. Type 2 diabetes: The most common form of diabetes. Unlike Type 1, a Type 2 diabetic can produce insulin but doesn’t make and/or use insulin properly. Type 2 diabetics need to take pills or insulin medications regularly to help balance blood sugar levels.
  3. Gestational diabetes: Diabetes that first occurs during pregnancy. Singapore has one of the highest rates of gestational diabetes in the world, with more than 6,000 pregnant women contracting this condition each year. Significant hormonal changes during pregnancy can make it hard for your body to use insulin properly, resulting in a spike in blood sugar. Once contracted, it is estimated that up to 50 – 60% of women who had gestational diabetes will eventually develop Type 2 diabetes over the years, especially those who remain overweight after pregnancy.

“How to prevent diabetes?”

good habits such as eating healthy and exercise helps fight off diabetesTwo words: Diet and exercise.

You can’t choose your genetics obviously (Type 1 diabetes), but you can choose your lifestyle to prevent Type 2 diabetes. Of course, it’s definitely easier said than done but being mindful about these two things can go a long way for you – not just to prevent diabetes, but to shield against other diseases and for your overall good health.

1. Diet

Eat your greens:  A diet that is high in fruits, vegetables, nuts and whole grains have been found to reduce the risk of diabetes and other heart diseases, i.e. half of your plate should be filled with these good-for-you foods, a quarter with protein, and the remaining quarter on starchy carbohydrates.

Cut down on refined and sugary foods: Refined carbs like white rice, white bread, pasta are high in Glycaemic Index (GI). Foods that are high in GI means that they release sugar into the blood more quickly. Sugary foods include carbonated drinks, cakes, sweets and the list goes on. So if you’re the type who can’t resist ordering a Coke with every meal or eat your daily helping of dessert or cake, be aware and keep track of your sugar consumption.  According to the Health Promotion Board, sugar intake should not exceed more than 40 to 55 grams a day, equivalent of 8 to 11 teaspoons of sugar.

2. Exercise

Working out regularly (3x a week): Exercise helps to control weight, lower blood pressure, lower harmful LDL cholesterol, strengthen muscles and bones, reduce stress… the benefits are limitless. Studies found that moderate-intense exercise can help increase insulin sensitivity, allowing glucose to be converted into energy faster.

Maintain a healthy weight: Obesity causes fat to gather in the pancreas. The more fat in the pancreas, the less insulin it makes. Exercise to lose the excess weight and shed pancreatic fat. It is estimated that the risk of diabetes doubles for every 20% increase over your desirable body weight.

“Am I more prone to diabetes? Here are 8 risk factors.”

Illustrations showing Diabetes risk factorsSource: HealthHub SG

  1. You’re overweight (BMI of 23.0 kg/m2 or higher)
  2. You don’t exercise and live a sedentary lifestyle
  3. Are above 40 years old
  4. Have a family member with diabetes
  5. Have had gestational diabetes when you were pregnant
  6. Have impaired glucose tolerance
  7. Have abnormal blood cholesterol or lipid levels
  8. Have high blood pressure

“Common Symptoms of Diabetes”

illustrations showing 9 common symptoms of diabetesSource: HealthHub SG

For more symptoms of diabetes, read our article 7 Symptoms of Diabetes Every Singaporean Should Know.

 “How can I check if I have diabetes?”

There is no other definite way to check if you have diabetes except undergoing a blood test. The blood test will determine your blood glucose level and you will know for sure if you have diabetes.

You could go for a blood glucose test at any time or after fasting.

In general, you have diabetes mellitus if your:

  • Random blood glucose is 11.1mmol/L or more
  • Fasting blood glucose is 7.0mmol/L or more

“Why is diabetes so serious?”

Diabetes is not fatal in the short term, but when left untreated it can lead to a whole host of problems that can be fatal. These problems include:

  • Nerve damage – ranging from complete loss of sensation to constant body aches and pains
  • Wounds that never heal can lead to limb amputation – Because of nerve damage and damaged blood vessels, diabetics often suffer from foot injuries without realising it. Overtime, a small wound or pus on the foot can fester, leading to infections, rotting and eventually amputation.
  • Permanent eye blindness – Diabetes is the No 1 cause of blindness in Singapore. It is a condition called diabetic retinopathy, which means the blood vessels in the eyes become thinner and eventually burst and bleed out.
  • Kidney failure – 70% of kidney failures in Singapore is caused by diabetes. This is a condition called diabetic nephropathy where waste and fluids build up in your blood instead of leaving your body, resulting in the failure of your kidneys to clean your blood. Over time, your kidneys get damaged and fail.

In Singapore,

  • 2 in 5 stroke victims were diabetic
  • 1 in 2 heart attack victims were diabetic
  • 2 in 3 new kidney failure cases were diabetes-related

If you hone it down, diabetes is really caused by a combination two bad lifestyle choices: a lack of exercise and poor dietary decisions. Fortunately, these two things are actually within our control. Spread the knowledge to your family and loved ones – and together, we can lower the incidence of diabetes here.

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