The term diabetes is an unavoidable one; often heard among adults yet many are still oblivious about it. Diabetes can occur in anyone regardless of one’s age. Indeed, it is a pressing concern in today’s society so let’s take a step ahead to learn more about it.
Diabetes mellitus is a health condition whereby the affected individual is detected with abnormally high blood sugar/glucose level (hyperglycemia). The name “diabetes” is originated from the Greek word, added with the adjective “mellitus”, meaning “honeyed” in Latin. Diabetes is either caused by inadequate secretion of insulin (a hormone that regulates blood glucose level) or the body cells don’t respond normally to insulin, which known as insulin resistance.
1) Types of Diabetes?
Type 1 diabetes (T1DM)
– represents about 5% (minority) of the diabetes population
– occurs due to autoimmune condition (immune system is activated to destroy pancreatic β-cells, a group of cells in the pancreas that responsible to produce, store and release insulin), resulting in insulin deficiency
– dependent on insulin injection to manage the condition
Type 2 diabetes (T2DM)
– constitutes for more than 95% (majority) of the diabetes population
– a progressive condition resulting in insulin resistance and β-cells failure
2) Diabetes may remain asymptomatic for years
Autoimmune condition only plays a minority role in contributing diabetes cases, but everyone has the risk of getting T2DM. It has been recognized as one of the most common non-communicable diseases globally, with the prevalence rising worldwide. International Diabetes Federation (IDF) has estimated approximately 415 million people worldwide had diabetes in 2015, of whom 75% live in low- and middle-income countries1. The aging population, with an increase in the proportion of people aged >65 years in most countries, has contributed significantly to this increase1. T2DM may remain asymptomatic for many years, whereby tissue damage may develop resulting in possibility of vascular complications at the time of diagnosis.
3) What are the complications of Diabetes?
Diabetes is associated with many medical complications, which its development and severity depends on the degree and duration of diabetes. Hypertension and dyslipidemia (abnormal lipid levels) often coexist in diabetic patients. Furthermore, a patient’s body is often detected with excess inflammation, high oxidative stress and formation of abnormal lipid masses at the arterial walls which also mean they’re prone to infection due to poor healing of the wound.
Chronic diabetes has always been associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, blood vessels, heart, nerves and kidneys. All these damage leads to the potential of vision loss, cardiovascular diseases, foot ulcers, amputation (especially lower extremity) and kidney failure.
4) What are the symptoms of Diabetes?
The diabetes symptoms are often mild or absent, especially when the condition is not severe (even having it for many years). However, some clinical symptoms might appear abruptly or gradually:
- Frequent urination
- Excessive thirst
- Excessive hunger
- Progressive weight loss for unknown reason
- Poor healing ability
- Blurring of vision
- Other vague symptoms such as restlessness, body pain, tingling feet and hands
People with diabetes, especially for T2DM, may remain undetected for many years. This may allow the condition exacerbates to uncontrolled medical emergency case known as “ketoacidosis” common in T1DM; and “hyperosmolar non-ketotic coma” common in T2DM.
5) Who are at Risk of getting Diabetes?
Increasing age is one of the common risk factors for diabetes. Aging causes metabolism rate to decrease resulting in burning lesser calories that leads to weight gain and loss of muscle mass. The other risk factors include having family history; overweight (including those with high abdominal fats); lack of physical activity; and having unhealthy diet intake.
Women with gestational diabetes is also at a higher risk for T2DM2. Gestational diabetes is defined as diabetes that develops during pregnancy due to changing hormone levels, causing the body unable to produce enough insulin. This happens on about 4% of all pregnant women. The blood glucose level usually goes back to normal after the baby is born. However, these group of women have 40-60% higher risk of getting diabetes in the next 5-10 years2,3. Their babies are also at a higher risk of developing diabetes throughout their lives.
There are also some recent emerging risk factors for diabetes that should be taken into consideration1:
6) Prevention and Management of Diabetes
Diabetes can be prevented or managed through cost-effective interventions, such as:
- Maintaining normal weight – keeping normal weight also helps keep away many diseases
- Taking balanced healthy diet – enjoy a variety of food by choosing the suitable carbohydrate food (eg: wholemeal, brown rice, barley, oat, unsweetened multigrains, buckwheat, sweet potato, peas, legumes, lentils, most fruits, non-starchy vegetables)
- Exercising regularly – an effective way to maintain the metabolism and weight
Good management of diabetes reduces the development of associated medical complications. Besides the common medical treatment (taking blood sugar control pills such as metformin), there are also several supplementations which may helps in preventing and managing diabetes:
- Hovenia Dulcis berry – several studies have reported for its anti-diabetic properties: showed significant improvement of blood glucose level; possess antioxidant properties that may prevent and/or delay β-cells dysfunction in diabetic patients
- Red Ginseng – studies reported improvement in diabetes upon consumption of red ginseng by improving insulin sensitivity and enhance insulin secretion31-35
- Policosanol – diabetic patients are prone to have imbalanced cholesterol levels, and policosanol can help improve vascular blood circulation, balance cholesterol LDL HDL36-39, and improve blood glucose.
7) Active Lifestyle with Healthy Diet
Diabetes is a chronic, lifelong disease without cure. It is renowned as a “silent epidemic” due to the slow progression and lack of symptoms in the early stages. This often delays people from going for glucose test, preventive care or medical attention. Furthermore, having diabetes is associated with substantially higher lifetime medical expenditures i.e. more than 2 times that for those without diabetes14. Therefore, active lifestyle with healthy diet is always recommended. For those above 50 years old, regular blood glucose check should be carried out regularly, as they possess higher risk of getting diabetes. After all, prevention is always better than cure. You not only get to save on long term medical cost, but also get to enjoy a healthier and better life quality.
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- Stratton IM et al. 2000. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. British Medical Journal. Vol 321: pp. 405-412.
- Diabetes Prevention Program Research Group. 2002. Reduction in the incidence of Type 2 Diabetes with Lifestyle intervention or Metformin. The New England Journal of Medicine. Vol 346 (6): pp. 393-403.
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- Cnop M et al. 2005. Mechanisms of Pancreatic β-cell Death in Type 1 and Type 2 Diabetes: Many Differences, Few Similarities. Diabetes. Vol 54 (suppl. 2): pp. S97-S107.
- Diabetes UK. 2017. Hyperglycaemic Hyperosmolar Nonketotic Coma (HONK). Retrieved on 08 April 2017.
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- Ismail H et al. 2016. Undiagnosed Type 2 Diabetes Mellitus and Its Risk Factors among Malaysians: Findings of a Nationwide Study. International Journal of Public Health Research. Vol 6 (1): pp. 677-684.
- Sheard NF et al. 2004. Dietary Carbohydrate (Amount and Type) in the Prevention and Management of Diabetes: A statement by the American Diabetes Association. Diabetes Care. Vol 27 (9): pp. 2266-2271.
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- Kim JS et al. 2005. Effect of Hovenia Dulcis thunb Extract on the Hyperglycemic Mice Induced with Streptozotocin. J. Korean Soc Food Sci Nutr. Vol 34 (5): pp. 632 – 637.
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- Ayas NT et al. 2003. A Prospective Study of Self-Reported Sleep Duration and Incident Diabetes in Women. Diabetes Care. Vol 26 (2): pp. 380-384.
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- Liu TP et al. 2005. Improvement of insulin resistance by panax ginseng in fructose-rich chow-fed rats. (abstract only) Hormone and Metabolic Research. Vol 37 (3): pp. 146 – 151. Retrieved on 28 April 2017.
- Su CF et al. 2007. Increase of acetylcholine release by Panax ginseng root enhances insulin secretion on Wistar rats. (abstract only) Neuroscience Letters. Vol 412 (2): pp. 101 – 104. Retrieved on 28 April 2017.
- Park MW et al. 2008. 20(S)-Ginsenoside Rg3 Enhances Glucose-Stimulated Insulin Secretion and Activates AMPK. Biological and Pharmaceutical Bulletin. Vol 31 (4): pp. 748 – 751.
- Shang W et al. 2008. Ginsenoside Rb1 stimulates glucose uptake through insulin-like signalling pathway in 3T3-L1 adipocytes. Journal of Endocrinology. Vol 198 (3): pp. 561 – 569.
- Vuksan V et al. 2008. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. (abstract only) Nutrition, Metabolism&Cardiovascular Diseases. Vol 18 (1): pp. 46 – 56. Retrieved on 28 April 2017.
- Berthold G&Berthold HK. 2002. Policosanol: clinical pharmacology and therapeutic significance of a new lipid-lowering agent. American Heart Journal. Vol 143 (2): pp. 356 – 365.
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