Diabetes: Subtle signs you should not ignore 

JUNE 2, 2021
​​Can you believe that 3.5 million Malaysians live with diabetes today? The number is expected to grow to 30% by 2025. By then, 1 in 3 Malaysian adults will have diabetes.

Most of us are very busy, have stressful jobs, or are too affixed to technology to make time for ourselves. Me-time is usually last on the agenda. Worse, we can sometimes feel guilty about taking the time required to take care of ourselves. Getting started with self-care surely can be challenging.

You could have diabetes and not know it
The initial symptoms and signs of diabetes can be very subtle in the early disease process. This makes it difficult for the public to recognize the symptoms. By the time a patient exhibits symptoms of diabetes, there is already 50% loss of insulin in the body.

Hence it is important to pay attention to your body, rather than simply brushing them off. Here are the symptoms associated with diabetes that you may want to watch out for:
  • You have to pass urine more often -  When glucose level is high, the excess glucose from the blood ends up in the urine where it draws more water out. The color of urine  is usually clear or very lightly colored.
  • You feel very thirsty - As you pass urine more often, your body loses fluid. Your brain tells you to drink more in order to replace the fluid. At the same time, you may experience dry mouth and dry skin with itchiness.
  • You may develop frequent urinary tract and vaginal infection - Sugar in the urine makes a fertile breeding ground for bacteria.
  • You experience unintentional weight loss – patients with diabetes have insufficient insulin which prevents the body from getting glucose from the blood into the cell to use as energy. When this happens, the body burns fat and muscle for energy, causing weight loss.
  • You experience occasional blurred vision - High blood sugar may cause the lens in the eye to swell, causing blurring of vision.
  • You get slow healing of cuts and wounds - this is the common symptom that arises. High blood glucose can affect the nerves and leads to poor blood circulation. This in return impedes the blood required for skin repair to reach the areas of the body affected by cuts or wounds.

Dr Wan Juani Wan Seman, Consultant Physician and Endocrinologist at KPJ Selangor emphasized the need to have a greater awareness of the signs and symptoms of diabetes within the younger generations.

“In the recent National Health and Morbidity Survey 2019, about 8.9% of people with diabetes were unaware that they have the disease. 42% of those with unknown diabetes are between the age of 18-39 years”.
 
Early screening
As the symptoms of diabetes can be insidious, those with specific risk factors should undergo screening for diabetes. Adults at risk of getting diabetes include having a family member with diabetes, being overweight or obese, having sedentary lifestyle, pregnant women with history of diabetes during pregnancy, having high blood pressure and high cholesterol level. Screening tests for diabetes are readily available in the public and private healthcare facilities.

One may think that getting people to voluntarily screen for diabetes is difficult. A bigger challenge would be to ensure those diagnosed with diabetes continue treatment and follow-up.

“I have seen a patient diagnosed with diabetes at a young age of 18 years old and did not continue treatment and follow-up. This young man presented again 15 years later at the age of 33 years old with a heart attack and complications associated with diabetes such as near blindness, chronic kidney disease and erectile dysfunction. It is sad when a man’s life is cut short”.

“We should strive to have better awareness and have a good patient reach-out programme in the community’’ adds Wan Juani. Acceptance to diabetes is difficult especially in the younger population. The emotional turmoil coupled with relentless effort to pursue a growing career pathway may lead patients to disregard the importance of having good diabetes control.

The ultimate goal in the management of diabetes is to prevent complications. The complications usually involve major organs in the body. Patients with poor diabetes control are at risk of developing eye blindness, kidney failure, heart attack, amputations and damages to the nerves.

“It is paramount for patients to take charge of their diabetes by ensuring they have a balanced diet, good physical activity, monitor their blood sugar level at home and know the tricks to achieve good blood sugar targets. 

“Should I totally avoid  sugar intake?” is a common question asked.
Ideally, the lesser sugar the better. But what is most important is to have a well-balanced diet with consideration in the sugar and carbohydrate intake.
  • Simple changes can dramatically reduce the amount of sugar in your diet.
  • Choose healthier snacks such as unsweetened yogurts, unsalted nuts, seeds, fruits and vegetables instead of chocolate, cakes or biscuits.
  • Try artificial sweetener to replace sugar.
  • Try to go for water with natural flavourings, like mint or sliced lemon.
  • Try to do self-cooking at home instead of taking away food.

“Diabetes medications are meant to control the blood glucose levels and there is no cure. One needs to understand that it is a chronic disease and it will not go away. Family support is important in helping patients to cope with the disease,”says Wan Juani.

“With the advent of new diabetes technology and advances in diabetes medications, there is good opportunity in getting good diabetes control. To do that, get the right information, meet the right people and get the right advice.” she added.

EXPLORE FURTHER

​Ethnic variations in glycaemic response to simple sugars and carbohydrates

​Impact on blood glucose levels in Caucasians versus Asians

One in 10 prediabetic individuals progress to diabetes within a year

​Limitations of finger prick testing for prediabetes diagnosis

Diabetic retinopathy: A common cause for blindness in adults

​Diabetic retinopathy is the most common eye disease

Empowering children with type 1 diabetes mellitus

​​Is complete avoidance of sweets and sugar the solution?

​Can diabetes be reversed?

​Discover the power to reverse diabetes through nutrition and lifestyle

Maggot debridement therapy: Rescuing limbs from amputation

​An innovative modality for the treatment of chronic wounds