Did you know that diabetes mellitus roughly translates as "excessive discharge of urine, which is sweet"? This disease has been around as early as the first century, and since then it has been posing an increasingly heavy burden on our healthcare system as one of the metabolic diseases. There are effectively 3 types of diabetes mellitus - type 1 diabetes, type 2 diabetes, and gestational diabetes (during pregnancy). For the purposes of clarity, we will focus on type 2 diabetes in this article.
The glucose sugar levels in our blood is regulated by various mechanisms and hormones, a key one of which is insulin. When we eat, food is broken down by our digestive system into basic units of glucose, fat, and protein and absorbed into the bloodstream at the small intestines. When glucose absorption causes our blood sugar levels to rise above a certain level, our pancreas will start releasing insulin, a hormone which turns glucose into fat storage for future use. What happens in type 2 diabetes mellitus (T2DM) is that the fat tissue resists the action of insulin. This excess glucose remains in the bloodstream, causing high readings of blood sugar when it is tested. To get rid of the excess glucose, the kidneys try to excrete them through the urine. Because high amounts of water and sugar are lost through urine, the diabetic person will feel thirsty and hungry easily. These mechanisms thus cause the symptoms of polyuria (frequent urination), polydipsia (frequent thirst), and polyphagia (frequent hunger).
Long-term poorly controlled T2DM can lead to various complications. It can cause worsening or loss of eyesight, increase risk of stroke and dementia, cause renal impairment and failure, increase risk of heart disease and heart attack, damage the nervous system, and cause peripheral vascular disease. The immune system will also be suppressed, and it will take longer than usual for wounds to heal. We therefore hope to impress upon all readers of the importance of checking for diabetes mellitus regularly, and ensuring good control if diagnosed to ward off such complications. This is especially so for individuals at high risk of developing T2DM - those who are overweight, have high blood pressure or high blood cholesterol, lead a sedentary lifestyle, and have a family history of diabetes.
There are various lifestyle modifications that we can undertake regardless of our diabetic status. Diet control and physical exercise are important, just like in any other metabolic diseases. It is highly recommended that we base our diet on low glycaemic index foods. High sugary food and drinks should be avoided because they cause huge spikes in blood sugar and can blunt our body's response to insulin in the long run. To push Malaysians towards this change, the government is introducing a "sugar tax" of 40 sen per litre on all sweetened beverages starting April 1, 2019. Now would thus be a good time to change your dietary habits!
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