Managing diabetes, a silent killer

Diabetes is one of the silent killers, it may not have any symptoms. So, regular health screenings are important to check for diabetes, especially if you are over 40 or have a family history of diabetes.

What is diabetes?

It is a medical condition in which the blood glucose levels remain persistently higher than normal.

It happens when insulin - the hormone that enables glucose to enter our cells to produce energy - is either lacking or not working properly. Too much glucose in the blood can lead to serious health problems.

How serious is the war on diabetes in Singapore?

The prevalence of diabetes among Singapore residents increased from 8.2 per cent in 2004 to 11.3 per cent in 2010. The prevalence of diabetes in adults here was 12.8 per cent in 2015.

This is expected to progressively increase as our population rapidly ages and becomes increasingly sedentary.

How will I know if I have diabetes?

It is best to visit your GP to check for diabetes if you feel thirsty all the time despite drinking a lot of water and pass a lot of urine both in the day and at night; feel constantly tired; are losing weight; have poor healing of wounds; or have itchy skin.

Diabetes is one of the silent killers, it may not have any symptoms. So, regular health screenings are important to check for diabetes, especially if you are over 40 or have a family history of diabetes.

If you are diagnosed to have diabetes, a close follow-up with your doctor is important.

Will I have to give up cake and chocolate if I am diabetic?

Cake and chocolate are rich in sugar, but a little of them once in a while is fine.

You will still be able to add some sweetness to your life even if you have diabetes - by sharing the cake with a friend instead of eating an entire slice, having a small piece of dark chocolate instead of a whole bar of milk chocolate, or baking with diabetic cake recipes.

Are diabetic patients more prone to developing certain health complications?

Long-term diabetes can affect the heart, blood vessels, kidneys and eyes, and lead to coronary heart disease, stroke, kidney failure, blindness, numbness, skin ulcers and erectile dysfunction.

Cardiovascular disease continues to be the leading cause of death among diabetics in adults.

In 2009, 46.4 per cent of patients here who suffered their first heart attack were diabetic.

Diabetes also increases the likelihood of erectile dysfunction by three times. Chronic pain was found to be prevalent in 60 per cent of female diabetics and 38 per cent of male diabetics.

How serious can diabetes get if it is left untreated?

Besides the symptoms of diabetes causing discomfort and the increased risk of complications, if left untreated, diabetes can result in coma and death.

Advanced kidney failure will lead to a need for dialysis. If the toes or feet become gangrenous, limbs will need to be amputated.

What is the worst case of diabetes you have seen?

An elderly lady with diabetes who had kidney failure and gangrene of her toes, which led to amputation of both legs.

She fell into depression after becoming wheelchair-bound.

The suffering she went through, and the distress the disease caused the family, made me realise how destructive diabetes can be.

What is in your arsenal to fight diabetes and the health complications that come with it?

Besides lifestyle modification, oral medications or insulin injections may be necessary to control the blood sugar, blood pressure and cholesterol levels.

When treating diabetes, the co-morbidities must also be treated. For example, I prescribe statins such as Lipitor for high cholesterol, Viagra for erectile dysfunction, Celebrex for chronic pain, and anti-hypertensive medication for high blood pressure.

Patients may need laser treatment for eye complications to prevent blindness.

For those with kidney complications, regular monitoring of their kidney function is needed to prepare them for dialysis.

Smoking increases the risk of complications. Hence, smoking cessation is also important.

fjieying@sph.com.sg

Dr Philip Koh is the chairman of the medical board at Healthway Medical Group.

This article was first published on Dec 5, 2016.
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