Only fat people get it, and other diabetic myths exposed

Did you know? The prevalence of diabetes has hit a 12-year high in Singapore - the percentage of adults aged between 18 and 69 with the condition has risen from 9 in 1998 to 11.3 in 2010, according to the National Health Survey.

The World Health Organisation estimates that the number of diabetes cases in Singapore will hit 695,000 by the year 2030. That's double the amount of cases reported in 2000.

Shape investigates the commonly held beliefs about the country's number six killer.

It's time to know our enemy better.

1. Eating sweets causes diabetes

THE TRUTH: It's more complicated than that.

Diabetes means your blood glucose (sugar) level is too high, and the problem is linked to insulin, a hormone which helps glucose from food get into your cells.

If your pancreas does not make enough insulin, or if the insulin doesn't work properly, glucose accumulates in the blood and leads to diabetes.

However, this doesn't mean you can start popping sweets at whim.

"If consumed excessively, energy-dense foods like candy could result in obesity, a risk factor for Type 2 diabetes. In the long run, it can tax the pancreas and trigger diabetes genes in those who are predisposed to it," warns Dr Kevin Tan, vice-president of the Diabetic Society of Singapore.

According to Singapore Health Services, 90 to 95 per cent of diabetics in Singapore are diagnosed with Type 2 diabetes.

The key is to exercise portion control when eating desserts, so you satisfy your sweet tooth without sacrifi cing your health, adds Jaclyn Reutens, clinical dietitian at Aptima Nutrition & Sports Consultants.

2. You must be fat in order to get type 2 diabetes

THE TRUTH: Skinny people aren't spared.

Just because studies have shown that most people with Type 2 diabetes tend to be overweight, being slim doesn't necessarily translate to a clean bill of health.

According to Dr Loh Keh Chuan, consultant endrocrinologist from Loh Keh Chuan Diabetes, Thyroid & Hormone Clinic, 30 per cent of people with Type 2 diabetes fall within the normal weight range (body mass index of 18 to 23).

That's because the same risk factors - age, genetic predisposition, and physical inactivity - apply whichever side of the scale you're on, explains Dr Tan.

Despite their slighter frame, underweight folks may also have a high percentage of "invisible" visceral fat (this lines vital organs like the liver), which ups their risk of Type 2 diabetes.

3. If there are ants in my pee, it's a sure sign of diabetes

THE TRUTH: It's likely, but not always the case.

Although sweet-smelling pee that attracts ants can be a sign of excessively high blood glucose level, it's not a good gauge.

Dr Tan explains: "In pregnancy, the kidneys' threshold for sugar may be lowered. This can cause glucose leakage from blood into urine, even though blood sugar levels are normal."

So don't panic if you see a trail of ants next to the toilet bowl. A more accurate way of diagnosing diabetes is a blood sugar test.

Exercise and fertility

4. If I have diabetes, I shouldn't run anymore

THE TRUTH: On the contrary, exercise is generally recommended.

Unless complications like nerve damage and organ failure have set in, there's no need to hang up your trainers just because you've been diagnosed with diabetes.

Past studies have found that exercise, especially resistance and aerobic training, can increase insulin sensitivity and control blood pressure at the same time.

However, intense physical activity such as long-distance running can lower blood sugar levels too quickly and bring on hypoglycaemia, a serious condition that leads to coma and death if left untreated.

"Always check with your doctor before embarking on such activities, and do a quick blood glucose test before and after each session to ensure it's within healthy limits," suggests Dr Lee.

5. Women with diabetes can't have babies

THE TRUTH: Pregnancy is possible.

As long as her blood glucose level is under control before and during pregnancy, a woman with diabetes can conceive.

Keeping her under the close supervision of her doctor for at least three to six months before conception will help to reduce her risk of miscarriage, birth defects, and stillbirth.

Dr Lubna Harharah, obstetrician and gynaecologist at The Obstetrics & Gynaecology Centre, advises expectant mothers with diabetes to have regular, balanced meals to stabilise blood glucose level throughout the day.

Folic acid supplements should also be taken during the first trimester to prevent birth defects.

6. Diabetics have to abstain from sex

THE TRUTH: You just need to know when to stop.

The risk of hypoglycaemia from a romp in the sack is generally low, especially if the patient's blood glucose level is well managed.

"However, if symptoms like dizziness and feeling cold during and after sex starts to surface, stop immediately and replenish blood glucose levels with a sweet drink.

"Or see a doctor immediately if symptoms persist, as they may indicate an underlying heart ailment," warns Dr Lee.


Get a copy of the November 2011 issue of SHAPE Singapore to read about the latest news in health, fitness, beauty and nutrition. SHAPE Singapore published by SPH Magazines is available at all newsstands now.

Bang Wei-Tin is a senior writer with SHAPE Singapore magazine by SPH Magazines.

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