Tips on how to manage diabetes

Diabetes is a chronic disease where the body does not produce or properly use insulin, a hormone needed to convert sugar, starch, and other food into energy.

Although its cause is not known, it is generally agreed that both genetics and the environment play important roles.

The number of diabetics in the country increased by almost 80 per cent between 1996 and 2006, and in 2012, the number of registered diabetic patients reached 2.6 million.

Symptoms vary and may include weight loss, increased fatigue, blurred vision and an increased need to urinate. As many of these symptoms are commonly experienced by healthy individuals, Sunway Medical Centre diabetes nurse specialist Wong Su Fei advises going for regular medical checkups and testing blood sugar level.

"Many patients stop going for regular checks once they think they have it under control. But diabetes is a progressive disease and often, doctors need to change the dosage of medicine provided," she says.


Diet is a crucial part of diabetes management. Many people have pre-conceived notions about what diabetics can and cannot eat. For example, it is a common belief that diabetics should avoid carbohydrate-laden foods such as potato and bread.

Sunway Medical Centre senior dietitian, Saw Bee Suan disagrees. "What diabetics need to be aware of is the serving size. Everything must be consumed in moderation and so it is important that they plan their meals."

An ideal meal should contain a balanced choice of food items in recommended portions.

Diabetics should also learn about healthier alternatives available to them and include these in their diets. An example is rice. Healthier alternatives to plain white rice include brown, parboiled or white basmati rice.

Diabetics should also eat more high fibre foods as fibre helps slow down the absorption of sugar.

Saw says people should not assume that food typically recognised as healthy can be eaten in large amounts. Fruit, for example, should be eaten in moderation as it is a form of carbohydrates as well.

"Diabetic patients should eat between one and two pieces of fruit a day and beware of drinking too much fruit juice as a single glass can be equivalent to four to five pieces of fruit. Dietary requirements vary and each patient should see a dietitian for proper management."


Gestational diabetes affects pregnant women who exhibit high glucose levels. Though the high sugar levels return to normal following the birth of their child, these women are at a high risk of being diagnosed with diabetes later on in life.

Women planning to start a family should work with their doctors to ensure healthy glucose levels during pregnancy.

"The first trimester is crucial to a child's development. If sugar levels are poorly controlled, the development of the foetus can be affected" says Sunway Medical Centre endocrinologist Dr Siti Harnida Md Isa.

"For diabetics who wish to get pregnant, planning is important and they should seek their doctor's opinion as to whether their sugar control is optimal. Moreover, the dosage of medicine required changes during pregnancy, so it is important that their doctors are kept updated" she adds.


Diabetics often suffer from ischemia, the reduction of blood flow to their peripheries, and neuropathy, damage to the nerves, resulting in poor blood circulation and a reduction in sensation in a patient's feet.

This leads to deterioration in the general health of feet and a reduction in the rate of healing and the sensation of injury. An untreated ulcer on the foot can become infected, leading to sepsis, gangrene and, in the more severe cases, amputation.

"People often take their feet for granted and don't pay enough attention to their well-being until it is too late. Women especially, should avoid wearing heels above 1½ inches as heels that are too high places pressure on the front of your foot. All diabetics should have their feet checked annually," says the medical centre's podiatrist, Dr Brendan J. Bergin.