An of­ten un­der­es­ti­mated fa­tal dis­ease

The Star Malaysia - Star2 - - World Diabetes Day - Dr Chan Siew Pheng.

MALAYSIA has the high­est preva­lence of di­a­betes in the re­gion. Ac­cord­ing to the Na­tional Health and Mor­bid­ity Sur­vey 2015, 17% of the sur­veyed par­tic­i­pants aged 18 and above had di­a­betes.

Han­dling this is­sue is fur­ther made dif­fi­cult be­cause di­a­betes is caused not just by life­style choices but also ge­netic risk fac­tors.

Ac­cord­ing to Dr Chan Siew Pheng, con­sul­tant en­docri­nol­o­gist at Subang Jaya Med­i­cal Cen­tre, most di­a­betic pa­tients in Malaysia have type 2 di­a­betes, which they get when their ge­netic risk fac­tors for de­vel­op­ing di­a­betes are trig­gered by ex­cess weight gain and phys­i­cal in­ac­tiv­ity. Type 1 di­a­betes, on the other hand, oc­curs be­cause the pan­creas does not pro­duce enough in­sulin.

“In Malaysia, the preva­lence sug­gests that about 95% of di­a­betic pa­tients have type 2 di­a­betes while less than 5% have type 1 di­a­betes,” she says.

Di­a­betes is a com­mon dis­ease in the gen­eral pop­u­la­tion, but Dr Chan shares that each case is unique and varies in sever­ity and cause. There­fore, the type of treat­ment given to each pa­tient is based on in­di­vid­ual fac­tors such as age, sever­ity of dis­ease, life­style and pres­ence of other med­i­cal con­di­tions such as heart dis­ease or re­nal im­pair­ment.

“We have to recog­nise the ge­netic fac­tors and causes that trig­ger the on­set of di­a­betes so that ap­pro­pri­ate treat­ment can be given. Not all peo­ple are di­a­betic be­cause of their life­style. Peo­ple who are slim and lead strict, healthy life­styles can still end up be­com­ing di­a­betic be­cause of the in­flu­ence of ge­netic fac­tors,” she says.

While some stud­ies claim that over­weight in­di­vid­u­als with di­a­betes may im­prove their health by los­ing weight, Dr Chan ex­plains that the same can­not be ap­plied to pa­tients who are al­ready of op­ti­mum weight.

Im­por­tance of con­trol­ling your blood glu­cose level

When it comes to man­age­ment of di­a­betes to prevent com­pli­ca­tions, it all boils down to con­trol­ling your blood glu­cose level as well as other risk fac­tors, in­clud­ing high blood pres­sure and high choles­terol.

“The good news is that we know a lot about how to prevent com­pli­ca­tions from di­a­betes, which are a re­sult of per­sis­tently high blood glu­cose level. The prob­lem is that hav­ing high blood glu­cose level is pain­less and there is of­ten a lack of ur­gency to con­trol it.

“Ur­gency in peo­ple with di­a­betes only comes when com­pli­ca­tions have oc­curred, and by then, it may be too late to fix the con­di­tion,” says Dr Chan.

There have been many ad­vances in re­cent years with new dis­cov­er­ies and new classes of med­i­ca­tion that al­low con­trol of blood glu­cose safely.

Th­ese new classes of med­i­ca­tion lower blood glu­cose to nor­mal lev­els with­out low­er­ing them too much.

Dr Chan feels strongly about the pre­vail­ing is­sue of di­a­betes in Malaysia, as it is one of the most com­mon causes of early heart at­tack, stroke and death.

“The se­ri­ous­ness of di­a­betes as a com­mon cause of heart at­tack is of­ten un­der­es­ti­mated. Peo­ple recog­nise high choles­terol and high blood pres­sure as risk fac­tors for heart at­tack and stroke, but not di­a­betes. Ac­cord­ing to an au­dit by the Health Min­istry, 40% to 45% of

When it comes to man­age­ment of di­a­betes to prevent com­pli­ca­tions, it all boils down to con­trol­ling your blood glu­cose level as well as other risk fac­tors, in­clud­ing high blood pres­sure and high choles­terol.

pa­tients ad­mit­ted for heart at­tacks in the past four to five years were peo­ple with di­a­betes.”

She is op­ti­mistic for the fu­ture of peo­ple with di­a­betes be­cause of break­throughs that have proven that cer­tain di­a­betes med­i­ca­tions can re­duce the risks of heart at­tack, stroke and death.

“Since 2015, three land­mark car­dio­vas­cu­lar out­come tri­als have proven that some newer classes of di­a­betes med­i­ca­tion not only help con­trol blood glu­cose level, but also lower the risk of heart at­tack and stroke in in­di­vid­u­als with di­a­betes and known heart dis­ease.”

Be­cause di­a­betes is gen­er­ally as­so­ci­ated with high choles­terol and high blood pres­sure, Dr Chan stresses that di­a­betes man­age­ment is no longer only about con­trol­ling blood glu­cose lev­els but blood pres­sure and choles­terol as well be­cause th­ese con­trib­ute to se­ri­ous com­pli­ca­tions. For more in­for­ma­tion, call 03-5639 1212.

Tak­ing the ini­tia­tive to con­trol one's blood glu­cose level can re­sult in pos­i­tive ef­fects down the line.

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