Diabetes is one of the major non-communicable diseases in Malaysia. The National Health and Morbidity Survey 2019 revealed that there are approximately 3.9 million Malaysian adults living with diabetes. That is equivalent to 1 in 5 adults in this “Sweetest Nation in Asia”.
What is diabetes?
A chronic disease, diabetes occurs when the pancreas is either no longer able to produce insulin, or when the body cannot make good use of the insulin it produces.
Insulin is a hormone that functions to let glucose from the food we eat pass from the bloodstream into the body cells to produce energy.
When the pancreas is not able to produce or use insulin effectively, this leads to increased glucose levels in the blood.
A person is diabetic when his fasting blood sugar level is more than 7.0 mmol/L or more than 11.1 mmol/L in a non-fasting state. However, many of the symptoms of diabetes occur only when blood sugar is greater than 15 mmol/L.
Types of diabetes
These are three main types of diabetes:
1. Type 1 diabetes
For type 1 diabetes, the pancreas produces very little or no insulin. To maintain blood glucose levels under control, the patients need daily insulin injections.
Type 1 diabetes can develop at any age but occurs most frequently in children and adolescents. According to the Centers for Disease Control and Prevention, type 1 diabetes is thought to be caused by an autoimmune reaction whereby the body attacks itself by mistake, stopping the pancreas from producing insulin. There’s currently no known way to prevent type 1 diabetes.
Causes
The exact cause of type 1 diabetes is unknown. As mentioned, it is considered to be caused by the immune system which attacks and destroys the insulin-producing cells in the pancreas, leaving the body with little or no insulin. This causes sugar to build up in the bloodstream.
Though unclear, type 1 diabetes is also thought to be caused by a combination of genetic susceptibility and environmental factors. Being overweight or obese is not believed to be a cause of type 1 diabetes.
2. Type 2 diabetes
For type 2 diabetes, the pancreas doesn’t use insulin effectively and can’t keep blood sugar at normal levels.
Type 2 diabetes develops over many years and is usually diagnosed in adults. However, it is increasingly diagnosed in children, teens, and young adults. Type 2 diabetes can be prevented or delayed with lifestyle changes, such as eating healthy, losing weight, and being active.
In Malaysia, of 1,614,363 diabetic patients registered with the National Diabetes Registry (NDR) in 2019, type 2 diabetes formed the majority with 93.71% of patients, followed by type 1 diabetes (6.2%), and other forms of diabetes (0.09%).
Causes
It’s believed that genetic and environmental factors contribute to the development of type 2 diabetes. While being overweight or obese is strongly linked to the development of type 2 diabetes, not everyone with type 2 diabetes is overweight.
3. Gestational diabetes
Gestational diabetes develops in pregnant women who have never had diabetes.
This type of diabetes can put the baby at a higher risk for health complications. Usually, this diabetes type goes away after the baby is born. However, the mother is at risk for type 2 diabetes later in life. It’s also more likely for the baby to become obese as a child or teen and to develop type 2 diabetes later in life.
Causes
During pregnancy, the placenta produces hormones to sustain the pregnancy. These hormones make the body cells more resistant to insulin.
Normally, the pancreas overcomes the resistance by producing sufficient insulin. However, sometimes the pancreas can’t keep up, and when this happens, too little glucose gets into the cells and too much glucose stays in the bloodstream, causing gestational diabetes.
What is prediabetes?
Prediabetes occurs when the blood sugar levels are higher than normal, but not high enough to be classified as diabetes. Prediabetes may progress to diabetes if appropriate actions are not taken to prevent the progression.
Symptoms of diabetes
Diabetes symptoms vary depending on your blood sugar levels. Some people, especially those with prediabetes or type 2 diabetes, may sometimes not experience any symptoms. In type 1 diabetes, symptoms tend to be more severe.
Some of the signs and symptoms of type 1 diabetes and type 2 diabetes are:
- Increased thirst
- Frequent urination
- Extreme hunger
- Unexplained weight loss
- Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough insulin)
- Fatigue
- Irritability
- Blurred vision
- Slow healing of sores
- Frequent infections, such as gums or skin infections and vaginal infections
How much does it cost to treat diabetes?
If you’re diabetic, you’ll have to undergo treatments to keep your blood sugar levels under control. A common test for diabetes is the Hemoglobin A1c test (HbA1c, A1c, or Hb1c) that determines the average concentration of glucose in the blood plasma. You need to take this test about two to seven times a year. You also need to consider blood test devices and medications. The outpatient treatments including full blood tests, blood test devices, test strips, medications and doctor’s consultation fees can easily cost you RM2,750 a year. As this estimated cumulative amount was as of 2017, the amount could be way higher today given medical inflation.
Bear in mind that diabetes could also lead to severe diseases such as kidney disease and heart disease. How much do these diseases cost? On average, kidney dialysis can cost you between RM150 and RM250 per session, while a heart transplant can cost you up to RM100,000!
How can you prevent diabetes?
While type 1 diabetes can’t be prevented, you can prevent type 2 diabetes and gestational diabetes by practising a healthy lifestyle.
- Eating healthy. Eat high-fiber food such as brown rice and beans, and avoid food that is high in fat and calories such as fried chicken and ice cream. Eat more fruits, vegetables and whole grains.
- Being physically active. Spend about 30 minutes on most days on moderate physical activities such as jogging and brisk walking. Target to spend at least 2.5 hours or 150 minutes on the activities.
- Lose excess weight. If you’re overweight, losing even 7% of your weight can reduce your risk of getting diabetes. For example, if you’re 155 cm tall and with a weight of 71 kg, for a start, try to lose 7% or 5 kg of your weight. You can then work on achieving your ideal weight. If you’re pregnant, please talk to your doctor first about how much weight is healthy for you to gain during pregnancy.
Conclusion
Keep a healthy lifestyle to reduce your risk of getting diabetes. Check your blood sugar at least once a year to check that you’re free from type 2 diabetes. 49% of diabetic people in Malaysia had never been examined or diagnosed with diabetes, so don’t wait until you get the symptoms of diabetes. The only way to know is to have a blood test. A screening test can be done at any health clinic in Malaysia and an annual check-up is recommended.
Please also protect yourself by getting adequate life and medical insurance. Start browsing for the best plan so you can get the most out of your insurance. Bjak is one good platform that lets you customize your insurance to best fit your needs and budget. Give it a try. It’s completely free.
(Sources: AstraZeneca, Centers for Disease Control and Prevention, iMoney, International Diabetes Federation, MalayMail, Mayo Clinic, MyHEALTH, National Health and Morbidity Survey 2019)
