Diabetes FAQ

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1. What is diabetes?
Diabetes describes a condition when there is excess glucose in the blood.
2. What are the symptoms of diabetes?
More than 50% of patients with diabetes have no symptoms and they are diagnosed on screening tests. Common symptoms of diabetes include increased thirst, frequency of urination, weight loss, weakness and blurred vision.
3. How common is diabetes?
In many developed countries, the prevalence of diabetes is between 8-9% of the population. The lifetime risk of diabetes can be as high as 35%.
4. Who gets diabetes?
Diabetes is strongly associated with excess weight. It is also more common with increasing age and among certain ethnic groups. There is a strong hereditary component and if you have a family member with diabetes, your risk of developing diabetes is 5-10 times higher. If both your parents have diabetes, you have a 50% risk of developing diabetes.
5. What causes diabetes?
Insulin is a hormone produced by your pancreas which allows glucose to enter your cells. Diabetes is caused when your pancreas produces too little insulin, or when your body is resistant to the effects of insulin or a combination of both.
6. What are the main types of diabetes?
a) Type 1 diabetes is when your pancreas is almost totally destroyed by your immune system and does not produce any insulin. It is much less common than type 2 diabetes and only accounts for 5-10 % of all patients with diabetes. It usually occurs in the young.
b) Type 2 diabetes is caused by a combination of insufficient insulin production by your pancreas combined with your body’s resistance to insulin. 90-95 % of patients with diabetes have type 2 diabetes and it usually affects older patients.
c) Gestational diabetes refers to diabetes developing during pregnancy. It occurs partly due to hormone changes in pregnancy. It usually resolves after delivery but it increases your risk of developing diabetes later in life.
7. Why is diabetes a serious condition?
Diabetes is a serious condition because it can lead to long-term complications such as kidney disease, heart disease, eye disease, nerve damage, foot ulcers and gangrene.
8. What are the complications of diabetes?
a) Kidney disease. Diabetes damages the kidney and if the damage is serious it can lead to kidney failure requiring dialysis or kidney transplantation.
b) Heart disease. Diabetes is a major risk factor for heart disease and heart attacks.
c) Eye disease. Diabetes damages the retina of your eyes and if the damage is serious it can lead to partial or total loss of vision.
d) Foot disease. Diabetes damages the nerves and blood vessels of your feet. If your nerves are damaged, you may experience pain or numbness of your feet and are more prone to foot ulcers. If you develop a foot infection and you have poor blood flow to your feet due to damage to your blood vessels, this may lead to gangrene of your foot.
9. How can I prevent diabetes complications?
You need to achieve good glucose control especially in the early stages of your diabetes. You should see your doctor every 2-4 months to check your overall glucose control. It is also equally important to achieve good control of your blood pressure and cholesterol levels. You should examine you own feet daily to look for cuts and blisters. Get your doctor to screen for kidney, eye and foot complications at least yearly. If early complications are detected, your doctor can intervene to slow down the rate of damage to the affected organ. If you have any symptoms such as chest discomfort or breathlessness, you may need an evaluation of your heart.
10. How do I test for diabetes?
A fasting blood glucose level or a glucose tolerance test are common methods to diagnose diabetes.
11. What is HbA1c?
HbA1c is a blood test that can be done in the clinic that gives an indication of your overall glucose control for the past 2-3 months. It measures the glucose molecules which are attached to your red blood cells. The higher your blood glucose, the more glucose molecules will attach to your red blood cells. Since your red blood cells have a life span of 120 days, your HbA1c reading gives a good indication of your past few months’ glucose control. This test does not require you to fast.
12. How is diabetes treated?
Life-style changes with diet and exercise are very important aspects of managing your diabetes. If you are overweight, aim to lose weight to get closer to your ideal body weight. Most patients will also require either tablets or insulin injections to achieve good glucose control.
13. What are the types of medication that can be used to treat diabetes?
There are now many classes of medication that are used to control your blood glucose. You can discuss with your doctor regarding the benefits of each type of medication:
a) Metformin
b) Sulphonylureas
c) DPP IV inhibitors
d) Alpha glucosidase inhibitors
e) Thiazolidinediones
f) GLP-1 analogues
g) Meglitinides
h) Insulin
14. Can I get pregnant if I have diabetes?
Diabetes is not a contraindication to pregnancy but you should aim for very good diabetes control before planning for pregnancy. This is because poor glucose control around conception increases the risk of birth defects. Good glucose control during pregnancy is also important to prevent large babies and complications during pregnancy and delivery.

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