Diabetes is a lifelong condition when your blood glucose level is too high.  According to the National Health and Morbidity Survey 2015, almost one in five Malaysian adults has diabetes. The survey also revealed that nearly 50% of patients diagnosed with diabetes were NOT even aware they have the disease!  The most common types of diabetes are Type 1 and Type 2 Diabetes.  Type 2 diabetes is the most common form of diabetes accounting for more than 90% of cases.

Click to view NovoDisk video on How Insulin Works in Diabetes

Causes Type 2 Diabetes

Type 2 diabetes occurs progressively when the body becomes immune to the effects of insulin (insulin resistance) and/or the pancreas does not produce enough insulin (insulin deficiency). This results in glucose staying in the blood and unable to be utilised by the body organs to be used as energy.  The following risk factors can increase your chances of getting diabetes;

• Overweight: Being overweight will cause your body cells to be resistant to insulin
• Sedentary lifestyle and physical inactivity
• Genetics: If you have a family member who has diabetes, you have a higher chance of getting diabetes
• Hormone disorders such as Cushing’s syndrome, Acromegaly or Thyroid disease
• Damage to the pancreas due to pancreatitis or cancer
• Non-Alcoholic Fatty Liver Disease (NAFLD)
• Some medications (such as steroids or HIV therapy)

Symptoms of Type 2 Diabetes

Majority of Diabetics do NOT have any symptoms until much later when they will experience some of these symptoms:

• feeling very thirsty
• passing urine more often than usual especially at night
• feeling more tired than usual
• unexplained weight loss
• blurred vision
• cuts and wounds take longer to heal

Click to view Diabetes UK video on Symptoms of Diabetes

Who should be Screened for Diabetes?

Screening for Diabetes is recommended in all adults (over 30 years age) YEARLY especially if they have the following risk factors;

1. Anyone with the diabetes symptoms described above

2. Women with Gestational Diabetes during pregnancy

3. Anyone who is Pre-Diabetic (HbA1c which is 5.7-6.2%) or has Impaired Glucose Tolerance / Impaired Fasting Tolerance on Oral Glucose Tolerance Testing

4. Adults who are overweight with BMI > 23 or with large waist circumference (female > 80cm or male > 90cm) with ANY 1 of these;

• History of cardiovascular disease
• 1st degree relatives with Diabetes
• Hypertension
• High lipids (HDL <  0.9mmol/l or TG > 2.8 mmol/l)
• Women who have delivered a baby > 4kg
• Those who have been from mothers with Gestational Diabetes
• Physical inactivity or sedentary lifestyle
• Treatment on long term medication (such as steroids or anti-retroviral therapy)

Diagnosis of Diabetes

There are a few ways to diagnose diabetes and tests should be carried out in your doctor’s clinic or a health lab prior to initiating therapy.

1. Fasting & Random Blood Glucose Test

The Fasting Blood Glucose (FPG) Test is a blood test to diagnose diabetes or pre-diabetes and requires you to fast for 8 hours before performing the test.

The Random Blood Glucose (RPG) Test measures your blood glucose at any time.

Results interpretation

• For individual with symptoms, 1 abnormal blood glucose reading is sufficient for diagnosis
• For individual without symptoms, 2 abnormal blood glucose readings are needed

	Fasting	Random
Venous Blood (mmol / l)	> 7.0	> 11.1

2. HbA1c Blood Test

The HbA1C Test measures your average blood glucose over the past 2-3 months. It shows how well your blood sugar has been controlled over the last 2-3 months period.  High values mean you are at risk of vascular complications of diabetes. 

Results interpretation

• For individual with symptoms, 1 abnormal reading is sufficient for diagnosis
• For individual without symptoms, HbA1c should be repeated within 4 weeks after first abnormal test

Normal	Pre-Diabetes	Diabetes
< 5.6%	5.7-6.2%	> 6.3%

3. Oral Glucose Tolerance Test

The Oral Glucose Tolerance (OGT) Test measures your blood glucose level before and after you drink a syrup glucose solution (a sweet drink). Your blood will be drawn once before you drink the solution and have your blood drawn again after 2 hours.

Results interpretation

• A 2-hour blood glucose over > 11.1 mmol/l confirms the diagnosis of diabetes
• A 2-hour blood glucose between 7.8-11.1 mmol/l is considered to be Pre-Diabetes (Impaired Glucose Tolerance)

Category	0 hour (mmol/l)	2 hours (mmol/l)
Normal	< 6.1	< 7.8
Isolated Impaired Fasting Glucose (I-IFG)	6.1-6.9
Isolated Impaired Glucose Tolerance (I-IGT)		7.8-11.0
Diabetes	> 7	> 11.1

Complications of Diabetes

It is important to get properly supervised treatment for diabetes because untreated or poorly controlled diabetes can cause serious health complications in the long term such as;

• Impaired Kidney function
• Peripheral neuropathy & arterial disease
• Diabetic retinopathy
• Foot numbness or ulcers
• Heart disease
• Stroke
• Sexual dysfunction
• Miscarriage

Statistics have shown that 60% of Diabetics die from cardiovascular complications while around 14% have kidney disease, around 11% have diabetic eye disease and around 2% have diabetic foot ulcers.  As such, it important to see your doctor, dietician / nutritionist or pharmacist regularly to help monitor your diabetes to prevent these complications. 

Take time to discuss your condition with your doctor, dietician/nutritionist or pharmacist to improve your diabetic control and AVOID diabetic related health complications.

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If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.