DM is a metabolic disorder characterized by high blood sugar levels. Normally, the food we eat is digested and converted to glucose or the form of sugar in the blood. Glucose is the body’s main fuel source. For our body to be able to use glucose for growth and energy, it needs to get into the cells. Insulin, produced by the pancreas, is needed for this process.
Think of insulin as a key that opens the door for glucose to enter the cells. In diabetes, however, the pancreas produces little or no insulin and/or the cells don’t respond appropriately to the insulin that is present. Put another way, in DM, the keys are either missing or don’t fit the locks so glucose can’t go into the cells. Thus, glucose builds up in the blood. This then leads to long-term damage to the body’s various organs such as the eyes, kidneys, nerves, heart and blood vessels.
The most common form of DM is type 2 diabetes. About 95 percent of people with DM have type 2 diabetes (previously known as adult-onset or non-insulin dependent diabetes). About a third of these people don’t even know they have the disease.
More than 50 percent of newly diagnosed type 2 DM patients already have coronary heart disease (CHD) or blockages in their heart arteries. People with type 2 diabetes are three to four times more likely to have a heart attack than people without DM. About half of these heart attacks are fatal. Therefore, patients with DM die primarily from CHD.
Individuals with type 2 DM are also more likely to have dyslipidemia or abnormalities in their blood lipid or cholesterol levels. Patients with type 2 DM can have high levels of small dense LDL or "bad" cholesterol, low levels of HDL or "good" cholesterol and high levels of triglycerides (which I consider "bad" cholesterol’s "sidekick"). "Bad" cholesterol can clump together and clog up one’s arteries. Thus, dyslipidemia increases one’s risk of dying of a heart attack or stroke.
Dyslipidemia, combined with diabetes, compounds the curse of CHD – contributing more corpses to the body count.
Should we screen for diabetes? The answer is a resounding yes! Every attempt should be made to diagnose DM early to prevent its devastating complications. A simple test to check a fasting blood sugar (i.e., no caloric intake for at least eight hours) in the morning can be done. (Testing for cholesterol levels can likewise be easily performed.)
People who should be tested for type 2 DM are those who have a family history of diabetes, are overweight, are 45 years old and over, have high blood pressure, have dyslipidemia, have previously been identified as having slightly elevated blood sugar levels, or have a history of diabetes during pregnancy or have given birth to babies over nine pounds.
In addition, people who may have symptoms of high blood sugar such as fatigue, dizziness, nausea, excessive urination, unusual thirst, weight loss, blurred vision, frequent infections and slow healing of wounds or sores should have their blood sugar levels checked.
Recent studies have shown that certain individuals who are at high risk of developing DM can reduce their risk of having diabetes by as much as 58 percent if they reduce their fat intake, lose weight, increase dietary fiber and exercise regularly (goal of more than 150 minutes a week).
Lifestyle modifications such as diet, exercise and smoking cessation can also do wonders in improving dyslipidemia. "‘Bad" cholesterol and triglyceride levels may decrease, while "good" cholesterol levels may increase. More importantly, people who make these lifestyle changes tend to live longer.
Let us all join hands to stem the tide of this devastating epidemic. Destroy the deadly duo of diabetes and dyslipidemia before they destroy us!
Get tested and get some peace of mind. Diabetes, if detected late, will erode not only your health but your peace of mind, and your family’s as well.
(The author is a consultant endocrinologist at FortMed Clinic and the Asian Hospital.)