Type 2 DIABETES
Type 2 Diabetes is the most common type of Diabetes in Singapore.
About 11.3% of our population are affected by Diabetes*.
That’s about 11 out of every 100 people which is quite a lot! This is from the MOH National Health Survey in 2010.
The percentage has probably gone up since then.
What happens in Type 2 Diabetes?
In type 2 Diabetes, there is not enough insulin produced as well as an increase in resistance of the body cells to insulin.
Insulin is produced in the Pancreas and it helps the body cells to use circulating glucose in the blood stream.
As there is insufficient Insulin produced and an increase in resistance to Insulin, the blood Glucose level is then increased, wreaking havoc on the entire body system.
What are some of the Signs and Symptoms of Type 2 Diabetes?
The most common symptom is NO SYMPTOM. Most of the time people will not know that they have even developed the condition. Developing symptoms usually means the disease has been there for a period of time and has started to cause problems.
Some of the common symptoms include:
So why is it important? I feel fine.
Diabetes can affect almost every part of the body. It commonly causes problems in the Eyes, Kidneys, Feet and a whole lot more.
New blood vessels can form in the eyes and these can bleed, causing impairment of vision. It is also associated with Glaucoma, a condition in which the pressure in the eye is increased.
For the Kidneys, the problem usually first starts with some leakage of protein in the urine and it can eventually lead to End Stage Kidney Failure, requiring dialysis.
The feet are commonly affected as Diabetes can impair nerve function.
Small cuts and wound can develop without you realizing it and these go on to get infected.
There is poor wound healing in diabetes and if the infection is not address it can progress and eventually lead to amputations or worse.
How can I check myself for Type 2 Diabetes?
Diabetes is diagnosed by doing a Fasting Blood Glucose test.
You need to fast over night for at least 8 hours.
If you have symptoms and the result is more or equal to 7.0mmol/L, then you have Type 2 Diabetes.
If you do not have symptoms, the test should be repeated again on another day in order to confirm the diagnosis.
What if the blood glucose level is between 6.1 - 6.9mmol/L?
This is usually a pre-diabetic state in which your fasting glucose is not normal.
It does not mean that you do not have Type 2 Diabetes.
A confirmatory test called a Glucose Tolerance Test must be done to ascertain your status.
This again involves fasting for 8 hours or more, doing a fasting blood glucose level, then drinking 75mg of glucose water and having your blood drawn again 1 hour after and again 2 hours later.
I already have Type 2 Diabetes, what do I need to do?
Well you need to accept that you have the condition and take steps to manage the condition.
There is no cure for Type 2 Diabetes as yet, but with lifestyle modifications and medications, it can be well managed.
You need to start controlling your diet in terms of reducing the amount of sugar you consume. Try to avoid canned or soft drinks and drink more water. Avoid sweets and too many desserts.
Besides sugary foods and drinks, you must control the amount of carbohydrate you take.
Carbohydrates are converted in sugars which enter our bodies after we eat and they contribute to the high circulating blood glucose levels.
You need to start exercising. By right we need to do daily exercise of 30 minutes each time.
Any form of exercise will be good.
Exercise not only helps you burn off calories and lose weight, but it also helps to sensitize your body and muscles to insulin. Allowing your body to better utilize the circulating glucose in the blood stream.
Medications
A lot of research has gone into Type 2 Diabetes and there continues to be new discoveries.
These days, there are new and more effective medicines available which have minimal side effects.
Broadly, the commonly used classes of Diabetic drugs are the Suphonylureas, Biguanides, Alpha-Glucosidase Inhibitors and Insulins.
There are newer classes of drugs which are the DPP-4 inhibitors and the SGLT2 Inhibitors.
DPP-4 inhibitors
This group of drugs works by preventing the breakdown of a group of hormones called Incretins. Incretins increase insulin secretion and inhibit Glucagon release. Glucagon acts to increase the amount of glucose released into the blood.
The end effect is that the DPP-4 Inhibitors increase Incretin levels and thus reduce circulating blood glucose in the body.
The good thing about the DPP-4 Inhibitors is that they have been shown to have much lower risks of Hypoglycaemia.
Hypoglycaemia is a situation in which the blood glucose level drops too low.
This is dangerous and potentially fatal. Most diabetic medications carry this risk, but the risk is much lower with the DPP-4 Inhibitors.
In addition, some of the DPP-4 Inhibitors come in combination with Metformin (another Diabetic drug). This makes it much more convenient as there is not need to take an extra tablet if you are already on Metformin.
SGLT2 Inhibitors
This new class of medication is exciting!
SGLT 2 is present in our kidneys. They work to absorb glucose. By Inhibiting SGLT2, excess glucose is excreted in the urine. You literally pass the glucose out.
There are some added benefits to this new class of drugs such as weight loss, lowering of the blood pressure and potential cardio protective effects.
However, as glucose is passed out in the urine, if you are on this medication, you must maintain good hygiene in your groin area.
Monitoring of Diabetic Condition
If you have Diabetes, make sure you are on regular monitoring with your doctor to make sure your blood glucose levels are controlled.
As Diabetes affects many other organ systems, your cholesterol and kidneys must also be monitored.
Once a year, you need to get your Eyes and Feet checked.
The tests for these are also known as the DRP (Diabetic Retinal Photo) and DFS (Diabetic Foot Screening).
Consult your doctor and talk to him about optimising the control and monitoring of your diabetic condition.
MEDISAVE
Our clinic is medisave accredited. Medisave can be used for management of Diabetes. You can use your own medisave or that of your immediate family members (Parents, Spouse and Children).
Drop by our clinic, GREENLINK MEDICAL CLINIC for a consult. We are located in Yishun, next to Khatib MRT station.
*Ministry of Health, Singapore. National Health Survey 2010, Singapore. Singapore: Epidemiology and Disease Control Division, Ministry of Health; 2011.
About 11.3% of our population are affected by Diabetes*.
That’s about 11 out of every 100 people which is quite a lot! This is from the MOH National Health Survey in 2010.
The percentage has probably gone up since then.
What happens in Type 2 Diabetes?
In type 2 Diabetes, there is not enough insulin produced as well as an increase in resistance of the body cells to insulin.
Insulin is produced in the Pancreas and it helps the body cells to use circulating glucose in the blood stream.
As there is insufficient Insulin produced and an increase in resistance to Insulin, the blood Glucose level is then increased, wreaking havoc on the entire body system.
What are some of the Signs and Symptoms of Type 2 Diabetes?
The most common symptom is NO SYMPTOM. Most of the time people will not know that they have even developed the condition. Developing symptoms usually means the disease has been there for a period of time and has started to cause problems.
Some of the common symptoms include:
- Frequent urination
- Waking up in the night to pass urine
- Increased thirst
- Unexplained weight loss
- Recurrent genital skin infections
- Poor wound healing
So why is it important? I feel fine.
Diabetes can affect almost every part of the body. It commonly causes problems in the Eyes, Kidneys, Feet and a whole lot more.
New blood vessels can form in the eyes and these can bleed, causing impairment of vision. It is also associated with Glaucoma, a condition in which the pressure in the eye is increased.
For the Kidneys, the problem usually first starts with some leakage of protein in the urine and it can eventually lead to End Stage Kidney Failure, requiring dialysis.
The feet are commonly affected as Diabetes can impair nerve function.
Small cuts and wound can develop without you realizing it and these go on to get infected.
There is poor wound healing in diabetes and if the infection is not address it can progress and eventually lead to amputations or worse.
How can I check myself for Type 2 Diabetes?
Diabetes is diagnosed by doing a Fasting Blood Glucose test.
You need to fast over night for at least 8 hours.
If you have symptoms and the result is more or equal to 7.0mmol/L, then you have Type 2 Diabetes.
If you do not have symptoms, the test should be repeated again on another day in order to confirm the diagnosis.
What if the blood glucose level is between 6.1 - 6.9mmol/L?
This is usually a pre-diabetic state in which your fasting glucose is not normal.
It does not mean that you do not have Type 2 Diabetes.
A confirmatory test called a Glucose Tolerance Test must be done to ascertain your status.
This again involves fasting for 8 hours or more, doing a fasting blood glucose level, then drinking 75mg of glucose water and having your blood drawn again 1 hour after and again 2 hours later.
I already have Type 2 Diabetes, what do I need to do?
Well you need to accept that you have the condition and take steps to manage the condition.
There is no cure for Type 2 Diabetes as yet, but with lifestyle modifications and medications, it can be well managed.
You need to start controlling your diet in terms of reducing the amount of sugar you consume. Try to avoid canned or soft drinks and drink more water. Avoid sweets and too many desserts.
Besides sugary foods and drinks, you must control the amount of carbohydrate you take.
Carbohydrates are converted in sugars which enter our bodies after we eat and they contribute to the high circulating blood glucose levels.
You need to start exercising. By right we need to do daily exercise of 30 minutes each time.
Any form of exercise will be good.
Exercise not only helps you burn off calories and lose weight, but it also helps to sensitize your body and muscles to insulin. Allowing your body to better utilize the circulating glucose in the blood stream.
Medications
A lot of research has gone into Type 2 Diabetes and there continues to be new discoveries.
These days, there are new and more effective medicines available which have minimal side effects.
Broadly, the commonly used classes of Diabetic drugs are the Suphonylureas, Biguanides, Alpha-Glucosidase Inhibitors and Insulins.
There are newer classes of drugs which are the DPP-4 inhibitors and the SGLT2 Inhibitors.
DPP-4 inhibitors
This group of drugs works by preventing the breakdown of a group of hormones called Incretins. Incretins increase insulin secretion and inhibit Glucagon release. Glucagon acts to increase the amount of glucose released into the blood.
The end effect is that the DPP-4 Inhibitors increase Incretin levels and thus reduce circulating blood glucose in the body.
The good thing about the DPP-4 Inhibitors is that they have been shown to have much lower risks of Hypoglycaemia.
Hypoglycaemia is a situation in which the blood glucose level drops too low.
This is dangerous and potentially fatal. Most diabetic medications carry this risk, but the risk is much lower with the DPP-4 Inhibitors.
In addition, some of the DPP-4 Inhibitors come in combination with Metformin (another Diabetic drug). This makes it much more convenient as there is not need to take an extra tablet if you are already on Metformin.
SGLT2 Inhibitors
This new class of medication is exciting!
SGLT 2 is present in our kidneys. They work to absorb glucose. By Inhibiting SGLT2, excess glucose is excreted in the urine. You literally pass the glucose out.
There are some added benefits to this new class of drugs such as weight loss, lowering of the blood pressure and potential cardio protective effects.
However, as glucose is passed out in the urine, if you are on this medication, you must maintain good hygiene in your groin area.
Monitoring of Diabetic Condition
If you have Diabetes, make sure you are on regular monitoring with your doctor to make sure your blood glucose levels are controlled.
As Diabetes affects many other organ systems, your cholesterol and kidneys must also be monitored.
Once a year, you need to get your Eyes and Feet checked.
The tests for these are also known as the DRP (Diabetic Retinal Photo) and DFS (Diabetic Foot Screening).
Consult your doctor and talk to him about optimising the control and monitoring of your diabetic condition.
MEDISAVE
Our clinic is medisave accredited. Medisave can be used for management of Diabetes. You can use your own medisave or that of your immediate family members (Parents, Spouse and Children).
Drop by our clinic, GREENLINK MEDICAL CLINIC for a consult. We are located in Yishun, next to Khatib MRT station.
*Ministry of Health, Singapore. National Health Survey 2010, Singapore. Singapore: Epidemiology and Disease Control Division, Ministry of Health; 2011.