AROUND the globe, there is a collective emphasis and urgency needed to improve the prevention, diagnosis, and management of diabetes. Hence, this year’s World Diabetes Day theme, “Breaking Barriers, Bridging Gaps”, underscores the commitment of the world’s healthcare system in reducing the risk of diabetes and ensuring that all people who are diagnosed with diabetes have access to equitable, comprehensive, affordable, and quality treatment and care.
At KPJ Hospital, Kuching, endocrinologist Dr Lau Bik Kui explained about the prevalence of diabetes in Malaysia during an interview with the Sarawak Tribune. In stressing the numbers, he shared a report by the National Health Mobility Survey 2023, which found that one in every six Malaysians is diagnosed with diabetes.
The report also stressed that there are many undiagnosed diabetes cases among young people and that it is only diagnosed when it reaches a critical stage. “Diabetes is always undetected and has no symptoms. That is why it is important to do a regular medical check-up, at least once a year, to detect any diseases.”
He added that by doing so, it does not only detect diabetes but also other underlying conditions a patient may have, such as hypertension, cholesterol and others.
More about diabetes
In general, the disease is caused by high blood sugar. Explaining further, Dr Lau revealed that there are two types of diabetes — Type 1 and Type 2. Type 1 is when the pancreas (an organ that produces the hormone insulin to control sugar levels) is not functioning or has failed, whereas Type 2 is when the pancreas can still produce insulin but the body is resisting it — called insulin resistance.
Elaborating on Type 2 diabetes, Dr Lau said the most common reason for insulin resistance is due to obesity and poor lifestyle choices.
“While obesity is the common reason, another reason is when a patient takes a certain medication that contains steroid medication, which can induce insulin resistance. Then there are certain supplements sold in the market like jamu (traditional medicine) and pati ikan haruan (snakehead fish essence) that contain steroids inside.
Ingesting a steroid-content supplement or medication can induce insulin resistance, and in the long run, this may cause diabetes, Dr Lau said.
Treating diabetes
While medication is important, the important issue to highlight when treating diabetes is having a change in lifestyle. In his practice at KPJ Hospital, Dr Lau disclosed that each time there is a newly diagnosed patient, he and the diabetic nurse would spend time with the patient to discuss their diet.
“Although there is social media these days to help with the awareness, and that it is common knowledge to eat healthily, to avoid sugary drinks, and others, but when we really dive deeper into the discussion about diet, it is things like eating kuih-muih or taking fruits that are full of sugar, all while having an empty stomach.”
If a patient is obese, the team would encourage them to lose weight by doing physical activities and regular exercising. “So lifestyle always comes first. Medication is important, but it is a complementary function to help regulate the sugar. But if you can eat healthily, have done regular exercises, as well as achieve the ideal body weight, then it helps to alleviate diabetes.”
The bigger picture
But the core problem of diabetes patients is not usually limited to one disease. According to Dr Lau, patients are usually affected with hypertension and cholesterol too. “So we have to look beyond the sugar. We also have to look at the blood pressure and the cholesterol levels.”
From diabetes, patients can get different complications such as stroke, kidney failure, ischaemic heart disease, eye problems, nerve problems, and others. Diabetic patients generally have a higher risk of mortality and morbidity.
So the important aspect to improve one’s health is usually the following — diet, lifestyle, exercise, and a controlled body weight. “If you have other diseases, it is important to treat the body as a whole package,” he highlighted.
Positive outlook in life
Dr Lau advises those with diabetes to take good care in the beginning, before it is too late. To him, the first six months are critical to reducing the complications. “We have to look at things from a positive perspective rather than on the dark side.
When we work hard from the beginning, there will always be a silver lining. We have to proactively treat diabetes seriously from the early stages.”
To be positive and to acknowledge the problem and move on with it is essential. To explain, Dr Lau said that if a patient is obese, then they’ll need to lose weight, and their diet has to change. When you need to take medicines, then it is important to keep with the routine.
Family support is also important, he said. Diabetes is not a one-person disease but a family disease. When the family eat healthily and lose weight together, it acts like good support for the patient.
“It also means that the one with diabetes has a chance for it to be controlled, while the ones who do not have diabetes can decrease the risk of having diabetes.”
Other than that, the endocrinologist also put an emphasis on doctor-patient information disclosure. He disclosed that by being informative and providing ample information, patients will feel less anxious and fearful. By decreasing the negativity, patients can feel at ease with their diagnosis and learn to manage it over time.
