MOST of us know that diabetes is caused by high sugar levels in the blood. Yet do we know that it is a life-long disease and is typically incurable at present?

More importantly, do we know if we have diabetes? Ahmad does not until he had a heart attack and Rama only knew he had diabetes when he was diagnosed with kidney failure and had to go for dialysis.

The constantly high blood glucose levels (hyperglycaemia) of diabetics, over time, will cause damage to many organs in our body, leading to serious complications.

Heart attack and kidney failure are not the only dreaded complications of diabetes – there are many others. These include other heart diseases such as heart failure and irregular heartbeats; transient ischaemic attack (TIA) and stroke; blurring vision and blindness; urine retention and incontinence.

The other complications are nausea, vomiting, diarrhoea and constipation; claudication (leg pain) and amputation; foot numbness, pain, ulcer and gangrene; poor sexual drive and erectile dysfunction for the male.

Excessively high blood sugar (glucose) levels, especially in people with type 1 diabetes, may lead to altered consciousness, coma or even death.

The various types of diabetes

There are three major types of diabetes: type 1, type 2 and diabetes during pregnancy (gestational diabetes). Each has its own features but all are either due to not having enough (or no) insulin (a hormone produced by the pancreas that helps bring glucose into the body cells) and/or inability of the body to effectively utilise insulin, a condition referred to as ‘insulin resistance’.

Those who are at risk of diabetes (the more risks you have, the more likely you have diabetes) are: those who have family member(s) with diabetes; being overweight or obese (body mass index of 23 or above or 25 or above, respectively); have excess fat around the tummy (i.e., having waist circumference of 90 cm or more for men or 80 cm or more for women); are not physically active at work and seldom exercise; and have high blood pressure (greater than 140/90 mmHg).

Also at risk are those who have abnormal blood fats levels (e.g., high (bad) LDL – cholesterol, low (good) HDL – cholesterol); have had diabetes during pregnancy; had delivered a large baby (more than 4.0 kg) in previous pregnancy; do not have adequate, restful sleep at night; and are more than 30 years old.

The symptoms of diabetes include frequently passing large amounts of urine, always feeling thirsty, losing weight without obvious reason, and always feeling tired and without energy.

Other symptoms (due to high blood glucose levels) include skin itchiness (especially in the private parts), frequent infection, pins-and-needles sensation in hands and/or feet and having a slow-healing wound.

Checking the blood glucose level

Those who have the above symptoms must have their blood glucose checked earliest to be certain that these are not due to diabetes. The earlier diabetes is detected, the faster effective treatment can be given to avoid damage to the body.

However, the above symptoms are more likely to occur in people suffering from type 1 diabetes or those with very high blood glucose levels, while many with type 2 diabetes (the most common form of diabetes) may not have (or have only mild) symptoms.

These people would realise that they have diabetes only when complications set in, as in the cases of Ahmad and Rama. As such, it is important that every (adult) person, especially if he/she is at risk, go for a blood glucose test.

The test takes only a slight finger-prick and less than a minute to know if your blood glucose (sugar) is up.

Your doctor, however, may order other tests including an oral glucose tolerance test (OGTT) and/or glycosylated haemoglobin (HbA1c) test, to ascertain if you have diabetes, especially when your finger-prick glucose test is normal though you are at high risk.

Emeritus Professor Datuk Dr Mustaffa Embong, Consultant Diabetologist, National Diabetes Institute (Nadi)