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Diabetes Mellitus



(by Marcus Heng, Guardian Pharmacist)

 
1. What are the types of Diabetes and how does the condition develop?
 
Diabetes Mellitus (DM) is a metabolic disease characterized by elevated blood glucose due to impaired insulin secretion or action.
 
There are 2 main types that account for nearly all DM patients. Type 1 DM (5-10% of patients) is autoimmune and results from an irreversible destruction of the body's own insulin producing cells. Type 2 DM (90-95% of patients) develops as a result of insulin resistance or insufficient insulin secretion by the pancreatic cells.
 
Other types of DM occur as a result from other diseases or conditions. For example, long term use of steroids can affect blood sugar control or gestational diabetes that develops due to hormone imbalance during pregnancy.
 
 
2. What are the ways to minimize the risk of developing the condition?
 
Type 2 DM can be largely avoided by adopting a healthier lifestyle. Increased physical activity, healthier food intake, weight control and smoking cessation are related to a low developmental risk of DM. 
 
Strategies for Type 1 DM prevention are still being researched, but there are ways to control and prevent the condition from lapsing into total insulin dependence by using immunosuppressants.
 
 
3. Which groups of people are at a higher risk of developing Diabetes?
 
Type 2 DM risk factors include age above 45 years, family history of DM, being overweight or obese and studies have shown that regular consumption of sugary beverages may increase the risk too! A high BMI of above 35 kg/m2 contributes to up to twice the risk of developing DM as compared to a person with BMI < 22kg/m2. Smoking impairs insulin sensitivity, thus increases DM risk too. Sleep duration and quality can affect DM risk too, with less than 6 hours or more than 10 hours per day attributing to higher risk.
 
Type 1 DM risk is mainly genetic, although pregnancy and infant virus exposure has been identified as risk factors for the condition in some studies.
 
 
4. How does food intake play a part in reducing the risk of developing Diabetes?
 
A Mediterranean diet, or one consisting of high consumption of fruits, vegetables, dairy products, whole grains, beans, nuts or seeds may help with better blood sugar control and also prevent the onset of DM. Avoidance of sugary food and beverages during childhood may also reduce this risk.
 
Some studies on chromium supplements did indicate better blood glucose control, but mainly with those with already elevated blood glucose levels.
 
Additionally, sources have indicated that vitamin D, selenium, bitter melon or iron intake help with blood glucose control but are not well-studied enough to be conclusive.
 
 
5. An active lifestyle is often quoted as an important factor in maintaining health. What level of exercise should people engage in?
 
Several lifestyle modifications are associated with lower DM risk and also better control of blood glucose in people living with the disease. The recommendation is at least 150 minutes of regular, moderate activity a week. (e.g. aerobic exercises such as brisk walking, swimming or cycling), This should be coupled with the aim of achieving an ideal BMI of between 18.5kg/m2 and 22.9kg/m2,as this would lead to not just a lower risk of developing DM and associated metabolic diseases -but also better weight management.
 
 
6. Does Guardian have any healthy lifestyle and dietary programs that it would recommend for people to follow?
 
Guardian pharmacists can provide personalized advice, individualized plans and follow-ups for weight and dietary management. We are also collaborating with the Health Promotion Board's programmes for health assessments, healthy lifestyle campaigns and smoking cessation programmes which you can participate in. Furthermore, our pharmacies stock a diverse range of health supplements and prescription medications to aid with any dietary or lifestyle modifications necessary for healthier living.
Guardian also has its own program for promoting healthy lifestyles and managing long term medical conditions. The Guardian Diabetes Patient Care Program (DPCP) for patients with DM involves counselling sessions with pharmacists on the safe use of medicines, healthy diet choices, appropriate supplement use and review of blood glucose results. The Start to S.T.O.P (Speak To Our Pharmacists) Smoking Cessation Program is a paid quit smoking program that involves face-to-face and phone counselling sessions to aid the smokers in their quit journey and successfully stop smoking and improve their health. To know more about these programmes, speak to our Guardian pharmacists today!

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