Diabetes Mellitus



Diabetes Mellitus - What it is

Diabetes mellitus is a condition in which patients have high blood sugar. It is a common condition and affects 8.6% of the population in Singapore. This is an increase from 4.7% in 1984. It is an important condition because there are many complications that can occur as a result of diabetes mellitus. These can be divided broadly into those that occur in the short term (the acute complications) and those that occur over a long time (the chronic complications). Before we go into details of these complications, there is one very important message that we must get across to you as patients and members of the public. These complications are preventable. Although this is not true in every case, well controlled diabetes mellitus through your own efforts and working with your doctor and other health workers, will at least delay the onset of these complications. Patients with diabetes mellitus can live healthy, active, rewarding lives.

Types of Diabetes Mellitus

There are 2 major types of diabetes mellitus.
Type 1 diabetes mellitus has also been known as juvenile-onset diabetes mellitus or insulin dependant diabetes mellitus. This is the less common type and usually occurs in young persons below the age of 35. In this condition, the body is unable to produce insulin. Insulin is a hormone produced by the pancreas, a gland that is in the abdomen. Insulin is a hormone that controls the use of different fuels for energy. It is especially important because it allows the body to use glucose (simple sugar) instead of fats. When there is no insulin, the body cannot use or store the glucose that comes from food and this causes the blood sugars to become very high. Instead, the body uses fat as a source of fuel giving rise to some of the acute complications of diabetes mellitus.
Type 2 (adult-onset or non-insulin requiring) diabetes mellitus is much more common and is the type of diabetes that affects most Singaporeans. In this type of diabetes, there is no shortage of insulin (at least at the start of the disease). Instead, the cells and tissues of the body are unable to respond to the insulin produced by the pancreas. They have "insulin resistance." (see cartoon below).

This type of diabetes commonly occurs in persons who are overweight and have high blood pressure. There are often other family members who also have the disease.



Diabetes Mellitus - Symptoms


There are several symptoms that you may experience if you have diabetes mellitus. You may feel very thirsty and pass lots of urine. You may also find that you are losing weight and that you feel tired all the time. Sometimes, patients complain of blurred vision. Others notice itching around the genitals, suffer from frequent skin infections or notice that that wounds take a long time to heal. If you have any of these symptoms, particularly if you are overweight, have high blood pressure or close family members with diabetes mellitus, you should see your doctor to ask him/her to test you for diabetes mellitus.

Diabetes Mellitus - How to prevent?

Important factors in the prevention of kidney disease
  • Good control of your blood sugar.
  • Good control of blood pressure.
  • Use of drugs called Angiotensin converting enzyme inhibitors (ACE inhibitors)
  • Cessation of smoking
  • Control of blood lipids
  • A low protein diet