by Dr. Robert Ling Tiew Hieng
Internal Medicine & Physician MBBS (IMU), MRCP (UK)
Type 2 diabetes mellitus (DM2) is a disease that can disturb our body’s glucose (sugar) metabolism.
DM2 is one of the major causes of hospitalisation and death. It constitutes for more than 90% of diabetic patients. Internationally, the estimated prevalence of DM2 is 6.4% in adults. For some regions, the rate of undiagnosed cases can go up to 50%.
A combination of genetic and environmental/lifestyle factors are considered to directly contribute towards DM2.
Genetic factors — In a person with a family history of DM2 or other conditions such as high blood pressure, high cholesterol, or obesity, the risk of developing DM2 is 5 to 10 times higher in his or her first-degree relatives (siblings/children).
Environmental factors — Uncontrolled diet and lack of exercise/ sedentary lifestyle, together with genetic factors, have much impact on the risk of having DM2
Specific patient groups who need DM2 screening include the following:
- Age ≥ 45 years
- Overweight (body mass index [BMI] ≥ 25 kg/m2)
- Sedentary lifestyle
- Hypertension (blood pressure ≥ 140/90 mmHg)
- History of pregnancy-induced diabetes mellitus
- History of vascular disease (e.g heart attack)
- Diabetes mellitus in a firstdegree relative
Most people show few or no symptoms before diagnosis. Common symptoms indicative of DM2 include:
- Polyuria (frequent urination)
- Polydipsia (Feeling thirsty)
- Blurred vision
If untreated, DM2 can lead to more serious ailments. Here are some of comorbid and dangerous health problems that can arise from untreated DM2:
- Cerebrovascular disease (stroke)
- Retinopathy (disease of the eye), causing blindness
- Coronary heart disease (heart attack)
- Nephropathy (disease of the kidney), causing kidney failure and dialysis
- Neuropathy (disease of the nerves), causing hands/feet numbness, ulceration of the foot and amputation
- Depression, low mood, irritability, no motivation, causing low self-esteem and can affect relationships
DM2 patients may need to take multiple medicines besides DM2 medicines e.g medications to lower high blood pressure/ cholesterol levels, and low-dose aspirin (bloodthinning agent) may be used for primary or secondary prevention.
Each medicine should be taken according to instructions i.e compliance is important. If the medication schedule is complicated, a written outline may be an aid in remembering to take particular medications at particular times.
It is also important to carefully manage situations that can complicate blood sugar control, such as during sickness.
In summary, Type 2 diabetes is a systemic condition that requires regular monitoring of blood sugar and complications. Compliance with taking medications is important to help minimise the complications.