SUNDAY STAR, 11 NOVEMBER 2018

WORLD DIABETES DAY

2 World Diabetes Day SUNDAY STAR, 11 NOVEMBER 2018

Proper management of the disease

ACCORDING to World Health
Organization, in 2016, an estimated
1.6 million deaths globally were
caused by type 2 diabetes mellitus
and the figure is expected to
increase tremendously in the years
to come.
Type 2 diabetes is a common
chronic disease. It is a condition
where one’s body is unable to
detect and use insulin efficiently,
leading to high blood glucose level.
Insulin is the hormone that
controls blood glucose levels.
Without insulin, cells cannot
absorb sugar (glucose), which is
needed to produce energy.
Many are unaware that type 2
diabetes is a progressive disease
that has no cure. Therefore, blood
glucose management is important
to control a diabetes patient’s blood
sugar levels.
Type 2 diabetes is ascribed to
high carbohydrate intake and an
unhealthy lifestyle. Therefore, Purslane, bitter melon and cinnamon extracts can help maintain a healthy blood glucose level.
besides taking oral diabetes
medication or insulin boosts, type 2 oleracea) is a culinary ingredient distinctive aroma in food, it is charantia) assists in glucose herb extract, cinnamon extract and
diabetes management also includes that is traditionally used for also known as an anti-glycaemic metabolism and prevents sudden bitter melon extract is an effective
losing weight for those who are achieving a healthy blood glucose herb. blood glucose spikes by aiding way to control and maintain
overweight, correct portioning of level. The polyphenols within glucose uptake by the cells. healthy blood glucose level.
high-carbohydrate foods, It is said to have anti-glycaemic cinnamon are known to improve Bitter melon extract has also Last but not least, the best way to
increasing exercise frequency and effects where it reduces glucose digestion and assist in the demonstrated its capability to keep your blood glucose at a
quitting alcohol and cigarettes. absorption from the intestine into breakdown and usage of activate body enzymes to healthy level is to adopt a healthy
Recent research shows that some the bloodstream and increases cell carbohydrates in our bodies. regulate the body’s glucose lifestyle. Good management is key
herbs and spices such as purslane, sensitivity towards insulin to In addition to helping to improve metabolism. to enjoying sweetness in life even if
bitter melon and cinnamon facilitate glucose uptake, thus cholesterol and triglyceride levels, Bitter melon is a well-known you have type 2 diabetes.
extracts could be useful in reducing glucose level in the cinnamon extracts have traditional herbal remedy used
complementing first-line diabetes blood. antioxidant and anti-inflammatory since ancient times in Chinese This article is brought to you by
treatment. properties. medicine and by Ayurvedic Medispec (M) Sdn Bhd.
Cinnamon practitioners as an adjuvant
Purslane Cinnamon extract (Cinnamomum Bitter melon therapy for individuals with high
blood glucose levels.
n For more information, call
1300 800 228 or e-mail
Purslane herb extract (Portulaca zeylanicum) not only provides a Bitter melon extract (Momordica The combination of purslane enquiry@medispec.com.my
SUNDAY STAR, 11 NOVEMBER 2018 World Diabetes Day 3

By SRIMAYEE SEN SARMA

“DIABETES is a serious global problem and

is at the point of becoming uncontrollable,
with one in two people with diabetes
remaining undiagnosed,” warns Prof Nam H.
Cho, president of International Diabetes
Federation (IDF).
The number of people with diabetes
worldwide has risen rapidly from 108
million in 1980 to 422 million in 2014,
according to World Health Organization
(WHO).
The number has since increased even
further to more than 425 million, according
to IDF Diabetes Atlas Eighth edition 2017.
To create awareness about the rapid
increase of diabetes patients around the
world, IDF with the support of WHO created
the World Diabetes Day campaign in 1991.
A global theme is selected each year to focus
on a specific area related to diabetes. The
theme for this World Diabetes Day is Family
and Diabetes.
Explaining the reason for this year’s
theme, Prof Cho says, “With such high
prevalence of diabetes, most families have
or will have a relative affected by the
disease.
“Hence, families have a key role to play
Having the entire family get in on being more physically active can contribute to lowering the global prevalence of diabetes.

Vital to have family support

since they are in a position to spot diabetes
early and help deliver care to any family
member diagnosed with it.”
However, the general level of knowledge
about the disease is worryingly low.
Educational programmes are necessary
to help raise awareness of the warning
signs and risk factors in order to encourage
early intervention – before the Together we stand things that you enjoy and knowing that this a challenge and requires daily commitment.
development of diabetes-related disease will never completely go away. Lifestyle changes include watching one’s
complications. According to Dr Loh Vooi Lee, consultant “Families can help by cooking delicious diet, taking medication, and checking blood
“Early detection, prevention and physician and endocrinologist at ParkCity healthy meals at home for the diabetic or sugar level and keeping it under control.
treatment will save money and needless Medical Centre, many people get depressed exercising together. This way, the diabetic “Families have a significant role to play in
suffering. Therefore, families need the right when diagnosed with diabetes. Family person would feel supported and the whole supporting any loved one with diabetes.
education, resources and environments to support is essential during such times to family can stay healthy too,” he suggests. They can get involved by learning how to
play the crucial role of helping patients cope provide emotional support and ensure the Prof Cho says, “A close-knit support monitor and control blood sugar levels,
with diabetes. The theme for this year’s well-being of the patient by helping with the network is often a great comfort during a whether in caring for a child who requires
World Diabetes Day aims to highlight this,” introduction of necessary lifestyle changes. time of need and diabetes is no different.”
elucidates Prof Cho. “Imagine not being able to eat certain He explains that managing diabetes can be > TURN TO PAGE 4
4 World Diabetes Day
Stay healthy with help from loved ones
> FROM PAGE 3
insulin injections or an elderly family
member who needs daily monitoring of
blood sugar levels,” he adds.
Regular monitoring of blood sugar levels is
also essential to prevent another problem
associated with diabetes – hypoglycaemia.
Blood sugar levels can sometimes fall
dangerously below the normal level,
which may take a fatal turn if not treated
fast.
Regular monitoring would point to any
abnormal decrease in blood sugar level,
which can then be treated by modifying the
dose and type of medication.
According to Dr Loh, “It is important to
educate patients and their families on the
signs to look out for, the amount of sugar to
take when hypoglycaemia strikes and how to
prevent getting it in the first place.”
He elaborates that fear of getting
hypoglycaemia is one of the reasons people
do not want to take diabetes medication.
However, there are many new medications
that can successfully reduce the occurrence
of hypoglycaemia.
Moreover, hypoglycaemia can be
effectively prevented with regular
monitoring and, if it occurs, easily treated
with prompt action.
Diabetes affects the entire family and
lifestyle change is just one side of the coin.
The world in figures
From the data collected globally last
year, International Diabetes Federation
presents an overview of the pandemic
nature of the disease.
l By 2045, the number of individuals
with diabetes worldwide will rise to
629 million.
l Seventy-nine per cent of adults
with diabetes were from low-income
and middle-income countries.
l The greatest number of people
with diabetes were between the ages of
40 and 59.
l Diabetes caused four million
deaths.
l More than 1,106,500 children were
living with type 1 diabetes.
l More than 21 million live births
(one in seven births) were affected by
diabetes during pregnancy.
l About 352 million people were at
risk of developing type 2 diabetes.
The staggering numbers go to prove
the importance of creating awareness
about diabetes and ways to stop this
disease from taking control of our lives.
With the number of people with type 2 diabetes rapidly increasing, it is important for everyone
to be aware of the disease and its management methods so they may offer support to loved
ones affected by it.
SUNDAY STAR, 11 NOVEMBER 2018
The state of the world
at present does not
look too rosy with the
number of people with
diabetes increasing at
an uncontrolled pace.
However, the more
prevalent type 2 diabetes
(when the body becomes
insulin resistant) can be
managed and prevented
effectively.
Stress and anxiety are commonly felt among
patients as well as family members as they
adapt to the diagnosis.
Prof Cho points out, “Being worried about
the overall cost of diabetes medication puts a
strain on the family, who may have to spend
beyond their means to pay for care.
“Many people don’t have access to the
right information to recognise and prevent
diabetes, and those who are already living
with diabetes often don’t have affordable
access to care.”
According to him, families need to have
access to ongoing diabetes management
education and support to reduce the
emotional impact of the disease.
Be the change
The state of the world at present does not
look too rosy with the number of people
with diabetes increasing at an uncontrolled
pace. However, the more prevalent type 2
diabetes (when the body becomes insulin
resistant) can be managed and prevented
effectively.
Eating and sitting too much is a culture
that we need to let go if we are to put a stop
to this growing global issue, and this effort
requires the participation of not just diabetes
patients and their families but every
member of society.
Prof Cho advises, “Improving awareness,
investing in education to promote
prevention, early diagnosis and treatment,
and ensuring affordable access to
medication and care are all critical to Understanding the silent killer
controlling the rise of diabetes.”
“Tackling the pandemic will require a Most of us know that diabetes is and physical inactivity.
whole-of-society approach. From characterised by an increase in the level International Diabetes Federation’s
governments and industry to individuals, we of glucose in the bloodstream, but do you president Prof Nam H. Cho explains,
all need to act.” know what causes this spike? “There are several forces that drive type
When we eat, the food consumed is 2 diabetes, such as rapid urbanisation,
converted to glucose and the pancreas the shift in our regular diet from healthy
produces a hormone called insulin to food to foods high in sugar and fat, and
transfer the glucose from the blood to the inactive lifestyles.”
body’s cells. Excess fat in the body prevents glucose
Diabetes is a serious condition where from being absorbed by muscles and
the sugar in the blood is not absorbed by tissues, leading to insulin resistance.
the cells. This happens when the Glucose accumulates in the bloodstream
pancreas is damaged and cannot produce because insulin is unable to cause the
insulin or when the body becomes body’s cells to absorb it, resulting in
resistant to this hormone. diabetes.
Type 1 – A person who is diagnosed Because the cells do not receive
with type 1 diabetes needs to be supplied enough glucose to convert to energy,
insulin externally since his pancreas is fatigue often accompanies type 2
incapable of secreting this essential diabetes.
hormone or the amount it produces is According to National Diabetes
insufficient. The root cause of type 1 Institute executive chairman Emeritus
diabetes is sometimes attributed to Prof Datuk Mustaffa Embong, Malaysia
genetic disorders, but current knowledge has the highest rate of individuals with
is inadequate to point to just one reason. diabetes in Asia and one of the highest in
Type 2 – This is the more common type the world.
of diabetes and occurs when the insulin The prevalence of diabetes in the
produced by the pancreas is sufficient country is 16.9% in adults, which equates
but unable to remove glucose from the to a staggering 3.5 million people.
blood. It happens when the body This is not surprising owing to the fact
becomes insulin resistant. that Malaysia is also the “fattest nation”
Although unmodifiable risk factors in Asia as reported by British medical
such as age and family history can journal, The Lancet.
contribute to the development of While we are yet to find preventative
type 2 diabetes, the disease remains measures for type 1 diabetes, we can
vastly preventable because the stop type 2 diabetes from taking over
biggest risk factor is obesity, which is our lives by eating healthier and being
modifiable and attributed to poor diet more active.
SUNDAY STAR, 11 NOVEMBER 2018 5
6 World Diabetes Day
Reducing risk through good nutrition
IN a fact sheet titled The top 10
causes of death, the World Health
Organization named diabetes as
a leading cause of death in the
world.
According to the International
Diabetes Foundation, people with
diabetes are two to six times
more likely to develop
cardiovascular disease such as
heart attack and stroke
compared to those without. The
onset of diabetes is usually
preceded by poor dietary choices
and unhealthy lifestyles.
Excessive consumption of
carbohydrate-rich foods can lead
to weight gain and increased risk
of elevated blood glucose levels.
Hence, for diabetes patients to
achieve positive glycaemic
response, they must reduce
their intake of carbohydrate-rich
foods and practise portion
control.
On the other hand, adopting a
high-fibre diet that comprises
foods with low glycaemic index
ratings and that contain oat beta-
Biogrow Oat BG22 contains oat beta-glucans, which can help delay the absorption and digestion of carbohydrates glucans may have a beneficial
and prevent sudden spikes in blood glucose level. effect on short- and long-term
blood glucose control among
diabetic patients, according to a
2008 study titled Beta-glucans in
the treatment of diabetes and
associated cardiovascular risks
published in Vascular Health and
Risk Management and a 2010
article titled Scientific Opinion on
the substantiation of a health
claim related to oat beta-glucan
and lowering blood cholesterol
and reduced risk of (coronary)
heart disease pursuant to Article
14 of Regulation (EC) No
1924/2006 published in European
Food Safety Authority Journal.
Biogrow Oat BG22
Slight modifications to our
daily diets to include fibre such as
oat bran can help regulate blood diabetes-friendly food as it
glucose levels and lower our risk has a low glycaemic index rating
of developing diabetes.
Oat beta-glucan, a soluble form blood glucose levels and let you
of dietary fibre that is found in
oat bran, can help control blood
glucose levels thanks to its high
viscosity, according to a 2012
study titled Oat Beta-Glucan: Its
Role in Health Promotion and
Prevention of Diseases published Cereal Chemistry.
in Comprehensive Reviews in Food
Science and Food Safety.
This increased viscosity acts as diabetes. Biogrow Oat BG22 is
a preventative barrier, delaying
the digestion and absorption of
carbohydrates and thus
preventing sudden spikes in
blood glucose level and abnormal
insulin secretion after meals.
The European Commission and Legosan (Malaysia) Sdn Bhd.
Malaysia’s Health Ministry have
approved oat beta-glucan and
acknowledged its role in
controlling high blood glucose
level after meals. Below are
SUNDAY STAR, 11 NOVEMBER 2018
Excessive
consumption of
carbohydrate-rich
foods can lead to
weight gain and
increased risk of
elevated blood
glucose levels.
Hence, for diabetic
patients to achieve
positive glycaemic
response, they must
reduce their intake
of carbohydrate-rich
foods and practise
portion control.
nutrition function claims for oat
beta-glucan as approved by the
European Food Safety Authority
and Malaysian Health Ministry.
l Consuming 3g of oat beta-
glucan daily helps lower
cholesterol.
l Oat beta-glucan helps lower
blood glucose, provided it is not
consumed with other food.
l Consumption of beta-glucan
from oats contributes to reducing
the rise in blood glucose level
after meals.
A daily serving of Biogrow Oat
BG22 oat bran powder provides
3g of clinically proven, bioactive
oat beta-glucans to lower the rise
of blood glucose and cholesterol
levels.
Biogrow Oat BG22 is a
(< 55), which can help stabilise
achieve energy balance
throughout the day, according to
a 2012 study titled Glycemic
Response to Extruded Oat Bran
Cereals Processed to Vary in
Molecular Weight published in
Therefore, it is suitable for
people with prediabetes and
low in calories, high in fibre and
free of lactose, added sugar,
artificial ingredients and
preservatives.
This article is brought to you by
n For more information, call
03-7956 2220 (Monday to Friday,
9am to 5pm) or e-mail info@
biogrow.com.my
SUNDAY STAR, 11 NOVEMBER 2018
EATING too much sugar can
bring about several negative
effects on our health, including
obesity, high blood pressure,
heart disease, liver problems
and diabetes.
Although diabetes is not
directly related to high sugar
intake, consuming too much
sugar can cause obesity, which is
a risk factor for diabetes.
It is thus essential to control
the amount of sugar you
consume daily. If you are
diabetic, it is especially crucial to
limit your sugar intake to the
daily recommended amount as
advised by your doctor.
However, the recommended
daily intake is often exceeded by
many Malaysians due to lack of
awareness.
Most people do not know the
difference between naturally
occurring sugar and added
sugar or have the knowledge of
how to read and decipher food
labels to understand how much
sugar is in food products, which
can lead them to unknowingly
consume large amounts of
sugar.
Identify the different
types of sugar
Sugar that we commonly
consume can be classified into
two types:
l Naturally occurring –
Sugar that is found in fruits,
dairy products, whole grains,
rice and vegetables rich in
starch such as corn, sweet
potatoes, beans and peas.
l Added – Artificial sugar
that is added during the
preparation and processing of
food. Some obvious examples
are candy, cakes and carbonated
drinks, but there are also
unexpected food sources that
contain added sugar such as
yoghurt, salad dressing and
chilli sauce.
Natural sugar is more difficult
to digest and hence makes you
feel sated for a longer period of
time. The body absorbs this kind
of sugar slowly, keeping your
blood glucose level from sudden
spikes and dips.
Added sugar, on the other
hand, is easier to digest and
provides a burst of energy right
after consumption. Excessive
consumption of added sugar is
harmful in the long run.
When you continue to
consume large amounts of
sugar, you need to work hard to
burn off those extra calories. If
you lead a sedentary lifestyle
and eat food that contains lots of
sugar, the excess sugar is
digested and deposited in your
body as fat, leading to obesity
and eventual health
complications.
World Diabetes Day 7
Read the label carefully
The hidden dangers
Unfortunately, the ingredient
lists on packaged food items
often do not differentiate
between natural and added
sugar. However, do check the
ingredient label to see if it
contains one or more of these
types of added sugar.
- Glucose - Maltose
- Molasses - Corn
- Malt sugar sweetener
- Lactose - Honey
- Fructose - Sucrose
- Corn syrup - Fruit juice
- Agave concentrate
- Inverted - Sorbitol
sugar - Mannitol
- Brown sugar
Another marketing gimmick
that consumers often fall for is
when products claim to be
sugar-free or have reduced
sugar or no added sugar. It is
important to understand the
meaning of these terms to
keep tabs on your sugar The amount of sugar each of us consumes is probably more than how much we think we consume, and that is because of
consumption. the hidden sugar in many processed food items.
l Sugar-free – In most cases
when a food label says “sugar-
free”, it means it does not
contain added sugar but has
artificial sweeteners, which may
be detrimental to health.
l Reduced sugar – This
means that the product contains
less sugar than similar food
items. It is still important to
check the ingredient list because
even the reduced amount may
exceed your recommended daily
sugar intake.
l No added sugar – This
means that no sugar was added
during preparation or
processing of the food item, but
it may still contain natural
sugar.
Stay vigilant, stay safe
Efforts to curb your sugar
consumption will be in vain if
you do not start to pay attention
to the ingredient lists of
packaged food items.
If you live with diabetes,
heed advice from your doctor
and nutritionist so that your
disease can be brought under
control.
As humans need sugar for
energy, it is quite impossible to
eliminate sugar from our diets.
You can, however, ensure that
you and your family adhere to
the recommended daily sugar
intake and take the right
precautions so you all lead
healthy lives.
8 World Diabetes Day
Keep your blood
glucose level in check
MALAYSIAN meals such as rice, noodles,
roti canai and cakes comprise mainly
carbohydrates. Carbohydrates are our main
source of energy. When ingested, they are
broken down into glucose and enter the
bloodstream from the digestive tract,
increasing the blood glucose level.
Under healthy conditions, the pancreas
will release a hormone called insulin to help
cells throughout the body absorb glucose
and use it for energy. Once glucose moves
out of the blood into the cells, the blood
glucose level decreases.
The problem with Malaysians is that their
carbohydrate intake is higher than the
recommended amount.
According to the Malaysian Adult
Nutrition Survey 2003, Malaysian adults
consumed an average of 21g of table sugar
daily.
Despite the Health Ministry calling for
people to reduce overweight problems, sugar
intake and smoking, live healthy and active
lifestyles, and consume healthier diets with
fewer fats and more fruits and vegetables,
the number of diabetics in Malaysia keeps
increasing.
Sedentariness and poor lifestyle choices
can impact diabetes management. When
diabetes is uncontrolled, it can lead to
numerous health complications such as
arteriosclerosis, retinopathy and
neuropathy.
As a diabetic, besides eating healthily and
exercising regularly, nutritional supplements
can play a role in helping you manage your
blood glucose level.
Alpha lipoic acid (ALA)
ALA is an antioxidant that can help
control blood glucose levels and prevent
premature ageing. Antioxidants come in two
varieties: water-soluble and fat-soluble.
A few, such as ALA, are both. This dual
nature allows ALA to work throughout the
body and protect it from damage caused
by free radicals. This ability is the reason
alpha lipoic acid is called the universal
antioxidant.
In Germany, alpha lipoic acid is approved
for the treatment of diabetic neuropathic
pain.
Chromium picolinate and biotin
Chromium is another nutrient that may
help maintain normal blood glucose levels. It
is an essential trace mineral required for
carbohydrate and lipid metabolism. The
body cannot make chromium. It must be
obtained through diet or supplementation.
Unfortunately, nutritional chromium,
which is found in minute quantities in food
such as organ meat, oysters, mushrooms and
broccoli, is poorly absorbed by the intestinal
tract.
One way to maintain sufficient blood
chromium levels is through supplementation
with chromium picolinate. Unlike other
forms of chromium, chromium picolinate
has a stable chemical structure and good
absorption. Chromium picolinate can
have positive effects in diabetes
management.
Biotin, on the other hand, is a water-
soluble B vitamin that plays an essential role
in carbohydrate and lipid metabolism. Biotin
can stimulate insulin secretion, hepatic
glucose uptake and suppression of glucose
synthesis in the presence of high-plasma
glucose, as in the cases of prediabetes and
diabetes.
Besides helping you manage high blood
glucose levels, a combination of chromium
picolinate and biotin may help bring down
levels of haemoglobin A1c – the advanced
glycation end product associated with
long-term exposure to elevated sugar
concentrations.
According to data from the Food and
Agricultural Association, sugar consumption
Importance of
regular screening
HIGH blood glucose level that occurs during
pregnancy is known as gestational diabetes.
Although it usually resolves after childbirth,
gestational diabetes can increase the
mother’s and baby’s risk of developing type 2
diabetes in future.
The body naturally becomes a little
insulin-resistant during pregnancy so that
more sugar stays in the bloodstream to be
carried to the foetus. However, when this
insulin resistance becomes stronger than
necessary, it can lead to gestational diabetes.
What makes this type of diabetes
dangerous is how it can cause birth-related
complications. Thankfully, these
complications can be prevented with early
detection and proper management.
Minimising risks
Gestational diabetes does not have clear,
telltale symptoms but can be easily detected
with a simple blood test. It usually develops
during the later stages of pregnancy, so a
diagnostic glucose screening test is done
during this period, specifically from week 24
to 28 of pregnancy.
In Malaysian public hospitals, a modified
glucose tolerance test (MGTT) is performed
to screen for gestational diabetes. If the
condition is detected, further check-ups and
management methods are advised, and the
mother is kept under careful observation
until delivery.
Done twice during the pregnancy, MGTT
consists of a fasting blood glucose test in the
morning, after which the mother drinks a
solution of water mixed with 75mg of
glucose. Another blood glucose test is done
after two hours to determine how much
sugar has been absorbed by the body.
Apart from regular blood test, MGTT is a
precautionary test initiative taken by the
Government to curb the prevalence of
SUNDAY STAR, 11 NOVEMBER 2018
In some cases,
supplementation
and reducing
sugar intake can
help diabetics
manage blood
glucose levels
better.
in Malaysia is one of the highest in the
world.
Consuming too much sugar can lead to
weight gain, diabetes and increased risk of
developing cardiovascular disease, among
others.
Therefore, in addition to reducing our
sugar intake and leading healthy lifestyles,
supplementation may help us manage our
blood glucose levels better.
This information is brought to you by
Cambert (M) Sdn Bhd.
n For more information, call 03-5638 3660
(Monday to Friday, 9am to 5pm) or e-mail
enquiry@cambert.com.my
Gestational diabetes
does not have clear,
telltale symptoms but
can be easily detected
with a simple blood
test. It usually develops
during the later stages of
pregnancy, so a diagnostic
glucose screening test is
done during this period,
specifically from week 24
to 28 of pregnancy.
gestational diabetes and reduce diabetes-
related birth complications.
When blood glucose level is high, an
expecting mother may experience symptoms
such as frequent need to urinate as well as
increased thirst and fatigue, but as these are
common occurrences during pregnancy,
they are often overlooked.
This is the reason every pregnant woman
in Malaysia, regardless of symptoms of
diabetes or risk factors, must undergo
regular blood glucose level monitoring and
MGTT screening.
The complications
Having gestational diabetes does not
necessarily indicate the possibility of
> SEE NEXT PAGE
SUNDAY STAR, 11 NOVEMBER 2018
Early detection saves lives
> FROM PREVIOUS PAGE
problems arising during childbirth because
most women with this condition have
perfectly normal pregnancies and
childbirths.
However, the risk of certain complications
occurring during childbirth is higher for
mothers with gestational diabetes. Some of
these complications are:
l Premature birth – The baby is born
before the normal stipulated time.
Premature birth is associated with several
future health complications for the baby.
l Stillbirth – Though rare, it is a
possibility.
l High birth weight – Gestational
Who is at risk?
Although anyone can develop
gestational diabetes, some women are
more at risk than others and should be
extra vigilant during their pregnancy.
Common risk factors are listed below.
l A history of hypertension
l A family history of diabetes
l A body mass index of more than 30
l Excessive weight gain during
pregnancy
l Multifoetal pregnancy
l Had gestational diabetes in
previous pregnancy
l Previously given birth to a baby
weighing more than 4.5kg
l Of Hispanic, Asian, African or
Middle Eastern ancestry
If you have any of the above risk
factors, you will need to undergo
regular blood glucose level tests and
follow a lifestyle conducive to
managing blood glucose level
throughout your pregnancy.
World Diabetes Day 9
diabetes causes the weight of the foetus to
increase rapidly, which can cause problems
during delivery. The need for surgical
intervention is higher with heavier babies.
l Pre-eclampsia – A condition that occurs
specifically in pregnant women, pre-
eclampsia is when the mother’s blood
pressure rises and potentially damages
organs, specifically the liver and kidneys.
It can be life-threatening for both mother
and child if left untreated.
l Polyhydramnios – Characterised by
too much amniotic fluid surrounding
the baby, this condition can cause
premature labour and delivery
complications.
l Low blood
glucose level in
baby – The mother’s
gestational diabetes
may cause the
newborn to have
low blood glucose
level and develop
jaundice, leading to the need
for immediate medical treatment
after birth.
Treatment procedures
The usual treatment for gestational
diabetes is usually lifestyle alteration, which
includes regular blood glucose level
monitoring, proper diet and light exercise.
However, if the mother’s blood glucose level
is high, insulin injections will be prescribed
by doctors.
Diabetes is not fatal, but it is associated
with other conditions that are life-
threatening. Gestational diabetes is no
different since it causes many birth-related
complications.
It is thus imperative for us to be vigilant
and keep our mothers-to-be and their
unborn babies safe from the grips of this
deadly disease.
10 World Diabetes Day
Facilitating good circulation
POOR circulation is believed to be
the root cause of numerous health
conditions.
Early indications of poor
circulation start with the hands,
feet or legs. The common causes of
poor circulation include unhealthy
lifestyle choices, obesity, lack of
exercise, and poor nutrition or
diet.
Common health afflictions,
including diabetes, hypertension
(high blood pressure) and high
cholesterol, can also interfere with
blood flow and cause poor
circulation.
The Circulation Thermal Slippers
by Thermoskin Walk-On is
changing the way we prevent,
manage and live with painful foot
conditions such as heel pain,
plantar fasciitis and circulation
issues.
Thermoskin Walk-On is the latest
range of footcare support products
by Thermoskin, which is an
Australian company developed to
revolutionise the treatment of soft
tissue and pain management.
Its close partnerships with the
Australian Institute of Sport and
the Australian Physiotherapy
Association establishes Thermoskin
as a category leader in orthopaedic
support products globally.
The Thermoskin thermal slippers
harness heat from your own body
to naturally provide heat therapy
to increase blood flow to the feet.
As the material wicks away
moisture for increased breathability
and comfort, the slippers are
designed to be worn for long periods
of time around the house or while
sleeping.
These orthopaedic circulation
slippers were crafted to assist in the
management of health conditions
such as diabetes, arthritis, Raynaud
syndrome, cold or sensitive feet and
cramped toes.
Many thermal slippers do not fit
correctly and can lose warmth
throughout the day. Thermoskin’s
slippers are equipped with pull-up
tabs, making them easy to put on,
and feature a soft-stretch strip to
allow air flow without sacrificing
heat retention.
Diabetes patients will
appreciate that these slippers
are designed with their needs
in mind, containing no hard
edges that could cause
abrasions and bleeding.
All Thermoskin products are
designed and manufactured
with high-quality, durable
materials specifically chosen
to ensure all product
benefits listed are
achieved.
For individuals considering the
purchase of thermal slippers, it is
important to closely examine the
quality of a product before making a
purchase as products made from
inferior materials will often cause
more harm than good.
The Thermoskin Walk-On
Circulation Thermal Slippers
combine medically proven
technology and supreme comfort.
They are available at AA
Pharmacy, Alpro Pharmacy, Aeon
Wellness, Caring Pharmacy, Wellings
Pharmacy, Georgetown Pharmacy
and independent pharmacies.
n For more information, e-mail
info@newage.my or visit www.
thermoskin.com
Practise
self-care
THE management of diabetes
mostly focuses on making
lifestyle changes and the use of
required medication. However,
the psychological effects
associated with this disease are
frequently overlooked.
Imagine having to live with a
disease for the rest of your life
and not be able to eat certain
foods you love. The knowledge
that it is a chronic disease adds
fuel to fire, potentially leading
one into a state of depression.
Because of the stigma attached to
mental health in our society,
however, many diabetes
patients refrain from seeking
counselling or other
psychological treatment.
It is important to take as much
notice of patients’ mental health
as we do their physical health.
For people living with diabetes, it
is crucial that they remember
there are ways to cope and
continue leading a fulfilling life.
Being diagnosed with diabetes
can be difficult for anyone.
Worse still is when a person with
diabetes becomes fixated on the
negatives of having to take
medications for life, be restricted
in food choice and adopt lifestyle
changes.
Hence, providing psychological
support should be an integral
part of diabetes management.
With proper counselling,
healthcare providers can make a
huge difference in encouraging
diabetes patients to combat the
psychological impact of their
disease.
Loved ones and support
groups also play a significant
role in assisting a diabetes
patient to develop a more
optimistic view of the future.
Nevertheless, the onus of
fighting off the negativity
falls first on the patient
herself.
Accept reality and put
your plan in action
The first step of coping with
diabetes is acknowledging the
possible signs of the disease and
going for a check-up.
SUNDAY STAR, 11 NOVEMBER 2018
It is important
to take as much
notice of patients’
mental health as
we do their physical
health. For people
living with diabetes,
it is crucial that they
remember there are
ways to cope and
continue leading a
fulfilling life.
Should the diagnosis be
diabetes, it is all about making
informed decisions. If you have
diabetes, start by accepting that a
lifestyle change is unavoidable.
The next step is to consider
how to go about making the
necessary lifestyle changes.
Critically plan out a workable
schedule that you are prepared
to adhere to.
There is no point in starting an
aggressive exercise routine only
to give up after a month or two.
A solid action plan would detail
a realistic allocation of time for
daily exercise, the types of
exercise that suit your physical
capabilities, the recommended
diet to help manage your blood
glucose level and the kind of
food you need to avoid.
List out the various food items
you should and should not eat
and their effects on your blood
glucose level and make conscious
decisions about what you put in
your mouth. Stick to the action
plan but allow for occasional
indulgences such as a treat every
one or two weeks.
Having diabetes is not the
end of the world as you can
still lead a full life. Yes, diabetes
is a chronic disease, but it is
manageable with medication
and not a journey you have to
make on your own.
SUNDAY STAR, 11 NOVEMBER 2018
Funny feeling in your feet
DO these statements apply to
you?
l You sometimes feel like you
have socks or gloves on when
you do not.
l Your feet hurt at night.
l You feel burning or
shooting pains in your feet.
l Your feet are numb and you
cannot feel your feet when
walking.
People who experience
tingling sensations, “pins and
needles” or numbness in the feet
may not think too much of these
symptoms. However, if they
persist, it may signal a condition
known as neuropathy that can
lead to bigger problems.
Neuropathy refers to a
medical condition where nerves
become damaged. It is caused by
a variety of reasons, including
diabetes, excessive alcohol
consumption, genetic
predisposition, infection, cancer,
nutritional deficiencies,
exposure to toxins, diseases that
cause chronic inflammation
involving the nerves and other
unclear factors.
Among all, diabetes is the
most prevalent cause of nerve
damage. This condition is
medically known as diabetic
neuropathy. It occurs when a
nerve or group of nerves is
damaged as a result of high
blood glucose level.
Below are some statistics
regarding diabetic neuropathy.
l Up to 50% of diabetics will
suffer from diabetic neuropathy
over the course of their disease,
according to a 2004 review
titled Diabetic Somatic
Neuropathies published in
Diabetes Care.
l According to a 2011 study
titled Metabolic correction in the
management of diabetic
peripheral neuropathy:
improving clinical results beyond
symptom control published in
Current Clinical Pharmacology,
up to 50% of diabetics with
diabetic neuropathy do not
experience any symptoms.
l The prevalence of diabetic
neuropathy increases with age
and diabetic years. It starts in
the prediabetic stage, and 8% of
diabetics already have diabetic
neuropathy when diagnosed
with diabetes, according to a
1993 study titled The prevalence
by staged severity of various
types of diabetic neuropathy,
retinopathy, and nephropathy
in a population-based
cohort: the Rochester Diabetic
Neuropathy Study published
in Neurology.
l Fifty per cent of diabetics
over 60 years old have diabetic
neuropathy, according to a 1993
study titled A multicentre study
of the prevalence of diabetic
peripheral neuropathy in the
United Kingdom hospital clinic
population published in
Diabetologia.
l Fifty per cent of diabetics
are unable to name diabetic
neuropathy as a complication
from diabetes because of low
awareness, according to a 2009
article titled Diabetes Mellitus:
Awareness of disease and life
style changes in female
patients published in Journal
of Postgraduate Medical
Institute.
World Diabetes Day 11
l Only 28% of diabetics are metabolism and formation of
aware that people with type 2 nerve myelin sheaths.
diabetes are more likely to In populations at risk of
undergo an amputation than neuropathy, especially diabetics,
those without diabetes, early detection and treatment of
according to ICM Research neuropathy is crucial to avoid
survey. irreversible damage to nerves.
Diabetic foot care The information in this article
is not intended or designed to
Most people take foot care for diagnose, prevent, treat or
granted. For diabetics, however, provide a cure for any condition
foot care is a serious matter that or disease, ascertain the state of
can bring about unfortunate your health or act as a
consequences if neglected. substitute for medical care.
This is because nerve damage Seek advice from a doctor or
can bring about reduced or loss healthcare professional if you
of sensation in the feet, causing have any questions or concerns
sores and small injuries to go about the information in this
unnoticed and become badly article.
ulcerated, infected or difficult to
heal. This article is brought to you
The healing process for by Merck Sdn Bhd.
diabetics is also compromised by
poor circulation. Eventually, n For more information, e-mail Proper foot care is essential for diabetics, who, because of diabetic neuropathy, may
amputation of the toe, foot or ch.my@merckgroup.com not have much sensation in their feet and thus cannot tell when they have an injury.
even lower leg may be necessary
if treatment is no longer
possible.
While you may know that
diabetes can lead to amputation,
you may not know that the
reason for amputation is nerve
damage. Amputation can be
avoided with proper nerve care.
Other complications of
diabetic neuropathy to watch
out for include joint deformities,
sharp pain and extreme
sensitivity in limbs, urinary tract
infections, incontinence, low
blood pressure, digestive
problems, sexual dysfunction
and eye complications.
Amputation and foot
ulceration are common, serious
problems among diabetics that
can be prevented or delayed
if identified and dealt with
early on.
The American Diabetes
Association recommends that
diabetic adults go for annual
health screenings to detect
diabetic neuropathy. Such
screenings involve recording
your disease history, a physical
foot inspection and neurological
and diabetic peripheral
neuropathy tests.
There are five simple clinical
tests to diagnose peripheral
neuropathy in the legs and
arms, including pinprick
sensation and ankle reflex
testing, vibration testing using
a tuning fork and
biothesiometry.
Tight blood sugar control,
appropriate dietary control,
proper foot care, regular
exercise and smoking cessation
are important to prevent or
delay neuropathy and associated
complications.
Vitamins B1, B6 and B12
B vitamins, specifically
thiamine (vitamin B1),
pyridoxine (vitamin B6) and
cobalamin (vitamin B12), are
used by the body in the
processes of nourishing and
regenerating nerves.
Vitamin B1 is involved in
energy metabolism, helps
maintain the myelin sheaths
that cover the axons of nerves,
and is used in the synthesis of
key signaling molecules in the
nervous system, which are
known as neurotransmitters.
Vitamin B6 is involved in the
synthesis of neurotransmitters
while vitamin B12 is involved in
nerve cell maturation and
regeneration, nerve cell
12 World Diabetes Day
The protective nutrient
ACCORDING to a Health Ministry report
titled Screening for Diabetic Retinopathy,
diabetic retinopathy is the leading cause of
blindness among adults aged 20 to 70.
Every diabetes patient is at risk of diabetic
retinopathy as prolonged periods of high
blood glucose levels can damage tiny blood
vessels that nourish the retina.
As there are often no symptoms until the
disease progresses, diabetic retinopathy can
destroy the eye’s blood vessels without any
noticeable symptoms.
Ninety-five per cent of severe vision loss
from diabetic retinopathy can be prevented
by early detection, timely treatment and
appropriate follow-up care.
Diabetes patients can lower the risk of
diabetic retinopathy by keeping blood
glucose levels under control, taking a dilated
eye examination once a year, quitting
smoking and maintaining a healthy lifestyle.
Consumption of Pycnogenol can also provide
protection to the eyes.
Pycnogenol is a natural ingredient
extracted from the bark of French maritime
pine trees (Pinus pinaster), which grow
exclusively along the coast of southwest
France.
Consisting of highly bioavailable
antioxidants called procyanidins,
bioflavonoids and organic acids, Pycnogenol
helps protect the eyes by neutralising the
harmful effects of free radicals. This enables
the body to heal and repair itself.
Untreated retinopathy may progress to the
proliferative stage, which is characterised by
growth of new capillaries to compensate for
the lack of oxygen supply in the retina.
However, the new blood vessels are fragile,
making them more likely to leak and bleed.
Pycnogenol strengthens retinal capillaries
to help control leakage of blood and fluids
into the retina. It also supports better blood
micro-circulation in the retina by improving
the endothelial function of retinal micro
vessels.
In a multi-centre study titled Pycnogenol
for diabetic retinopathy. A review. published
in the International Ophthalmology in 2001, a
total of 1,169 subjects with type 1 and type 2
diabetes were provided with Pycnogenol in
dosages ranging from 20mg to 160mg,
depending on the severity of retinal
bleeding, for six months.
The outcome of the study showed that
after six months, on average, no further
vision loss occurred, suggesting that
Pycnogenol effectively stops the progression
of retinopathy.
Besides that, visual acuity improved as
soon as after three months of treatment and
further improved after another three
months of treatment with Pycnogenol.
Visual impairment can significantly
impact a person’s daily activity. Hence, it is
important especially for individuals with
high blood sugar to protect their eyes
to prevent the development of
diabetic retinopathy.
This article is brought to
you by BiO-LiFE Marketing
Sdn Bhd.
n For enquiries, call BiO-LiFE
Customer Care (Monday to
Friday, 8am to 5pm) at 03-7499
7999 or e-mail health@biolife.
com.my
SUNDAY STAR, 11 NOVEMBER 2018
Why is foot
care important?
FOR people with diabetes, dry skin of the
feet may lead to cracking and fissuring,
which create points of entry for bacteria. The lotion is easy to
Moreover, people who have diabetes can
lose feeling in their feet, which can make it
spread and quickly absorbs
hard for them to tell when they have a into the skin. It contains
blister, sore, callus or cut on their feet.
It is therefore important to ensure proper essential linoleic acid,
foot care so that the underlying tissue is
protected from bacterial infections.
which helps improve
Here are a few foot care tips you should skin regeneration and
practise every day.
l Inspect your feet – Check your feet and resistance. Its low pH value
toes, looking out for any spots, sores, cuts,
cracks or calluses. Use a mirror or ask
of four can help to keep
someone for help if you have trouble skin healthy and promote
bending over to do this. Examine the six
major locations on the bottom of each foot. the reduction of cracked
• The tip of the big toe
• The base of the little and middle toes
calluses.
• The heel
• The outer edge of the foot
• Across the ball of the foot product is thoroughly researched and tested
Cover any cuts or blisters and change your to ensure that it meets the specific, unique
bandage every day. Consult a doctor if the needs of the different target areas of the
wound does not start healing. body. The whole range is available
l Wash your feet – Use lukewarm water exclusively at Caring Pharmacy outlets.
and mild soap to wash your feet every day.
Hot water may end up damaging your skin. n For more information, call 03-5638 3660,
Remember to check the water temperature e-mail enquiry@cambert.com.my or visit
with your hand or elbow. www.linola.my
l Dry your feet – Infections tend to
develop in moist areas, so make sure to dry
your feet well by patting them dry, paying
attention to the area between your toes.
l Use a suitable lotion – Emollients are
highly useful in the management of dry skin
and recommended as part of foot care
regimens for diabetics. Moreover, improving
the skin barrier function to prevent the skin
from excessive water loss is important.
Linoleic acid is a fatty acid that can help
maintain a healthy skin barrier. The body
cannot produce linoleic acid, so it must be
obtained from other sources.
Linola Foot Lotion, which contains linoleic
acid, is suitable for use by diabetics and
provides relief from dry skin.
Lotion should be applied to the top and
bottom of your feet but not between your
toes as the moisture may bring about
infections.
Gentle care for dry feet
Linola Foot Lotion is specially designed for
dry, cracked and callused skin on feet.
The lotion is easy to spread and quickly
absorbs into the skin. It contains essential
linoleic acid, which helps improve skin
regeneration and resistance. Its low pH
value of four can help to keep skin healthy
and promote the reduction of cracked
calluses.
Linola has specially formulated products Linola Foot Lotion contains linoleic acid,
that target different areas of the body, which is essential for maintaining a healthy
including the face, hands and feet. Each skin barrier.
SUNDAY STAR, 11 NOVEMBER 2018
Full-body workout
A RELATIVELY modest single session of
exercise can improve the way your body
regulates glucose, according to a 2013 study
titled A Single Session of Low-Intensity
Exercise Is Sufficient to Enhance Insulin
Sensitivity Into the Next Day in Obese Adults
published in Diabetes Care.
Exercise can boost your sensitivity to
insulin, which is a hormone that helps keep
your blood glucose level within normal
range. With an active lifestyle, you can better
control your blood glucose level, weight and
blood pressure, increase “good” cholesterol
and lower “bad” cholesterol.
Exercise may also help prevent heart and
blood flow problems, thus reducing your risk
of developing heart disease and nerve
damage, which are common problems for
people with diabetes.
Among the most preferred home exercise
machines is the elliptical, which is also
known as a cross trainer. The NordicTrack
E7.5Z elliptical is one of the best cardio
equipments available, providing a full-body
workout with reduced impact to your knees
to keep you moving longer.
The NordicTrack E7.5Z is a must-have
elliptical. NordicTrack is a brand from the
United States and dubbed the No.1 fitness
brand in the world.
The elliptical makes workouts easy and
delivers a full-body workout experience right
at home.
The NordicTrack E7.5Z elliptical comes
with 20 built-in preset workout apps that
were designed by a certified personal trainer
to help you achieve your fitness goals.
For best results, increase your
performance by adjusting the elliptical’s
resistance control. With this feature, you get
to optimise your energy expenditure and
may end up burning more calories and fat in
less time.
Moreover, with the NordicTrack E7.5Z
elliptical, burn more calories with its upper-
body workout arms that have soft-touch
grips. With this soft-touch feature and
multiple grip positions available to
accommodate people of any height, these
workout arms are easy to hold and help keep
you comfortable throughout your workout.
Available at Fitness Concept, the NordicTrack E7.5Z elliptical helps you perform full-body
workouts with reduced impact to your knees.
Furthermore, target and tone your
quadriceps, calves and glutes with the ability
to set your ramp incline to anywhere
between 0° and 20°. Simple controls on the
elliptical can help change the shape and
length of your stride to maximise your
training efforts for better results.
The NordicTrack E7.5Z’s Silent Magnetic
Resistance feature makes every adjustment
quiet, smooth and natural, which results in
your comfort and an easy-to-use machine.
Another useful feature of this elliptical is
its integrated EKG pulse grips that send
accurate heart rate readings to the console.
This feature helps you stay in the right heart
rate zone to achieve your fitness goals.
If you want to lose weight, do it with the
elliptical’s iFit technology. Connect your
electronic tablet to the NordicTrack E7.5Z
elliptical to maximise your exercise
experience with customised training
programs, automatic statistics tracking,
Google Maps routes, a new workout every
day and much more. This feature requires
membership and is sold separately.
While working out on this elliptical,
multitask with the integrated tablet holder,
USB charging station and water bottle
holder.
Enjoy the Super Fit Sale, which ends on
Dec 31, and grab Fitmas Gifts from as low as
RM25. With purchase of RM1,000, get two
free gifts such as the FC 2-in-1 shaker with
storage and a plank mat or FC Live + yoga
mat with a bag.
Get up to RM900 when you trade in your
old exercise equipment or massager in any
condition. Terms and conditions apply for
prices and promotions above. Items are only
available while stocks last.
Fitness Concept is Malaysia’s largest fitness
specialist chain as certified by The Malaysia
Book of Records, with 45 outlets in leading
shopping malls nationwide.
n For more information, call 03-7726 7787
(IPC Shopping Centre outlet)/03-2282 3200
(Mid Valley Megamall outlet), e-mail
enquiries@fitnessconcept.com.my, visit
any Fitness Concept store or shop online at
www.fitnessconcept.com.my
World Diabetes Day 13
Some things to consider
IN addition to administering insulin and be connected to an insulin administering
undergoing other treatments, having type 1 device, ensuring that you do not experience
diabetes means that you need to constantly hypoglycaemia from too much insulin.
monitor your blood glucose level, sometimes
even a few times a day. To do this, people l Memory capacity – Reviewing past
with type 1 diabetes usually use glucometers. blood glucose level readings to look out for
Using a glucometer involves pricking your spikes and dips can help you manage your
finger with a lancet and putting a small condition better.
amount of blood on a test strip, which is then If you do not want to transfer your
fed into the glucometer. Within seconds, the glucometer data to other devices, it would be
glucometer will display your blood glucose helpful to have one that can store a higher
reading. number of readings.
Because you won’t find yourself too far
away from your glucometer, it is important l Cost – It is obvious that you should
to choose one that fits your lifestyle and consider the cost of glucometers, but make
needs. Several features that you may want in sure to factor in the cost of test strips/discs/
a glucometer are detailed below. cartridges needed to deliver the sample to
l Amount of blood needed – Most the meter as well, especially since some type
glucometers require sample blood volume 1 diabetes patients need to take readings up
between 0.3μl and 1μl. to four times a day.
Some people have trouble expressing
blood from their pricked fingertip because of
poor circulation (which is associated with
diabetes), so a device that requires a smaller
amount of blood for accurate readings will
be more suitable.
l Data transfer – It may be convenient
for you to be able to export your blood
glucose level readings to your smartphone or
computer.
More sophisticated glucometers can even
14 World Diabetes Day SUNDAY STAR, 11 NOVEMBER 2018

Towards a healthier lifestyle

“DIABETES does not present clear
symptoms in the initial stages. You
can have diabetes for a long time
without knowing. This is the
reason it is known as a silent
killer,” says Dr Loh Vooi Lee,
consultant physician and
endocrinologist at ParkCity Medical
Centre.
“The symptoms of diabetes
include intense thirst (especially at
night), frequent need to urinate,
fatigue, numbness in the feet and
blurred vision. However, these
symptoms develop when the
disease has already progressed to
an advanced stage.
“About 30% to 40% of people
would have already developed
Dr Loh Vooi Lee.
diabetes-related complications
such as eye, nerve, kidney and
heart problems when they are first
diagnosed. Some come in for a
check-up for some other disease,
but their blood tests reveal that
they have diabetes.”
According to Dr Loh, diabetes is
multifactorial and does not have
an absolute cause that can be
pinpointed. There are only
associative causes such as genetic
predisposition and family history.
Diabetes can be diagnosed with
a simple blood test, which is
performed after the patient has
fasted overnight.
A careful handle on the
future
“Once you are diagnosed with
diabetes, your first course of
action should be a lifestyle change.
Regardless of what you did in
the past, you must start leading
a healthier lifestyle,” advises
Dr Loh.
Adopting a healthy lifestyle
involves regularly exercising,
eating healthy food and sleeping
well. It is also crucial for a diabetic
person to keep tabs on her blood
glucose level and not skip doses of
medication.
Dr Loh adds, “Diabetes is not a
curable disease. The most we can
do is control it, and the only way to
do so is with medication and
lifestyle changes.
“The same applies to diabetes
prevention. People who have high
blood pressure, obesity and a
strong family history of diabetes
need to take preventative
measures by making the necessary
lifestyle changes to reduce their
risk of developing diabetes.”
A common misconception is
that a diabetic can stop taking
medication once her blood glucose
level is under control or continue
leading an unhealthy lifestyle
because she is on medication.
Dr Loh dispels this, saying,
“Diabetes is a chronic condition.
If you have it now, you could
still have it 20 years later.
Medication and lifestyle changes
are meant to control your blood
glucose level to prevent further
complications, so they should be
continued.
“People also have the
misconception that diabetes
medication can cause side effects How we move forward a spike in blood glucose level
that lead to kidney problems or because diabetes brings with it a
heart failure. However, it is not the “Diabetes is not an easy disease plethora of fatal diseases,” says
medication that causes these to treat, especially in Malaysia, Dr Loh.
problems, but diabetes itself. because although people are Despite efforts from the
“People who think they can eat aware, they are ignorant. With Government, diabetes is on the rise
whatever they want because they so many unhealthy food choices, in the country. The only way we
are on diabetes medication need to Malaysians face difficulty in can prevent it from causing more
understand that they can easily controlling their urges to binge harm is by leading healthy
out-eat their medication if they on unwholesome food and lifestyles and ensuring that our
keep loading up on sugar. There choose to bear the consequences loved ones do the same.
are limitations to the level of blood instead.
glucose that medication can “We need to understand that the n For more information, call
control.” consequences are graver than just 03-5639 1212.

An often underestimated fatal disease

MALAYSIA has the highest
prevalence of diabetes in the
region. According to the National
Health and Morbidity Survey 2015,
17% of the surveyed participants
aged 18 and above had diabetes.
Handling this issue is further
made difficult because diabetes
is caused not just by lifestyle
choices but also genetic risk
factors.
According to Dr Chan Siew
Pheng, consultant endocrinologist
at Subang Jaya Medical Centre,
most diabetic patients in Malaysia
have type 2 diabetes, which they
get when their genetic risk factors
for developing diabetes are
triggered by excess weight gain
and physical inactivity. Type 1
diabetes, on the other hand, occurs
because the pancreas does not
produce enough insulin.
“In Malaysia, the prevalence
suggests that about 95% of diabetic
patients have type 2 diabetes while
Taking the initiative to control one's blood glucose level can result in positive
effects down the line.
less than 5% have type 1 diabetes,”
she says.
Diabetes is a common disease
in the general population, but
Dr Chan shares that each case is
unique and varies in severity and
cause. Therefore, the type of
treatment given to each patient is
based on individual factors such as
age, severity of disease, lifestyle
and presence of other medical
conditions such as heart disease or
renal impairment.
“We have to recognise the
genetic factors and causes that
trigger the onset of diabetes so that
appropriate treatment can be
given. Not all people are diabetic
because of their lifestyle. People
who are slim and lead strict,
healthy lifestyles can still end up
becoming diabetic because of the
influence of genetic factors,” she
says.
While some studies claim that
overweight individuals with
diabetes may improve their health
by losing weight, Dr Chan explains
that the same cannot be applied to
patients who are already of
optimum weight.
Importance of controlling
your blood glucose level
When it comes to management
of diabetes to prevent
complications, it all boils down to
controlling your blood glucose
level as well as other risk factors,
including high blood pressure and
high cholesterol.
“The good news is that we know
a lot about how to prevent
complications from diabetes, which
are a result of persistently high
blood glucose level. The problem is
that having high blood glucose
level is painless and there is often a
lack of urgency to control it.
“Urgency in people with diabetes
only comes when complications
have occurred, and by then, it may
be too late to fix the condition,”
says Dr Chan.
There have been many advances
in recent years with new
discoveries and new classes of
medication that allow control of
blood glucose safely.
These new classes of medication
lower blood glucose to normal
levels without lowering them too
much.
Dr Chan feels strongly about the
prevailing issue of diabetes in
Malaysia, as it is one of the most
common causes of early heart
attack, stroke and death.
“The seriousness of diabetes as a
common cause of heart attack is
often underestimated. People
recognise high cholesterol and high
blood pressure as risk factors for
heart attack and stroke, but not
diabetes. According to an audit by
the Health Ministry, 40% to 45% of
When it comes
to management of
diabetes to prevent
complications, it
all boils down to
controlling your blood
glucose level as well
as other risk factors,
including high blood
pressure and high
cholesterol.
Dr Chan Siew Pheng.
patients admitted for heart attacks
in the past four to five years were
people with diabetes.”
She is optimistic for the future of
people with diabetes because of
breakthroughs that have proven
that certain diabetes medications
can reduce the risks of heart
attack, stroke and death.
“Since 2015, three landmark
cardiovascular outcome trials have
proven that some newer classes of
diabetes medication not only help
control blood glucose level, but
also lower the risk of heart attack
and stroke in individuals with
diabetes and known heart
disease.”
Because diabetes is generally
associated with high cholesterol
and high blood pressure, Dr Chan
stresses that diabetes management
is no longer only about controlling
blood glucose levels but blood
pressure and cholesterol as well
because these contribute to serious
complications.
n For more information, call
03-5639 1212.
Treatment made
personal
According to Dr Chan Siew
Pheng, consultant
endocrinologist at Subang Jaya
Medical Centre, diabetes
treatment must be tailored to
the individual.
Factors that are taken into
consideration include age, body
weight and history of other
medical conditions such as
heart disease, stroke and renal
impairment.
This assessment will then
help doctors determine a
treatment plan for the patient,
covering health goals and
guidelines that include:
l Recommended diet
l Targeted blood glucose
level (A1c level)
l Recommended exercise
intensity
l Targeted blood pressure
and cholesterol levels
SUNDAY STAR, 11 NOVEMBER 2018
Watch what you eat
THE topic of a healthy diet with
low glycaemic index (GI) value
and sugar content is no stranger
to diabetes and prediabetes
patients.
According to the American
Diabetes Association, the GI
ranks carbohydrates on a scale
from zero to hundred, based on
how quickly and how much each
type of carbohydrate raises blood
sugar levels after consumption.
The fluctuation rate of sugar
levels depends on the type of
carbohydrates in food, such as
simple carbs (simple sugars) and
complex carbs (compound
sugars).
Because sugar is widespread
in most of our favourite foods, it
can be hard to plan meals
involving low GI value and sugar
content that satisfy your taste
buds.
Foods such as white bread,
corn flakes, potatoes and pretzels
are prime suspects for carrying a
considerable amount of sugar,
but there are others that may not
be as obvious, posing a risk for
people who are not careful of
what they eat.
Beware of toppings
Pasta has a low GI value of 30 to 60, making it a suitable food for people who need to
control their blood glucose level. However, attention should be paid to what goes on top of
the pasta.
Ready-made pasta sauces may taste savoury instead of sweet but can contain around 6g to
12g of sugar per half cup serving, approximately the same amount as a chocolate chip cookie.
While people can opt for tomato-based sauce, which has a lower sugar content, they have
to be careful when adding more ingredients into the pot.
Healthy options gone wrong
Often used as a “healthy” option at fast
food restaurants, coleslaw contains around
15g of sugar per serving. Although its GI
value is lower in comparison to other food
items on the menu, the sugar content in the
dressing is not to be ignored as it still
contributes to rising blood sugar levels.
You can always make a healthier version
at home. After all, this is an incentive for you
to eat your vegetables.
World Diabetes Day 15
Back to basics Rethinking healthy drinks
While providing plenty of calcium and For centuries, tea has been known for its
protein, flavoured yoghurt and instant oatmeal health properties and widely drunk in most
are surprising culprits that contain high Asian cultures. Some variants have been said
amounts of sugar. A serving of low-fat yoghurt to be able to help regulate blood sugar levels
can contain around 17g to 33g of sugar, while as well.
instant oatmeal can have 10g to 15g of sugar. However, the common perception that all
Nevertheless, this does not mean that you teas are healthy must be reconsidered, as the
have to eliminate your go-to breakfast from production of sweetened teas has changed
your life. The best option is to consume the plain the landscape of the tea industry. A small
version of these foods with fresh fruits, thus cup of sweet tea at a fast food restaurant
lowering the amount of processed or added contains around 36g of sugar, while an
sugars in your diet. average 250ml bottle of tea has around 23g
of sugar.
Therefore, check the sugar content of your
teas before your purchase. The best option is
to drink unsweetened tea to optimise the
health benefits.
Too much of a good thing
While fresh fruits are
recommended to diabetics as a
healthier source of natural sugar,
GI values and sugar contents
differ according to the type of fruit.
For example, apples have a GI
value of 39, which is in the low
range, while watermelon is in the
high range with a GI value of 72. GI
values are higher in dried fruits, as
the loss of water makes the sugar
content more saturated.
Hence, it is best for people
to check the glycaemic
index and sugar
content of all foods
to ensure they are
always on top of
their health.
Sweet company
Malaysians love to add a dash of chilli
sauce to spice up any dish that comes their
way. From fried chicken to keropok lekor, it is
not unusual to see a generous serving of chilli
sauce at every meal or see bottles of chilli
sauce available at most eateries.
However, chilli sauce contains high
amounts of sugar – anywhere from 14g to 22g
per serving. Ketchup, another favourite
condiment, contains around 4g of sugar in
just one tablespoon.
Because these sauces and other condiments
such as honey mustard and teriyaki sauce
come in liquid form, your sugar intake can
quickly rack up if unmonitored.
16 World Diabetes Day SUNDAY STAR, 11 NOVEMBER 2018

HYPERTENSION or high blood pressure is a

major risk factor for many life-threatening
conditions, including cardiovascular diseases
and stroke.
Dr Sudarwin Tjanaka, consultant internal
medicine physician at Columbia Asia
Hospital – Setapak, shares that hypertension
is common among diabetes patients and vice
versa.
“Diabetes and high blood pressure are
corelated because they share the same risk
factors – obesity, smoking, uncontrolled
alcohol consumption, lack of exercise, age
and family history,” he explains.
He adds that the risk of getting
cardiovascular diseases and stroke increases
if a patient has both diabetes and
hypertension.
“It is imperative to control the risk factors
for hypertension, and more so if one has
diabetes,” warns Dr Sudarwin. A person is
diagnosed with hypertension when his blood
pressure is higher than 140/90.
“Diagnosis of hypertension usually takes
more than one visit to the clinic because a
one-time spike in blood pressure might be
caused by other factors such as pain and
anxiety.

Controlling the risks

“However, if the blood pressure reading is
very high – for example, around 180/100
during the first visit – doctors would
consider it hypertension and advise patients
to start treatment immediately.”
According to him, people need to be
aware of not just hypertension but pre-
hypertension as well and take the necessary
precautions to avoid future health
complications.
“Even if a patient has a blood pressure
reading of 135/85, which is within the
normal range, doctors consider it pre-
hypertension. The patient would not need
any medication yet, but controlling risk
factors is essential at this stage,” says Dr
Sudarwin.
Treatment depends on the patient’s stage
of hypertension. He elaborates, “The systolic
range of 140 to 160 is considered stage 1 of
hypertension, 160 to 180 is stage 2 and
anything above 180 is stage 3.
“When a patient comes in with stage 1
hypertension, non-pharmacological
treatment such as lifestyle alteration might
work, but for patients with stage 2
hypertension or higher, medicinal treatment
is essential.”
What makes hypertension dangerous is
that it shows no typical symptoms – earning
it its reputation as a silent killer. Oftentimes,
it is diagnosed when a patient undergoes a
check-up for some other problems.
Dr Sudarwin says that it is possible for
everyone, even people with unmodifiable
risk factors such as family history of
hypertension and type 2 diabetes, to prevent
the occurrence of these diseases by making
simple lifestyle changes.
“Sitting for long hours and lack of physical
activity can increase the chances of getting
diabetes and hypertension. For people who
provide the excuse of having no time to
exercise, the minimum they can do is walk
more. It is crucial to walk at least 8,000 steps
daily to stay away from these diseases.
“Weight reduction is also essential for
people who are obese. As little as 5% weight
loss may reduce blood pressure and make
diabetes easier to control.
“Additionally, it is important to be careful
with one’s diet because too much salty food
is one of the leading causes of hypertension.
Intake of fruits and vegetables must be
increased to keep hypertension and diabetes
in check.”
Among Dr Sudarwin’s concerns is that
there are people who stop taking their
hypertension and diabetes medications once
they believe they have their diseases under
control.
He advises, “The importance of continuing
with medications and leading a healthy
lifestyle cannot be emphasised more,
especially for individuals who have both
hypertension and diabetes.
“People need to understand that although
these are not curable diseases, they can be
successfully controlled with lifestyle
alterations and medication. Hence, continual Dr Sudarwin Tjanaka.
treatment and follow-ups are vital.”
With proper awareness, prevalence of Take the pledge to empower yourself and
diabetes and hypertension can be mitigated, others with knowledge about preventing and
equating to lives being saved from the treating these diseases.
clutches of cardiovascular diseases and
stroke. n For more information, call 03-4145 9999.

Good protein source for stronger, healthier bones

PROTEIN is built from blocks called amino
acids. Quality protein contains all 20 types of
amino acid, including the nine essential
amino acids that our bodies cannot produce
and must obtain from dietary sources.
Long-term high consumption of animal
protein (meat) can have detrimental effects
on one’s bone health and increases the risk
of developing diabetes. Animal protein is
laden with saturated fats and cholesterol,
which may lead to obesity.
Findings from a 2000 study titled
Overweight, obesity, and health risk published
in Archives of Internal Medicine show that
high intake of animal protein is associated
with insulin resistance, thus increasing the
risk of developing type 2 diabetes.
On the other hand, plant protein can
provide essential amino acids along with
plenty of fibre when consumed in the right
combinations. Some examples of such plant
protein are non-genetically modified soy and
pea.
Several studies such as a 2017 one titled A
plant-based diet for the prevention and
treatment of type 2 diabetes published in
Journal of Geriatric Cardiology show that the
consumption of plant protein is associated
with lower blood glucose levels and a
reduced risk of developing diabetes as plant
protein can improve insulin sensitivity and
glucose metabolism.
Additionally, a 2006 study titled The
underappreciated role of muscle in health and
disease published in The American Journal of
Clinical Nutrition found that people who met
their daily protein requirements maintained
bone health better than those eating less
than the recommended levels.
Calcium is a key nutrient for bone tissue
as it constitutes a large part of them.
However, supplementation with calcium
alone is not enough to maintain optimal
bone density.
Several studies have shown that a
combination of calcium with other nutrients
such as magnesium, vitamin D3 and vitamin
K2 significantly improved bone health.
This is because magnesium and vitamin
D3 facilitate the absorption and utilisation of
calcium while vitamin K2 helps improve
bone density by effectively depositing
calcium to bones and teeth for proper
storage, according to a 2017 study titled The
Synergistic Interplay between Vitamins D and
K for Bone and Cardiovascular Health: A
Narrative Review published in International
Journal of Endocrinology.
Hence, magnesium, vitamin D3 and
vitamin K2 work synergistically for effective
calcium utilisation and metabolism.
According to the European Food Safety
Authority, vitamin K2 (also known as
menaquinone and MK-7) is a highly
bioavailable form of vitamin K that helps
maintain healthy bones.
Biogrow HPF-5 PLUS is a new-and-
improved formula with a blend of plant Containing many essential nutrients, Biogrow HPF-5 PLUS is a good protein source to maintain
protein and digestive fibre. It is enhanced bone health.
with nutrients for bone health such as
calcium, magnesium, vitamin D3 and l Provides synergistic effect between l Suitable for all ages, including people
vitamin K2. magnesium, vitamin D3 and vitamin K2 for with diabetes and lactose intolerance
One scoop (≈16g) of Biogrow HPF-5 PLUS better absorption, retention, utilisation and
daily: deposition of calcium This article is provided by Legosan
l Provides more than 61% plant protein l Provides more than 18% digestive fibre (Malaysia) Sdn Bhd.
(non-genetically modified soy and pea to regulate bowel movement
proteins) complete with all nine essential l Contains no added sugar or cholesterol n For more information, call 03-7956 2220 or
amino acids for protein synthesis and is lactose free e-mail info@biogrow.com.my