Diabetes...It's not Sweet News

True Story : HS, a 14 year old boy was brought in to the emergency department of a hospital by his parents for abdominal pain and vomiting for 2 days. He has been feeling more tired than usual for the past few weeks. He noticed that he had lost a significant amount of weight , passing urine frequently and feeling excessively thirsty recently . A simple finger prick for blood was done which showed HS’s sugar level was abnormally elevated. HS and his parents were informed that he likely has diabetes mellitus and he will need a few more blood investigations done and requires admission. HS’s parents were in shock, as they have never heard of diabetes in children. They have family members who have diabetes, but they were diagnosed in their 40s and 50s. HS has been habitually consuming fizzy drinks & sweetened packet juices on a daily basis since his younger days. He frequents fast food outlets after school with his friends regularly as his parents both go to work and come home late . His parents felt remorseful as they blamed themselves for the mishap. Unfortunately, in Malaysia, this scenario is increasingly common. Type 2 diabetes has become a concern in children and young people as a result of increasing prevalence of obesity.

One in five adults or about 3.9 million people aged 18 years and above in Malaysia, suffer from diabetes, according to the 2019 National Health and Morbidity Survey (NHMS 2019). About 49 per cent of diabetics in Malaysia have never been screened or diagnosed with the disease which is very alarming. Malaysia also has the highest prevalence of diabetes in Southeast Asia. An estimated 54.2 per cent of the Malaysian adult population is overweight or obese which is a contributory factor. The national obesity prevalence rate in 2019 for children under the age of 5 is 5.6% and 14.8 % in those aged 5-17 years old.

Type 2 Diabetes is caused by the body’s inability to produce or utilise insulin properly.

Symptoms of Type 2 diabetes are:

• urinating frequently
• feeling very thirsty
• feeling very hungry
• feeling fatigued
• having blurred vision
• having cuts or sores that don’t heal properly
• Numbness or tingling hands or feet

Can Type 2 Diabetes Be Prevented?

Yes! Type II Diabetes Mellitus can be prevented or delayed with lifestyle changes—such as losing a small amount of weight and getting more physically active—even if you’re at high risk. You can get a simple blood sugar test to find out if you have diabetes. Prediabetes refers to those with borderline diabetes which is potentially preventable with lifestyle changes. However, if left untreated, this group of people would eventually develop diabetes in the near future. The good news is that prediabetes can be reversed.

If you have prediabetes, losing a small amount of weight if you’re overweight and getting regular physical activity can lower your risk for developing type 2 diabetes. A small amount of weight loss means around 5% to 7% of your body weight. A good first step is to cut out highly processed foods, refined grains such as white bread, sugary food and sugary drinks. Plan your meals around vegetables, plant-based proteins, whole grains, dairy, lean meats, oily fish, nuts and healthy oils . Incorporate regular physical activity of at least 150 minutes which would mean 30 minutes a day, five days a week of brisk walking or a similar activity .

Type II Diabetes In Young adults

Although Type 2 Diabetes Mellitus is a disease related to ageing, the prevalence of young-onset diabetes has increased around the world. This is due to the increasing rates of obesity, highly processed foods , high carbohydrate/ calorie diets and sedentary lifestyle particularly in young people. Early-onset Type II Diabetes Mellitus has been associated with the accelerated development of complications and worse outcomes. The risk of diabetes-related complications such as heart, kidney, eye and nerve diseases were higher among young diabetics than the older ones as they tend to live with the disease longer. Individuals who are diagnosed with type 2 diabetes at age ≤40 years have a greater risk of cardiovascular disease and mortality than same-aged individuals without T2DM or individuals diagnosed with T2DM in later life according to studies done.

Protecting teens and young adults from Type 2 diabetes

Like any human behaviour, dietary patterns can be shaped at an early age and these habits and preferences can become difficult to change as a person gets older. In Malaysia, the consumption of sugary drinks has increased dramatically over the past decade. Parents can do a lot to help their kids prevent type 2 diabetes. Set a new normal as a family & start some healthy changes together. Eating healthy and exercising is key to reversing or preventing Type 2 diabetes altogether. Make sure your child is eating plenty of vegetables, while reducing the potion size of carbohydrates (which increases blood sugar) and beverages containing sugar. Instead of buying junk foods, sweets and sugary drinks, opt to buy vegetables, protein and good fats. If you chose to eat out , order water instead of soft drinks/ sweetened beverages. Make meal planning a family affair and teach your children to read food labels so they can learn what’s good for them. It is important for kids to get at least 60 minutes of physical activity each day and limit screen time. Some kids might like sports while others may like other physical activity such as walking or cyling. Even chores indoors or outdoors can count for physical activity. Also, know the entire family needs to be committed to these changes. Changes begin with you. Speak to your doctor if you or your family members need to be tested and start making changes today.

Know Diabetes, Fight Diabetes.

This article was contributed by Dr Tivya A/P Soundarajan, Resident Consultant Physician & Endocrinologist at Pantai Hospital Ipoh. To know more about where and when to see Dr Tivya A/P Soundarajan at her clinic, click here.