World Diabetes - 8 November 2015

sunday star, 8 november 2015

special

world diabetes day

2 world diabetes daySUNDAY STAR, 8 NOVEMBER 2015

DESPITE the notorious reputation diabetes has garnered over the years, many remain unaware of how dangerous it can be.

“The idea that diabetes is not dangerous as many people have it could not be further from the truth. This disease can lead to serious complications and there is no such thing as mild diabetes,” says Emeritus Prof Datuk Dr Mustaffa Embong, executive chairman of the National Diabetes Institute (Nadi) and consultant diabetologist/endocrinologist at Nadi’s Diabetes Resource Centre D’Centers.

The disease is closely associated with metabolic syndrome – increased blood pressure, abnormal cholesterol level, high blood sugar level and excess body fat around the waist.

This cluster of conditions increases one’s risk of developing a non-communicable disease such as diabetes, which is caused by the body’s inability to regulate blood glucose levels due to insulin insufficiency or resistance.

Warning signsDiagnosis of the pre-diabetic

condition helps address the growth in number of diabetics by identifying the condition at the earliest stage. Using simple blood tests, doctors are able to determine whether or not a patient is borderline diabetic.

There is also the now popular HbA1c (glycated haemoglobin) test, which is able to provide an average sugar level reading of the past two to three months, as opposed to the fasting plasma glucose test that only measures glucose concentration in the blood at that point in time.

Those at the pre-diabetic stage are still able to delay or prevent the onset of diabetes with proper management of lifestyle factors.

This is a crucial period in

risk of developing diabetes, which is why weight loss through healthy methods is one of the prescribed actions at the pre-diabetic stage.

Scientists and doctors say that increased abdominal fat in particular has been shown to contribute to insulin resistance because of the release of pro-inflammatory chemicals (substances that attack cells, vessels and tissues to slowly damage them) by fat cells, which decreases cell responsiveness to insulin.

Insulin resistance is the defining characteristic of Type 2 diabetes. Obesity further exacerbates the condition by disrupting the body’s metabolism, which causes the release of more fat molecules, thus keeping the cycle going.

> SEE ALSO PAGE 4

diabetes management as there is no way to cure the disease – pre-diabetes diagnosis can be considered a final warning for high-risk individuals to make significant changes.

According to Siah Guan Jian, senior diabetes educator at the National Heart Institute (widely known by its Bahasa Malaysia acronym IJN), preventive measures are vastly similar to diabetes control methods.

“Diabetes prevention and management rely on blood sugar management, so we generally advise high-risk patients to improve their diet by cutting down on sweet, fatty and cholesterol-rich foods, eat regular meals in small portions, and exercise regularly,” she says.

Being obese places one at great

Risk-free livingEducation, guidance

AS the premier non-government organisation dealing with diabetes in the country, the National Diabetes Institute (Nadi) is dedicated to spreading the word on and assisting with prevention and optimal management of diabetes, its complications and associated diseases.

This non-profit organises activities and sessions aimed at promoting early detection and elevating best diabetes management practices through:l Talks, road shows,

exhibitions and counselling sessions l Screening for diabetes

and risk factors

l Publishing booklets, posters and the NADI Diabetes Magazinel Two conferences held

annually for healthcare professionals: Diabetes Asia Conference and Diabetes Complications Conferencel Diabetes Resource Centre

called D’Centers, offering specialist services and consultation as well as affordable diabetes testsl Health and diabetes talks

open to the public l T-1 Club to provide assistance

to children with Type 1 diabetesl DEWI Project to empower

and support diabetic mothers- to-be

INSULIN is a pancreatic hormone that converts glucose into energy, thus controlling the level of blood sugar in the body.

When insulin, which is produced by beta cells, is insufficient or unable to function optimally, this conversion process is interrupted and the level of sugar rises beyond the healthy range. This is how diabetes comes about.

Although the basic mechanism is general, diabetes cases vary from one individual to the next due to different root causes and degrees of environmental impact. Hence, follow-up treatment and control measures may also differ.

“People react differently to medication, which is why every case is dealt with individually – some need to have insulin introduced into the system while others may need to reduce it.

“A balance of lifestyle changes and medication is needed for diabetics to be in the best of health and a very small percentage of people can depend on only one or the other,” says Dr Lim Siang Chin, endocrinologist and physician at Mahkota Medical Centre.

Know the disease

It is important to understand and get the right treatment for your type of diabetes.

By THERESA BELLE

Here is a brief overview of the types of diabetes:l Type 1 – The less common of

the two, Type 1 diabetes shows its symptoms earlier in life.

“Many people do not understand this type of diabetes and assume that it develops due to lifestyle factors, but it can be genetic,” says Dr Lim.

The body’s immune system destroys insulin-releasing cells, thus inhibiting its production and curtailing glucose absorption in the blood.

Patients can face low blood sugar (hypoglycaemia) or diabetic ketoacidosis, which is caused by acid build-up due to excessive fat breakdown. The body tries to convert fat into energy in the absence of insulin to properly regulate glucose conversion.

l Type 2 – Previously known to affect older, inactive folks, Type 2 diabetes today affects people at an earlier age due to the prevalence of unhealthy lifestyles in the past few decades.

In this condition, the body is unable to properly manage glucose due to insulin resistance, in which there is less glucose uptake than necessary for energy production.

As Type 2 gradually worsens without proper care, pancreatic function is affected as the beta cells become unable to secrete required amounts of insulin. Together, the insulin resistance and insufficiency make it hard to control sugar levels.

l Diabetes insipidus – This rare type of diabetes is not related to blood sugar level or insulin function – instead, the body is unable to properly manage and regulate fluids.

This causes extreme thirst and excessive excretion of diluted urine. Depending on the method of disruption, diabetes insipidus can be central (stemming from a dysfunction of the pituitary gland), nephrogenic (related to the kidney) or gestational.

For John (not his real name),

a tumour near his hypothalamus gland affected his body’s antidiuretic hormone (ADH, the hormone that regulates fluid excreted by the kidneys) production when he was just a teenager, causing central diabetes insipidus.

“It was difficult to cope with unquenchable thirst followed shortly after with urination, leaving me thirsty again,” he shares.

“Fortunately, today I am able to control the symptoms with ADH pills daily.”

Getting your eyes checked regularly will go a long way in preventing diabetes-related eye complications.

Keep a watchful eye

DIABETES brings about a host of complications relating to other parts of the body, one of which is diabetic retinopathy. As the name suggests, this condition affects blood vessels in the retina (light-sensitive tissue) of the eyes.

According to Dr Pall Singh, consultant ophthalmologist at Tun Hussein Onn National Eye Hospital, more and more younger people are being affected by this condition, which is known to be the leading cause of blindness among adults.

“Patients with diabetic retinopathy may not immediately notice their vision deteriorating, but over time, the condition can worsen to cause vision loss in both eyes,” he says.

As an ophthalmologist,

approximately 30% of Dr Pall’s patients are afflicted with diabetic retinopathy.

Exploring effectsThe condition arises because

excess sugar in the blood can cut off blood supply by blocking small retinal blood vessels.

As it progresses, patients may begin to have blurred sight, see spots or experience dark, empty areas in their line of vision.

In some diabetic retinopathy cases, blood vessels may swell, leak fluid or abnormally grow on the

surface of the retina.On top of that, Dr Pall explains

that diabetics tend to develop eye complications such as cataracts (clouding of eye lens) much earlier than the general population. Another common concern is diabetic-induced glaucoma (damaged optic nerve fibres).

While diabetics cannot directly prevent diabetic retinopathy, good control of blood sugar, blood pressure and cholesterol can delay its onset.

This is why diabetics must remain vigilant about the potential complications of the disease.

“Diabetes patients are encouraged to check their eyes once a year, including a dilated fundus examination to detect early diabetic changes. Check-ups should be regular and not delayed until they begin to experience vision impairment,” says Dr Pall.

He also advises healthy members of the public to not take their eyes for granted and get them checked every two years, and every year after the age of 50.

Elevating treatmentAs with almost all other diabetic

conditions, the key management method is control. No specific treatment is prescribed in the early stages unless the patient has macular oedema, which develops when the central area of the retina becomes swollen with fluid due to blood vessel leakage.

Laser surgery is only used to treat diabetic retinopathy in its advanced stages. The scatter laser treatment applied helps shrink abnormal blood vessels in the eye within two or more sessions.

Severe bleeding would call for a different surgical procedure called a vitrectomy, during which blood is removed from the centre of the eye.

These methods seek to cure complex complications, but Dr Pall says advancement in medical research has brought new hope to early-stage diabetic retinopathy treatment.

“We can now be proactive in treating the retina by injecting the eye with anti-VEGF (anti vascular endothelial growth factor) drugs, which are able to reduce fluid leakage and interfere with growth of new blood vessels in the retina,” says Dr Pall.

Studies and research findings vouch for the potential efficacy of this treatment, which could play a greater part in visual improvement compared to laser surgery.

n For more information, contact Tun Hussein Onn National Eye Hospital.Dr Pall Singh.

SUNDAY STAR, 8 NOVEMBER 2015

world diabetes day 3


Protection and vigilance

The National Health and Morbidity Survey report from 2011 indicates that one in seven Malaysian children are obese, an alarming jump from one in 19 reported in 2006.

It is easy to dismiss childhood obesity as a temporary phase, but the host of conditions that are caused by obesity can stunt overall development of growing children.

This is a major reason doctors and health experts stress the importance of proper nutrition and adequate physical activity from as early in life as possible.

“We see more 20- to 30-year-olds developing diabetes, but we are also increasingly seeing this among children. This is linked to increasing obesity among the young, which causes them to develop risk factors such as high cholesterol and high blood pressure much earlier in life,” says Dr Mustaffa.

The hereditary aspect is also at play – according to Dr Mustaffa, one of the reasons diabetes is so prevalent in Malaysia is that a growing number of diabetics who live longer have children who are more prone to developing Type 1 and Type 2 diabetes.

But genes do not solely influence the development of Type 2 diabetes – it is triggered by controllable environmental factors, which is why medical professionals say the condition is preventable.

Yet, Type 2 diabetes affects more and more people each year.

Parents do not merely pass down their genes. They influence children’s lifestyle habits and diet from the moment they are born, thus designing the environment that directly influences health.

Children pick up dietary and exercise habits, meal portion control and overall lifestyle management from those around them, so unhealthy parents are

likely to raise children that are in even poorer health.

Clearing the airIn an effort to tackle the growing

national issue of childhood obesity, the National Coordinating Committee on Food and Nutrition of the Health Ministry released the Malaysian Dietary Guidelines for Children and Adolescents in 2013.

This guide outlined 15 key

messages for healthy children and adolescents, from breastfeeding to the breakdown of nutritional requirement for optimum growth.

Guides such as these are commonplace as the Health Ministry is on its toes when it comes to managing obesity and its associated non-communicable diseases.

With the wealth of authoritative information available, members of the public have better resources to

depend on for information.Coupled with the improving

level of medical expertise in the country and increased access to health screenings at public and private facilities alike, individuals are encouraged to take matters into their own hands by initiating proactive action to guard themselves and their families against diseases such as diabetes.

Even diabetics are able to better manage their condition and lead more fulfilling lives thanks to these factors, as long they are disciplined in adhering to set rules and regimes for diet and exercise.

Here are three key steps towards a better, risk-free life:l Keep weight within healthy

body mass index range (19 to 24). If you are obese, losing as little as 5% of body fat can make a difference and reduce your susceptibility to developing diabetes.l Move about and exercise for

at least 30 minutes every day. Obese people who have had long periods of physical inactivity can begin with light, simple aerobic exercises and move on to brisk walking.l Maintain a balanced diet

rich in fibre and protein and low in carbohydrate and fat, complemented with an abundance of fruits and vegetables. Meals should be small and low in sugar yet nourishing.

> FROM PAGE 2

Unhealthy lifestyle habits such as constant overeating can increase one’s risk of developing diabetes.

> SEE PAGE 8 FOR INFORMATION ON WORLD DIABETES DAY

5SUNDAY STAR, 8 NOVEMBER 2015


MOST people take foot care for granted. To the diabetic, however, caring for the feet is a serious matter with unfortunate consequences if neglected.

In diabetics, prolonged high blood sugar level damages nerve cells and causes tingling, impaired sensitivity, numbness or pain.

Most often, this affects the nerves to the feet as they are the longest in the body. Loss of sensation in the feet means that sores or injuries may go unnoticed and become ulcerated or infected.

Eventually, amputation of the toe, foot or even lower leg may be necessary if treatment is no longer possible.

According to the World Health Organization, diabetic neuropathy is the most common complication of diabetes. It has been implicated in 50% to 75% of non-traumatic amputations.

Foot care tipsKeeping blood sugar in control

is just the first step in avoiding amputations caused by diabetic neuropathy. Proper foot care is also necessary to prevent or reduce the risk of amputations.

Good foot care involves the following: l Inspect your feet daily to

check for cuts, sores, blisters, cracks, redness, swelling or other problems.l Wash your feet daily with warm water and a mild soap. Dry them with a soft towel and dry carefully between your toes.l Moisturise your feet with lotion but avoid getting lotion between your toes.l Cut your toenails regularly. l Avoid walking barefoot to prevent injuries on the feet. l Wear shoes that fit well. l Attend to foot injuries promptly.l Undergo regular foot examinations with a doctor who will be able to identify problems sooner than you.

The American Diabetes Association recommends that adult diabetics have annual health screenings to detect diabetic neuropathy.

Such a check includes noting down your history, physical foot inspection, neurological tests and screening for diabetic peripheral neuropathy (nerve damage of the legs and arms).

In conjunction with World Diabetes Day, Merck Sdn Bhd is providing nerve tests in pharmacies and during various

Managing neuropathyhealth events nationwide using a biothesiometer.

By taking the nerve test, you will be able to understand the condition of your nerves better and seek further medical consultation or treatment if needed.

To avoid amputations, it is important to both keep blood sugar in check and practise proper foot care and control nerve damage that can cause it to happen.

Treating or slowing down neuropathy

Neuropathy can be treated or slowed down by providing nerve cells with the nutrients that they need to function properly, especially vitamins B1, B6 and B12.

While a healthy person usually has a sufficient supply of these vitamins in the body, diabetics often experience deficiency. The longer a person has diabetes, the worse this is and the more severe the nerve damage becomes.

Therefore, diabetics need to ensure that they get sufficient amounts of these vitamins in their diet or via a health supplement.

Neurobion is a health supplement brand that has been trusted for more than 50 years and offers diabetic patients the synergistic benefits of vitamins B1,

B6 and B12.It has been clinically proven to

help manage diabetic neuropathy. It nourishes your nerve cells to help improve nerve function and relieve nerve pain.

On top of that, Neurobion can

help you slow down the progress of diabetic neuropathy. If you have diabetes, come for Merck’s nerve tests.

n This article is brought to you by Merck Consumer Health.



Consultation and guidance provided at IJN’s Diabetes Care Centre ensure patients are aware of how the disease works so they can better understand management measures.

Discretion in managementIN-DEPTH education and awareness are important aspects of diabetes management and control. This is why the National Heart Institute (widely known by its Bahasa Malaysia acronym IJN) opened its Diabetes Education Clinic back in 2007 – to advise people with diabetes on healthy eating and lifestyle changes, preventing complications and monitoring blood sugar levels.

Since then, it has expanded to also offer services by visiting endocrinologists to better manage all aspects of the disease.

“With the expertise of specialist doctors, we are able to properly address diabetes-related issues and treat them as soon as possible,” says senior diabetes educator Siah Guan Jian.

Lifelong monitoring The majority of those who seek

consultation at IJN’s Diabetes Care Centre are existing patients with some type of heart disease who must address their risk of developing diabetes complications.

According to Siah, diabetes educators advise patients from pre-diabetic stage onwards because the aspects of diabetes care are wide ranging and all-encompassing.

Patients are prescribed oral, subcutaneous insulin injection or pump insulin replacement therapy based on their body’s ability to regulate and neutralise sugar

levels, but beyond that, several lifestyle components are taken into account.

“People with diabetes are made aware that their condition is manageable with proper blood sugar levels, which involves dietary changes and exercise on top of the prescribed insulin therapy,” says Siah.

Patients can become hyperglycaemic (high blood sugar level) or hypoglycaemic (low blood sugar level). To avoid this and

reduce the long-term damage of diabetes, they must be cognizant of their blood sugar levels.

These patients are encouraged to perform regular self-monitoring of blood glucose at home using testing strips available at pharmacies and undergo HbA1c testing so doctors can assess their average blood sugar control over the past three months.

“It is important to not only monitor the readings, but respond with appropriate controlling

measures. This is when patients must exercise self-discretion and discipline,” says Siah.

Although it is a lifelong condition, people with diabetes can manage their lifestyle to control its effects. As their health improves, they can go on to live normal lives with lower risks of complications.

Among other measures, this involves maintaining a high-fibre diet with appropriate carbohydrate intake, eating regular meals in small portions and, most

importantly, minimising or eliminating refined sugar in foods and drinks.

Prevention, controlIt can be hard to eat and live

healthy with sweet and savoury foods available at all hours of the day at Malaysian eateries and fast food outlets.

When combined with the generally sedentary lifestyles of most citizens, it comes as no surprise that the obesity rate continues to rise.

Even those without family history of diabetes can develop this disease, and Siah says the centre has even attended to teenage patients with Type 2 diabetes.

“Everyone should at least go for yearly check-ups and go for blood glucose testing to stay on top of their health risks,” she says.

The heart screening programmes at IJN’s Wellness Centre include blood glucose testing. Besides guidance and consultation, the Diabetes Care Centre also offers diabetes education, comprehensive foot examination and endocrinologist consultation.

n For more information, contact IJN.


THOUGH diabetes is a non-communicable disease – it is not contagious – its spread throughout the world is accelerating at an alarming rate.

According to the International Diabetes Federation (IDF), the number of people who have a form of diabetes in the world is larger than the population of the United States.

To bring awareness to the diabetes epidemic and growing threats it poses, the IDF and the World Health Organization (WHO) created World Diabetes Day, which falls on Nov 14, in 1991. It is now the world’s largest diabetes awareness campaign and draws attention to the issues that are of paramount importance in preventing the disease.

Navigating the disease The IDF has gathered its

research and statistics into the IDF Diabetes Atlas. First published in 2000, it is produced biannually in collaboration with international experts and contains data on diabetes cases, prevalence and expenditure on the national, regional and national levels.

One of the key findings of the sixth edition of the Diabetes Atlas, published last year, is that 387 million people have diabetes and the number will rise to 592 million by 2035 – in 20 years.

Of this, 75 million are in South-East Asia and this figure will rise to > SEE NEXT PAGE

A growing health threat

123 million by 2035.Here are a few more important

statistics from the Diabetes Atlas:l The greatest number of people

with diabetes are aged between 50 and 59

l More than 79,000 children worldwide developed Type 1 diabetes in 2013l More than 21 million live

births were affected by diabetes during pregnancy in 2013

The research also found that the number of people living with Type 2 diabetes is increasing in every country and that the disease caused 4.9 million deaths last year; one person dies of diabetes every

seven seconds. The Diabetes Atlas calculated

that diabetes caused about 1.19 million deaths in South-East Asia, about 54% of which were of people under the age of 60.

However, the region has the lowest diabetes-related expenditure per person with diabetes, totalling only US$7bil (RM30.15bil).

Compared to the US$310bil (RM1.335 trillion) total expenditure by countries in North America and the Caribbean, which have a total population that is about half that of South-East Asia, this is a dismal figure.

What is more worrying is that in this region, almost half of the people with diabetes are undiagnosed. This means that the overall figures of people living with diabetes and those who die from it are actually higher.

Also, it means that people who remain undiagnosed do not get the treatment and medication required to manage the disease.

The latest IDF Diabetes Atlas with new global figures will be released on Nov 12 and will be made available on www.idf.org/diabetesatlas

The number of people living with diabetes is continually rising. Leading an active lifestyle as a family can prevent you and your loved ones from developing this disease.

3. DIABETES

1. CHINA2. INDIA

4. USAmost populous country

DIABETESWorld’s is the

3rd

Global healthcare expenditure

IS SPENT ON DIABETES CARE

1US

in 9

DIABETES

CONSISTENTLY

HIGH blood SUGAR LEVELS

DIABETES poses a THREAT to

GLOBAL SUSTAINABLE

DEVELOPMENT

Make HEALTHY EATING a RIGHT, not a privilege

and physical activity

HEALTHY EATING

COULD PREVENT

of type 2 DIABETES

70%

UP TO

IS AN IMPORTANT

PART OFEFFECTIVELY MANAGING

type 1 DIABETES

HALT the diabetes EPIDEMICwww.worlddiabetesday.org

#WDD

All figures from the IDF Diabetes Atlas Update 2014

If left unmanaged can result in serious health complications



This year, the World Diabetes Day campaign is a year-long attempt to reflect the realities faced by people living with diabetes, focusing on healthy eating as a key factor in fighting the disease and as a cornerstone of global health and sustainable development.

Here is how you can be a part of the World Diabetes Day campaign, spread awareness of the disease and prevent yourself and your family from developing diabetes.

Act to change your life today

IDF and WHO statistics show that almost 600 million people may be living with Type 2 diabetes by 2035. Delayed diagnosis means that many people with Type 2 diabetes suffer from at least one complication of the disease by the time they are diagnosed.

A generally healthy lifestyle can prevent up to 70% of Type 2 diabetes.

A healthy diet containing leafy vegetables, fresh fruits, wholegrains, lean meat, unsweetened yoghurt and nuts can help reduce a person’s risk of Type 2 diabetes and reduce complications in people who

already have diabetes.While Type 1 diabetes cannot

be prevented, a healthy lifestyle is an important part of effective management of the disease.

Encouraging healthy eating habits in young children is key to halting the rise of the diabetes epidemic. Further, by ensuring the health of future generations, overall sustainable development can be assured.

Act to change the world tomorrow

Diabetes does not only affect individuals suffering from the disease and their families; it is a growing burden on communities and economies. According to IDF statistics, global health spending to treat diabetes and manage complications was estimated to cost US$612bil (RM263.6 trillion) last year.

Up to 11% of total healthcare expenditure in every country across the globe can be saved by tackling the preventable risk factors of Type 2 diabetes, and up to 70% of Type 2 diabetes cases can be prevented or delayed by adopting healthier lifestyles. This is equivalent to up to 150 million cases by 2035.

Access to affordable healthy food is essential to reducing the global burden of diabetes and ensuring global sustainable development.

However, a healthy diet is more expensive than an unhealthy one, which means that the number of people with diabetes in low- and middle-income countries will continue to grow, posing a threat to sustainable development.

In Malaysia, the Health Ministry is already working with state governments and health professionals to spread awareness about the disease and the importance of healthy lifestyles.

On the ground, ordinary people can push for improvements in lifestyle by engaging with community leaders and creating opportunities for activities and exercise in the community, especially among young people.

Large-scale improvements to accessibility of healthy food will take some time, but can be achieved simply by people making any healthy food they can afford as their first choice. Economies of scale dictate that prices go down as demand goes up.

n For more information about diabetes and the World Diabetes Day campaign, visit www.idf.org

Halting the diabetes epidemic> FROM PREVIOUS PAGE


Recognising the symptomsWITHIN the last 10 years, the percentage of diabetes cases among Malaysian adults has not only risen but doubled to 20.9%.

According to Dr Lim Siang Chin, endocrinologist and physician at Mahkota Medical Centre, part of this high percentage is due to the obesity rates in Malaysia.

“In the past two decades, Malaysians have begun to lead a less healthy lifestyle, contributing to the nation reporting the highest obesity rates in South-East Asia. Obesity is one of the causes of insulin resistance,” she says.

Insulin is the hormone produced by the pancreas that helps glucose (a type of sugar) to enter the body’s cells for energy.

When the pancreas is damaged or unable to produce sufficient insulin (Type 1 diabetes) or if the body’s cells begin to develop insulin resistance (Type 2 diabetes), the glucose levels in the blood will rise and become abnormally high.

“Unlike Type 2 diabetes, Type 1 diabetes is not caused by lifestyle factors. The condition mainly affects younger children but adolescents and adults can also develop it,” says Dr Lim.

Early diagnosisSymptoms of diabetes include

being constantly thirsty, needing to frequently urinate, experiencing weight loss and having blurred vision.

However, many people (especially those who have developed Type 2 diabetes) only recognise the need to seek medical attention when their symptoms significantly worsen and this may only happen after a few years.

“Many of our patients never get checked for diabetes because they still feel generally good.

“It is only when they find

something amiss with their vision or urine would they seek medical treatment,” says Dr Lim.

“When patients come in after realising something is wrong, it usually means the condition has worsened and requires additional treatment and more expensive medication.

“But this may be too late. In serious cases, patients could experience kidney failure, while others may require their feet to be amputated as the condition reduces blood supply to the

feet,” Dr Lim adds.

Specialised facilityThe Mahkota Diabetes Centre

aims to provide diabetic care services as a precautionary measure to battle the condition.

It also strives to educate patients on the common diabetic symptoms, highlight the importance of a regular full body screening and inspire people to lead healthier lifestyles.

“A full body screening helps

patients be constantly aware of their diabetes risk and to treat the problems before the condition causes further complications,” says Dr Lim.

The team at the centre, which consists of consultants, a diabetic educator and physiotherapist, conducts a wide range of tests that include a diabetic retinopathy screening programme (to monitor the health of the human eye), blood tests (to monitor cholesterol), urine tests (to monitor protein in the urine) and foot checks.

After all the tests have been completed and assessed by a dietician, a physician will advise patients on their health status.

All diabetes patients are advised to have their comprehensive body screening of possible complications at least once yearly.

Besides screenings, at-risk adults can take fasting plasma glucose tests (finger pricking) to help detect early diabetes or pre-diabetes.

HbA1c test is a tool to assess average glucose control. This test is very important as it can accurately predict diabetes complications.

Diabetes patients are recommended to undergo HbA1c blood check every three months.

n For more information, contact Mahkota Diabetes Centre.

Dr Lim says that a full body screening keeps individuals aware of their diabetes risk and allows early treatment.

Keep activeDIABETES is a lifelong disease with no cure. However, daily care can help to control blood sugar level and manage complications arising from diabetes.

Diabetes has a negative impact on red blood cells and causes thickening of the blood. This increases the resistance of blood flow and causes poor blood circulation that lead to high blood pressure and high cholesterol.

Diabetes sufferers are twice as likely to suffer from heart attacks and stroke compared to healthy adults and the average life expectancy of diabetes sufferers may be reduced by up to 12 years.

Due to poor blood circulation and low body oxygen, diabetes can cause severe damage in the nerves especially in the arms and legs.

Diabetes can also affect vision when it damages the tiny blood vessels in the retina, which causes it to leak fluid or bleed, leading to distorted vision and blindness.

Diet and lifestyle can help to minimise the health complications associated with diabetes. Keeping track of carbohydrate consumption, increasing fibre intake and maintaining a healthy balanced diet helps in controlling blood sugar levels.

Regular exercise such as brisk walking and swimming for about 30 minutes a day helps to strengthen the heart and lungs and help with weight loss.

As many of these health complications occur due to poor blood circulation, it is important to improve blood circulation and body oxygen level.

Owell BIO-Ge Titanium Health Accessories are specifically designed to improve blood circulation and body oxygen levels using Germanium (BIO-Ge) health minerals.

Each necklace, bracelet and timepiece contains BIO-Ge health minerals that help to minimise health complications associated with diabetes through the positive hole effect and far infrared rays.

Regular check-ups and comprehensive screenings will keep diabetic complications in check.

Owell will be bringing health check facilities closer to you through its popular 3 Step Health Check in support of World Diabetes Day.

Using proprietary diagnostic tools, the approachable health consultants help to check your body oxygen level and pulse rate, vascular age, and blood capillary shape and blood circulation.

The no-obligation, non-invasive health check only requires minutes to complete and provides you with a clearer picture of your health.

Owell health consultants will also share with you how you can further enhance and maintain your health.

In support of World Diabetes Day and to kick-start your journey towards greater health, Owell is providing the 3 Step Health Check and giving away a BIO-Ge Titanium Health Pendant with any purchase of two BIO-Ge Titanium Health Accessories.

n For more information, call 012-785 1368.

Owell’s BIO-Ge Titanium Heath Accessories are designed to improve blood circulation, minimising the complications caused by diabetes.

Containing maltitol from cereals, Kordel’s Sweetsanté provides the same sweetness as sugar but with only half the calories.

Healthy sweet life



IN the process of supporting their loved ones to ensure that they stay healthy and happy, caregivers of diabetes patients often end up doing the opposite.

Caregivers tend to want to take charge of what patients should or should not eat. For instance, sweetened beverages and sweet delights such as cakes, cookies and desserts are commonly banned from the diabetic’s diet.

Often, it reaches the extent of over-controlling what diabetes patients eat. However, should they be deprived entirely of sweet delights?

Overwhelmed after learning that they are sick, some patients undergo stages of depression before accepting the reality of the disease.

Caregivers should help smooth out the transition by making the necessary changes, especially diet modification, gradually. Abrupt changes not only frustrate patients but also make them lose hope in managing their blood sugar levels.

Sugar cravingPatients who have long been

taking sweet food habitually will find it difficult to give up muffins, puddings and cakes in their diet.

As a result, they might eat these forbidden foods behind their caregiver’s back.

This has become the common complaint of most caregivers who think they have been taking good care of the patient’s diet, yet the sugar level of their loved one does not respond accordingly.

Preference for sweetness is not acquired within a day or two. Our body learns and responds to sweet food from the time we were first exposed to it.

The more we are exposed to sweetness, the higher the dose of sweetness required to satisfy our taste buds the next time. This is termed sugar addiction.

Sweetness from food sends a signal to the body that food or energy supply is en route. If we decide to remove sweetness or sugar totally from our diet, our body would automatically think that nothing is being fed to the body, causing the body to fight back by requesting for more food.

Alas, food craving ensues and the vicious cycle of uncontrollable behaviour towards sweet food and sugar spike starts all over again.

Understanding calorieAlthough sugar is often

accused of being the culprit of diabetes, medical practitioners can tell you that sugar is not the

reason for diabetes; the calorie content is.

Every gramme of sugar provides four calories and food that is high in sugar is usually packed with calories.

Diabetics need calories and energy too, but not too much. The energy needed is about 1,800 calories a day, depending on body weight.

If one takes more calories than recommended, blood sugar level can easily go up. To prevent sugar spike, it is best to avoid sugar loading.

This can be done by spacing out the calorie intake throughout the day or simply by sparing calories. A useful tip to achieve this is to always opt for lower-calorie alternatives.

However, never attempt to achieve zero calories. This is made possible by adding artificial sugar like aspartame into coffee, which adds virtually no calories to the drink.

As artificial sugar evokes the sweet sensation, the body would expect the delivery of calories. But because artificial sugar only provides a sweet stimulus with no calories, the body will crave for the calories it does not receive, leading to binge eating during the next meal.

Many scientific studies have emerged with proof on the negative effects (such as obesity) of taking artificial sugar such as aspartame.

Enjoy sweetness with less calories

Many caregivers try their best to look after their loved ones by attempting different recipes to satisfy their taste buds. However, many find it challenging to prepare a healthy yet palatable meal.

With Kordel’s Sweetsanté from France, preparing your next diabetic meal becomes easier. Containing maltitol sourced from cereals, it is as sweet as sugar but with only half the calories.

Moreover, Kordel’s Sweetsanté is a low glycaemic index (GI) food. Unlike sugar, which has a high GI of 68, Sweetsanté’s GI is only 29.

With Kordel’s Sweetsanté, you can now enjoy the previously forbidden foods in moderation. No special recipe is required as you can replace sugar with Kordel’s Sweetsanté. This gives you the same sweetness with no worries.

This information is brought to you by an in-house pharmacist at Cambert (M) Sdn Bhd.

n For more information, call 1300 881 712 or e-mail [email protected]


Life-saving knowledge

The natural solution

Certain herbs and spices can aid with blood sugar management.

ACCORDING to a news report from the International Diabetes Federation, 387 million people have diabetes and the figure is estimated to increase to 592 million by 2035.

There were 3.2 million cases of diabetes in Malaysia, which were responsible for the death of 34,422 people last year.

Prof Dr Mohd Ismail Noor, president of the Malaysian Society for the Study of Obesity, stated that Malaysia has the highest rates for both obesity and diabetes in South-East Asia.

Diabetes is a health condition characterised by high blood sugar levels in the body. Type 2 diabetes is the most common type of diabetes, accounting for at least 90% of all cases.

Risk factors include physical inactivity and bad diets or if someone in your family has diabetes, you have a higher risk of developing it.

The symptoms may not be obvious for some individuals. It is therefore important to get your blood sugar checked regularly and monitored closely. If poorly managed, diabetes can lead to several life-threatening complications such as heart disease, stroke, kidney failure, nerve damage, blindness and lower-limb amputation.

The good news is you can prevent or delay the onset of Type 2 diabetes with positive lifestyle modifications. Maintaining a healthy weight, exercising regularly, following a healthy eating plan and quitting smoking may help lower the risk of this deadly disease and its complications.

Some herbs and spices such as fenugreek, cinnamon and bittergourd offer natural alternatives to help improve blood sugar levels.

Fenugreek is effective in lowering blood sugar as it helps increase feeling of satiety and slows down the absorption of glucose from food.

It also stimulates insulin production when blood sugar levels are high. Cinnamon has also gained much attention for its positive effects on blood sugar levels.

It contains a water-soluble polyphenol compound called methylhydroxychalcone polymer (MHCP), which is able to mimic insulin, increasing the uptake of blood sugar by cells.

Bitter melon, turmeric and olive leaf are among other herbs that are known to be effective in managing blood sugar levels.

This informational article is brought to you by VitaHealth.

n For more information, call VitaHealth at 03-7729 3873.

A MAJOR part of preventing diabetes is knowing what to look out for.

At the current rate of diabetes prevalence, the World Health Organization projects that it will be the seventh leading cause of death by 2030. In 2014, the worldwide statistic for adult deaths caused by diabetes was 9%, placing the disease in the top 10 leading causes of death.

Understanding treatmentDiabetes may be gaining notoriety around

the world, but according to Siah Guan Jian,

senior diabetes educator at the National Heart Institute (IJN), many remain unaware of important details about the disease and are misled by inaccurate information, including on side effects from treatment.

This leads to many refusing their best treatment options.

“There have been patients who were apprehensive about taking oral medication because they heard that it causes kidney failure. In actuality, it is poorly managed diabetes that can cause kidney failure and refusing medication will only exacerbate the condition,” says Siah.

Insulin replacement therapy is widely applied to manage diabetes and plays a crucial role in providing the glucose-converting hormone to those who are unable to produce it or can only produce small, insufficient amounts.

The type of treatment prescribed depends on individual requirements and reactions to insulin replacement therapy with different onset time (how quickly it starts to work), peak time (period of time when it is most effective in lowering blood sugar) and duration (how long the insulin remains working in the body).

You can start proactive action against this lifelong condition by equipping yourself and loved ones with vital information on the disease. Consult a medical professional if you have any serious qualms.

Remember these for diabetes prevention and early detection:

Risk factorsl Family history of diabetesl High blood pressurel High cholesterol levell High blood triglyceride and low HDL (high-density lipoprotein) levelsl Pre-diabetes diagnosis l Obesity, especially excessive fat in abdominal areal Antibody presence (Type 1 diabetes)

SymptomsFrequent thirst and urination – Kidneys

are forced to work harder in filtering excess glucose, which exits the body in the form of urine along with other liquids.

You urinate more because of this increased nephrogenic action, which in turn

deprives the body of essential liquids and tissue moisture, leaving you thirsty.

l Weight loss – Excessive urination also forces calories out of the body and prevents the sugar we eat from reaching the body’s cells. This deprives cells of energy, which alerts the brain that you are hungry.

In Type 1 diabetes where insulin is not produced, the hunger-weight loss cycle goes on due to constant urination caused by the body’s inability to convert glucose. The body is simply unable to use food for energy, leaving you thin and malnourished despite eating well.

l Blurred vision – Optical tissues are also affected by dehydration, causing eye lens to lose moisture. This negatively influences the ability to focus and can cause blood vessel damage over the long term.

l Fatigue – Major organs are affected as they are dehydrated by constant removal of fluids from their tissues while the kidneys continue to remove excessive sugar through urine.

Go for a check-up and speak to a doctor if you are concerned about developing diabetes.

The NordicTrack T13 treadmill sports impressive performance features – a variety of workout apps, one-touch controls and cushioning, all to suit your various exercise needs.

Kick-start your workout



INACTIVITY promotes Type 2 diabetes and every hour you spend watching television instead of participating in physical activities increases your chances of developing diabetes by 14% (source: www.hsph.harvard.edu).

Working your muscles more often and intensely improves their ability to use insulin and absorb glucose, which puts less stress on your insulin-making cells.

Findings from the Nurses’ Health Study (source: www.channing.harvard.edu/nhs/) and Health Professionals Follow-up Study (source: www.hsph.harvard.edu) suggest that walking briskly for 30 minutes every day can reduce the risk of developing Type 2 diabetes by 30%.

Begin your healthy lifestyle today

Get started on your healthy lifestyle today with the NordicTrack T13 treadmill.

The treadmill is equipped with impressive features designed to make your workouts more effective and enjoyable at the comfort and convenience of your own home.

This treadmill features a smooth and powerful 2.75 CHP DurX Commercial Plus Motor, 20-inch (50.8cm) x 60-inch (152.4cm) tread belt.

Track your total calories burned and your workout progress with a six-inch (15.2cm) large backlit display and enjoy your workout with an iPod-compatible music port and the AutoBreeze workout fan that automatically adjusts its speed to match your workout speed.

Impressive features Performance features of the NordicTrack T13 treadmill include:l 32 workout appsGet the training you want

with built-in workouts designed by a certified personal trainer that target calorie-burning, incline, speed or intensity goals.

l 1Touch speed and incline controls

Take your speed up to 20kph and incline up to 12% with the touch of a button to increase

intensity and calorie burn. You can choose to stay focused on your current mode or easily scroll through various settings.

l FlexSelect cushioningThe adjustable treadmill

cushioning offers two different modes – superior impact reduction and joint comfort as well as a surface that likens to running on road.

l Convenient usageFold your treadmill up and

out of the way for convenient cleaning and storage.

A hydraulic dampening spring does the heavy lifting for you, making it easy to fold your treadmill and save precious floor space.

Get a head start todayThe NordicTrack T13 treadmill

is now available exclusively at all Fitness Concept outlets nationwide.

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.

Fitness Concept is running a year-end sale promotion with exciting deals on treadmills, crosstrainers, exercise bikes, gym stations and fitness accessories.

Enjoy up to seven years warranty for the NordicTrack T13 (terms and conditions apply).

n For more information, call 03-7726 7787 or e-mail your enquiries to [email protected] or visit www.fitnessconcept.com.my

The FlexSelect cushioning allows you to switch modes to simulate running on different surfaces.

Exercise is made convenient with the NordicTrack T13 treadmill.


Getting your diet rightKEEPING a diabetic diet involves controlling blood sugar (glucose) level and managing weight. An ideal diet for diabetics is naturally rich in nutrients and low in fats and calories with an emphasis on fruits, vegetables and wholegrains.

Eating excess calories and fat causes the body to respond by creating an undesirable rise in blood glucose.

If not kept in check, this can lead to health issues such as hyperglycaemia and chronic complications such as nerve, kidney and heart damage.

What to includeComplex carbohydrates and fibre-rich

foods should make up the main part of your meals. These are not so easily broken down to blood glucose and will keep you fuller for longer without causing a high glucose spike. Examples are fruits, vegetables and wholegrain products.

Since it is common for Malaysians to include white rice and bread as well as foods with high sugar content such as breakfast cereals in their diet, diabetics should find healthier alternatives such as brown rice, wholewheat or wholegrain bread and rolled oats.

A diabetic diet should also include “good” fats that contain monounsaturated and polyunsaturated fats as these can help lower cholesterol levels if taken sparingly. Foods with good fats include almonds, walnuts, avocados and olive oil.

What to avoidDiabetics should learn to avoid foods high

in saturated fats, trans fats and cholesterol as these accelerate the development of clogged

and hardened arteries. Saturated fats are found in high-fat dairy

products and animal protein such as beef, sausages and bacon, trans fats in processed snacks and baked goods, and cholesterol in high-fat dairy products, egg yolks, shellfish, liver and other organ meats.

As these foods often exist in the meals cooked by food outlets, diabetics should

always be aware of the ingredients being used in their dishes.

For example, fried noodles and rice often contain a lot of oil and fast foods often use processed meat.

The same goes for store-bought items, which often contain high amounts of sugar, sodium or preservatives.

Check the glycaemic index (GI) of food items before buying or consuming. The GI indicates how quickly a food turns into blood glucose in your system.

Foods with high GI cause a greater spike in blood sugar levels compared to those with low GI, such as complex carbohydrates.

Try to consume more low-GI foods but always be sure to check what they contain before buying.

Sweet tooth satisfactionWhile it may not be necessary for

diabetics to completely cut out sugar, it is

important to control your sugar intake and reduce or completely cut out refined sugar, which is often found in packaged and processed sweets or baked items, soft drinks, and flavoured foods such as flavoured yoghurts and milk.

You can make soft drinks at home using sparkling water flavoured with lemon or lime juice and you can use healthier ingredients in your homemade sweets.

For example, instead of having ice cream from the tub, blend up frozen bananas to make a creamy frozen treat. You can add cinnamon or coconut flakes to give it extra flavour.

Try to buy natural-flavoured products such as natural yoghurt and sweeten it with fruits or honey.

Eat out wiselyOne of the biggest problems diabetics

face is how to manage their food intake when they eat out.

Since Malaysian food outlets mostly offer foods high in fats, sodium, cholesterol and sugar, diabetics must be particularly careful when it comes to making choices when they dine out.

Here are some important things you should consider when you dine out:l Do you know what’s in the dish? If

the menu does not say, be sure to clarify with the waiter or cook. Avoid foods that are breaded or fried too as these include added fats and carbohydrates as well as a high content of oil. l Try to eat the same portion as you

would at home. If the serving size is bigger than usual, ask if you can share it with someone else or take away the leftovers. l Request toppings and flavourings

such as cream and gravy to be given on the side so you can control how much to add to your main meal.l If you can substitute something with

a heathier option, go for it. For example, instead of chips with your burger, get a salad without a high-calorie dressing.

Ingredients:l 3 tbsp chia seedsl 2 large organic oranges, juiced and zestedl 300g almond meal l 2 tbsp honeyl 1/4 cup poppy seeds l 3 eggs l 1 tbsp lemon juice

Instructions:Preheat the oven at 160°C. Mix chia

seeds with six tablespoons of water in a small bowl. Leave aside for chia gel to form.

In a large mixing bowl, combine orange

juice and zest, almond meal, honey, poppy seeds, eggs and lemon juice. Mix manually or with a kitchen mixer until well combined. Fold chia gel into the muffin mixture.

Grease muffin tray with vegetable oil or line individual muffin slots with baking sheet. Spoon mixture into nine or 10 muffin slots. Bake at 160°C for 35 to 40 minutes or until a skewer inserted in the middle of a muffin comes out clean.

Serve and enjoy with tea or coffee. Muffins can be refrigerated and kept for up to five days.

Source: denisechewsnutrition.weebly.com

Healthy orange and poppy seed muffins

Complex carbohydrates and fibre-rich foods such as fruits

and vegetables should make up the main part of your meals.



For a healthy heart

Attention to the feetDIABETICS are highly prone to foot complications due to diabetic neuropathy, which is nerve damage that can cause numbness of the feet.

According to Dr Harikrishna K. R. Nair, head of the Wound Care Unit at the Department of Medicine, Hospital Kuala Lumpur, approximately 1.5 million diabetics suffer from foot complications yearly, and in many cases, their infected wounds are left untreated. In fact, diabetic foot ulcers are the most common foot wound among Malaysians.

Dr Nair explains that there are three types of nerve damage: sensory, autonomic and motor neuropathy.

“Sensory neuropathy is characterised by numbness of the feet or insensate feet or abnormal sensations such as pins and needles, autonomic neuropathy is characterised by dryness of skin, which can lead to cracks, while motor neuropathy involves the gradual weakening of muscles that eventually waste away.

“Muscle atrophy can increase pressure on the skin, causing it to break and form a wound,” he says.

Besides that, the compromised immune systems of diabetics can make them more susceptible to infection and vascular abnormalities can interrupt blood supply to the feet as blood vessels are damaged.

These patients can be helped as long as the infected wound does not develop into gangrene, after which point not much can be done to save the affected area – the foot or part of it has to be amputated. This calls for greater caution and care among those living with diabetes.

“Diabetics must ensure their feet are always clean, wear proper footwear, and tend to any wound immediately to prevent infection. Wounds must be thoroughly

assessed, cleaned and dressed,” says Dr Nair. Regularly checking the feet will also

allow diabetics to identify any cuts or abnormalities as soon as possible, even though they may not be able to feel those injuries. Dr Nair recommends using a mirror to check the bottom of the feet, too.

Diabetic wounds are easily infected, especially if the patient is also experiencing renal failure as it restricts blood supply to the feet.

However, Dr Nair explains that this situation can be managed with greater vigilance and constant management of blood sugar levels.

“Eighty-five percent of all diabetic foot wounds can be prevented with yearly foot check-ups at the hospital or health centres as well as regular monitoring by diabetics themselves,” he says.

n This article is brought to you by Soza.

Diabetics should perform regular foot checks to quickly identify abnormalities.

One packet of Oat BG22 Crispy Cereal provides 3g of oat beta-glucan.

Oat BG22 oat bran powder.

AT this year’s recent meeting of the European Association for the Study of Diabetes, researchers from the University of Texas Health Science Center presented a study of a three-and-a-half-year-old girl with Type 2 diabetes, one of the world’s youngest sufferers of the chronic disease.

They noted that the child’s diet provided evidence of poor family nutritional habits with uncontrolled consumption of calories and fat.

According to the European Society of Cardiology, carbohydrate digestion and absorption can be slowed down by choosing foods with a low glycaemic index (GI).

The GI allows identification of the absorption rate of glucose from carbohydrate-rich foods into the bloodstream.

Starchy foods such as white rice and highly processed grains are usually high in GI and low in fibre content, which could raise blood sugar level almost instantly. Hence, daily intake of it should be limited.

Decreasing the GI in everyday foods is most practical and best obtained by increasing the fibre content in your diet, particularly the highly viscous soluble fibres such as oat beta-glucans.

You can just add one to two scoops/sachets of Oat BG22 oat bran powder (9g to 18g) into a bowl of rice porridge or into three rounded tablespoons of cooked oatmeal in a bowl.

This will add more fibre to your

meal, especially the viscous oat beta-glucan of 1.8g to 3.6g for optimal health effect.

Healthy eating begins at home. Sprinkle a teaspoonful of Oat BG22 oat bran powder into your children’s favourite beverage or start their mornings with a heart-healthy breakfast such as Oat BG22 Crispy Cereal with some fresh fruits.

Dr Robert E. Steinert, clinical trial manager and scientist for DSM Nutritional Products based in Switzerland, attested that recent GI

testing in collaboration with Glycemic Index Laboratories, Canada, confirmed Oat BG22 Crispy Cereal as a low-GI food (less than 55) compared to dextrose used as control in 10 healthy subjects.

“For people with diabetes,

monitoring and being mindful about their total carbohydrate intake is important for achieving glycaemic control,” he says.

“Based on the data, Oat BG22 Crispy Cereal is a snack solution with a low GI and a low glycaemic load (GL) (less than 16g of total carbohydrates) and, therefore, a good alternative to commonly consumed sugary snacks.”

Containing only 102 calories, one packet of Oat BG22 Crispy Cereal provides 3g of oat beta-glucan, more than 6g total fibre, 4g protein and laboratory-tested low-GI and low-GL cereal.

Healthy eating is important for everyone, including people living with diabetes.

Enjoying healthy foods and staying active will help manage blood glucose levels and body weight.

Incorporating low-GI, high-fibre oat beta-glucan and high-protein Biogrow Oat BG22 into your diet can help you eat healthy easily.

This article is brought to you by Legosan (Malaysia) Sdn Bhd.

n For more information, e-mail [email protected]

16 world diabetes daysunday star, 8 november 2015

eating healthy is an important aspect of blood sugar level control.

maintain thorough foot care to keep diabetic complications at bay.

The International Diabetes Federation estimates 382 million people have diabetes worldwide and reported 3.2 million cases in Malaysia last year.

But did you know that 85% of all amputations caused by diabetes are preventable with proper management?

People with diabetes have an increased risk of developing a number of serious health problems that affect the heart and blood vessels, eyes, kidneys and nerves.

One of the most feared complications of diabetes is losing a limb. An amputation caused by diabetes occurs every 20 seconds somewhere in the world. It is debilitating, causing reduced quality of life and being a financial burden to sufferers.

What is diabetic foot?People with diabetes have very

high blood sugar levels and over time, this can damage the nerves, decreasing a person’s ability to notice pain and pressure.

Losing these sensations can increase the risk of developing calluses on pressure spots and getting injured.

Nerve damage can also weaken foot muscles, which can result in change of foot shape.

elevated blood sugar levels can also damage the blood vessels and deprive the foot from getting enough blood and oxygen, making healing of tissues harder.

Consequently, minor foot injuries such as cuts and blisters, if not properly managed, can cause ulcers, infections and, in serious cases, may even lead to amputation.

Managing diabetes

1 Control blood sugar healing and defence against

infections improve as blood sugar returns to normal or near-normal range. People with diabetes need to work with their healthcare providers to achieve the ideal blood sugar and hbA1c range.

For people with diabetes, diet is essential when it comes to

3 MedicinesIf medicines are prescribed,

ensure compliance and proper coordination of meals and medicines.

Some medicines are meant to be taken before meals and some after meals. Always speak to a pharmacist for any inquiry regarding medicines.

Those who are on insulin should learn the proper injection technique and timing of injection as well as ascertain the correct dose of insulin.

Consult a healthcare provider if your blood sugar level is too high or too low.

4 Blood sugar monitoringThis is another important part

of the diabetes management plan. Keeping track of the numbers will guide people with diabetes on making the proper choices in their diet and lifestyle as well as medicines.

The hbA1c test shows your average blood sugar level over the past two to three months. Therefore, it is important to routinely check with the hbA1C test and discuss your results with a healthcare provider.

Care for the feet

Inspect your feet every day from all sides,

controlling their blood sugar level. They need to be concerned of the content, portion and timing of their meals.

Carbohydrates have a huge impact on blood sugar levels and diabetics should learn about carbohydrate counting as well.

They should also avoid sweetened food or beverages as these contain very high amounts of sugar.

2 Physical activity Being physically active usually

lowers blood glucose levels as the muscles use more sugar as energy and the body becomes more sensitive to insulin.

People with diabetes should accumulate 30 to 45 minutes a day, three to five days a week exercises such as walking, jogging, swimming, skipping, bike riding and brisk walking.

save a limb

DAePerIO rumqui iliquia de et asint, te a idignis cipsam, te ium commolor rent modi volupta prem elessit optaquo blaut volestium ipsam vellandae magnim qui conserum consectet ernam, si omnimusa dolorru mquatia consed ut dolorro et as eaquis restiis ma nobis ad et ma nonsequos min nostium si ut repedissitia vent, conseceris exerum rae numquatur? Quias vollatur?

Cat omnimag nienisDolupta tinulpa nobit, ut volupiendis

ent od quam, que num, tene ni ut modit ari nemporp oressit aut lam dollatur aut officto is mincidu ndiscillia sum nam quatemquia eos eatem quas qui verum eostis reptatquatur raepudaeptas rest, quibusciur reprae maximil incid mos andundigeni unt.l Gia dolore voluptam veles ut minis

as et faccust, tem voloreictur?l equi de lanimus eum quae ducient

oreptat aligent, quossit ut quo ventur, quiae volorro videlest, optatus et omnihici officim uscimus audam, natur? Fictem. rem hilland ebistis evendus as est faccus qui quo consecum cus deliqui delicie nienime turessin corecup tatemporibus asserspe voluptae voleni aborpor empore.

�� š

n For more information, visit www.facebook.com

source genuine medicinesincluding the space between your toes.

Look out for dry patches or cracks, cuts, blisters, corns, calluses, swelling, ingrown toenails or places that are red or pale. Feel for increased heat in the skin.

Seek early care for any foot injury and ensure annual foot

checks at the diabetes foot clinic. These clinics are currently available at hospital Kuala Lumpur

(hKL), hospital Tengku Ampuan rahimah Klang (hTAr), University Malaya Medical Centre (UMMC) and Institut

Jantung Negara (IJN).There are many things

one can do to keep feet healthy. here are some tips: l Wash feet with mild

soap or body wash and dry feet well, especially the space in between toes with a soft towel.l Apply moisturising

lotion daily to prevent skin dryness but avoid the

DO you know where your medicines come from? This is an important question to ask when obtaining medication.

There are many counterfeit medicines in the market that are substandard, spurious, falsely labelled and falsified, all of which can harm you.

Community pharmacies are now playing an important role in educating the public about the medication that they are taking. As access to medicines is getting much easier, there is likelihood that one may end up getting fake medicines.

Since its inception 21 years ago, Caring Pharmacy has always emphasised integrity in its pharmacist services to the community.

It believes in delivering medicines that are genuine, good quality, safe and efficacious to consumers.

As a leading pharmacy group

in Malaysia, Caring Pharmacy has the responsibility to educate the community to say no to counterfeit or fake medicines and to be aware of substandard products of unverifiable sources.

Caring Pharmacy is planning to launch its Choose Genuine Medicines Campaign in the fourth quarter of this year, with the aim of educating the community on the importance of choosing genuine medicines from genuine sources that comply with regulatory requirements right up to proper storage prior to consumption.

This programme is supported by the health Ministry, pharmaceutical companies and the Malaysia Pharmaceutical Society.

Visit any Caring Pharmacy outlet today to find more information about genuine medicines from its in-house pharmacists.

space between toes.l Stop smoking.l Avoid using heating pads or

hot water bottles. These can burn the skin without warning if you have nerve damage in the feet as a cause of diabetes.

Never walk barefoot and choose proper footwear with sufficiently thick and flexible rubber soles, closed toes and closed heels with wide and deep toe boxes.l Cut toenails after bathing or

cleaning. Trim toe nails straight across and file sharp edges with an emery board. Ask for assistance if you have poor vision.

In conjunction with the World

Diabetes Day in November, Caring Pharmacy has been organising in-store activities every year for the public, inclusive of health screening, counselling on medicines and lifestyle advice.

This year, apart from the usual activities for diabetic patients, additional emphasisis has been given to foot care.

n For more information, contact Caring Pharmacy.

Documents

World Diabetes - 8 November 2015