Some may refer to it as a sweet disease because of its link to high sugar levels, but diabetes is definitely not what you would call a ‘sweet deal’.

The Crisis at Hand

In 2011, the National Health and Morbidity Survey (NHMS) reported that the prevalence of diabetes in people aged 30 years or more has increased by 40% compared to the figure in 2006. If you thought diabetes was a disease that only affects older adults, you are sadly mistaken. The survey reported further elaborated that the prevalence was actually increasing across all the ages studied. What is of particular concern is that the number of individuals who were unaware of that they were diabetic has increased. This was most apparent among younger adults (below 30 years), where about three-quarters were undiagnosed. So it doesn’t matter whether you’re young or old, you should stop living in denial and start living a healthy lifestyle now!

Considering that 1 out of 5 of us are diabetic, half of us overweight or obese (45.3%) and ranking 6th on the top ten list of highest pre-diabetes prevalence, it’s no surprise that Malaysia is a ticking NCD time bomb!

Belly of the Beast

There are 3 types of diabetes mellitus, namely type 1 and 2 and the more atypical gestational diabetes. However, it is known that type 2 diabetes is the most common of the three, accounting for almost 90% of all reported cases.
Unhealthy lifestyle, characterized by physical inactivity and overconsumption of food is an unequivocally established risk factor for type 2 diabetes. Genetic, age and ethnicity might play a role in Type 2 diabetes but the disease can manifest even if it doesn’t run in the family. A person can easily get diabetes by being/having:

• unhealthy eating habits and diet choices
• overweight or obese
• physically inactive
• unhealthy lifestyle habits (i.e. smoking, excessive drinking, etc.)

When you eat carbohydrate-based foods, they are broken down into simple sugars (mainly glucose) and released into the blood. Your pancreas (an internal organ) produces insulin (a hormone) to help transport glucose from the blood into the body cells, to be used as energy. You can imagine the scenario as a bus [insulin], ferrying workers [glucose] to the office [cells] so that the company [body] may function. Diabetes occurs when the pancreas either cannot produce insulin or does not manufacture enough of this hormone, or when the insulin produced cannot work properly.

Naturally, the body needs sugar. However, it becomes harmful when you consume it excessively – this is true for fats as well. An unhealthy diet which is high in these components (e.g. sugary beverages and foods, high fat foods) provides you with several hundred calories in just one serving but lack of other essential nutrients. When extra calories are not used by body cells, they turn into fat and become deposited in the body, leading to overweight and/or obesity. Cells in the body are unable to respond to insulin when there is presence of too much body fat; it rejects the glucose-transporting insulin. Eventually, because the glucose has nowhere else to go, it accumulates in the bloodstream and sugar levels skyrocket. If untreated, the situation can lead to diabetes.

Uncontrolled diabetes can be a serious threat to health. Persons with diabetes are at greater risk of developing several health complications:

Heart disease

Diabetics are 2-4 times more at risk of cardiovascular failure and it is the #1 cause of death amongst sufferers. High blood glucose levels over time can lead to increased deposits of fatty materials on the insides of the blood vessel walls which may affect blood flow, increasing the chance of clogging and hardening of blood vessels (NIH, 2013). This situation increases the risk of heart disease.

Nerve damage

About 60-70% of diabetics will suffer from some form of neuropathy (i.e. nerve damage). This affects nerves at different parts of the body such as muscle and limbs (which may lead to amputation).

Kidney damage

Kidneys help to remove waste from the blood. High levels of sugar put extra work on kidneys and over time damage the millions of tiny filtering units within each kidney. This eventually leads to kidney failure.

Eye complications

The three major eye problems that people with diabetes may develop and should be aware of are retinopathy (damage to the retina), cataracts and glaucoma.

Fighting Against Diabetes

It should now be abundantly clear that we should do all we can to prevent diabetes. To live diabetes-free, we must pay close attention to 4 key essential aspects of lifestyle:

Eat BMV (Balance, Moderation, Variety)-style!

The key in the fight against diabetes is healthy eating. Therefore, I fervently suggest adopting a diet plan based on the ‘BMV’ approach. The basics are simple and you don’t even need to give up your favourite foods! Essentially, go for balance, eat in moderation (portion management), and have variety in your meals. The Malaysian Food Pyramid will help you through this by identifying everything from the different food types you can take to the recommended portions/servings you should have daily.

Keep fit and keep it going

Being physically active everyday can help you to manage your body weight and blood sugar level better. If you’ve been sedentary for far too long, don’t worry, you can start small (i.e. walk to the store, take the stairs instead, do some gardening and wash your own car). Gradually increase your regime to include a mix of cardiovascular (e.g. brisk walking), strength (e.g. use resistance bands) and flexibility (e.g. leg lifts, taichi, yoga, jumping jacks) exercises as well. Even the littlest of efforts can go a long way, so don’t get too discourage or quit if you can’t finish a full workout. However, you should know that the Malaysian Dietary Guideline suggests spending at least 30 minutes a day of moderate intensity exercises or 60 minutes if you’re looking to lose weight. Remember that it’s all about burning away more calories than you actually take in.

Kick the bad habits

Poor lifestyle habits such as being sedentary, practicing poor dietary habit, smoking, and excessive alcohol intake should be reduced or eliminated altogether.

Mind over matter

In the immortal words of Kung Fu legend, Bruce Lee, “Defeat is a state of mind. No one is ever defeated until defeat has been accepted as a reality”. So, never give up! Foster a positive attitude towards your efforts and continue to motivate yourself and have your family and friends on board supporting you through this lifestyle transition. If the change is to be long-term, the mind must be prepared. It’s a journey and like all journeys, the road can sometimes be daunting.

Undertaking these lifestyle changes may be challenging and arduous initially. However, I assure you these are necessary changes you must make without delay. If you think exercising and eating well is hard, imagine having to cope with the life-long complications (and treatment cost) of diabetes and its co-morbidities.