By Dr Cynthia May D. Malong*

Diabetes mellitus is increasing all over the world, and its particularly increasing in Asia. According to the International Federation of Diabetes’ 2014 annual report, 387 million people were estimated to be living with diabetes. It is estimated to increase to 592 million within the next twenty years.

Based on recently published medical articles, type 2 diabetes mellitus has increased in Việt Nam.

What is diabetes mellitus type 2?

This is a metabolic disorder in which the body increases blood sugar production. Diabetes mellitus type 2 is the most common form.

What are the symptoms?

Most people are often asymptomatic in its early stages and can remain undiagnosed for many years. Early detection and treatment can decrease the risk of developing the complications of diabetes.

• Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual.
• Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger.
• Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolise glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine.
• Fatigue. If your cells are deprived of sugar, you may become tired and irritable.
• Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus.
• Slow-healing sores or frequent infections. Type 2 diabetes affects your ability to heal and resist infections.
• Areas of darkened skin. Some people with type 2 diabetes have patches of dark, velvety skin in the folds and creases of their bodies — usually in the armpits and neck.

If you noted that you have these symptoms, please see a doctor. He or she will test your fasting blood sugar, oral glucose tolerance test (OGTT) and/or HgbAic. Fasting blood sugar as the test implies is checking your sugar levels after 10 hours of fasting. OGTT test is a test wherein your sugar is tested after eating a specific amount of sugar. HgbAic is a test to check the control of blood sugar.

Who are at risk?

DM type 2 is more common for the following cases:

• Family history (parents and/or siblings with diabetes)
• Certain racial/ethnic groups
• Age: 45 or older
• Low HDL ("good") cholesterol
• High triglycerides
• Unhealthy weight, obesity
• High blood pressure, even if it’s treated and under control
• Gestational diabetes during pregnancy
• Women who have polycystic ovarian disease, gestational diabetes
• Polycystic ovary syndrome (PCOS)
• Acanthosis nigricans: a skin condition with dark rashes around your neck or armpits
• Depression
• Hypertension and/or have history of heart and blood vessel disease
• Other risk factors have to do with your daily habits and lifestyle. These are the ones you can really do something about: Have sedentary lifestyle with little or no exercise, smoking, stress, sleeping too little or too much.

What are the complications?

This is metabolic disease which affects almost every other system in the body.

• cardiovascular diseases (e.g. hypertension, heart attack, stroke)

• blindness

• renal failure

• nerve problems: numbness and/or tingling sensation in hands and feet. If unchecked and there is a non-healing wound in the feet (since the person cannot feel it), this may lead to lower limb amputation.

• pregnancy: large babies

How to stop progress?

We cannot over emphasise the importance of lifestyle changes. Once your doctor tells you that your sugar is elevated, start exercising! Based on American Heart Association, 30 minutes of moderate to intense aerobic activity at least 5x a week for a total of 150 minutes is  recommended. Start by walking. You can start slowly at 10 minutes a day. You can spread your activity out during the week, so you don’t have to do it all at once. You can divide your time into two or three segments of 10 to 15 minutes per day.

Having a healthy well balanced diet is also important. You can read more about this at American Diabetes Association website. — Family Medical Practice HCMC

* Dr. Cynthia May D. Malong is an internal medicine physician who has been working at Family Medical Practice HCM City since 2008, with mist of her patients seen at CARE1.  Dr Cynthia also sees applicants for visa medical check- ups.  She has solid exposure in primary and preventive medical care management. In addition to this, she has valuable insight into health program coordination, health and physical examinations, clinical processes, patient needs assessment and education, as well as healthcare management. 

For more advice on any medical topics, visit Family Medical Practice Hanoi at 298 Kim Mã Street, Ba Đình. Tel: (04) 3843 0748. E: hanoi@vietnammedicalpractice.com. Family Medical Practice’s downtown Hồ Chí Minh clinics are located at Diamond Plaza, 34 Lê Duẩn, District 1 and at 95 Thảo Điền Street, District 2. Tel: (08) 38227848. E: hcmc@vietnammedicalpractice.com.