Poisoned by Sugar

The domino effect of cellular and organ damage from long-term high blood sugar levels will make you think twice before ordering another sugared drink, writes Kasmiah Mustapha

IT is called a silent killer for a reason. With no symptoms or pain, people can suffer from diabetes for years without realising it.
And since many do not realise they are diabetics, when compounded with high blood sugar and an unhealthy lifestyle, their condition can worsen, leading to certain organ failure.
Diabetes is the top cause of cardiovascular disease, blindness, kidney failure and foot amputations.
Type 2 diabetes is the most common form of diabetes and accounts for 90 per cent of cases worldwide. People with type 2 diabetes can experience either insulin deficiency or insulin resistance.
 One gets insulin deficiency when the body does not produce enough of the hormone. Insulin resistance refers to body cells not reacting to the hormone, resulting in high levels of glucose in the blood.
Universiti Sains Malaysia professor of medicine Datuk Dr Mafauzy Mohamed says a high blood sugar level over a long period of time can damage the small blood vessels in the body. The excess sugar will turn toxic and kill the blood cells, leading to other complications.
“Patients are likely to suffer from oxidative stress which causes protein damage and plays a major role in diabetes complications, both microvascular and cardiovascular,” he says.
“Over time, the nerves will be damaged, leading to foot problems. They are also at risk of kidney failure, vision loss and cardiovascular disease.”
 Dr Mafauzy says diabetics suffer from diabetic nerve damage and poor blood flow which result in numbness in their feet. This can cause complications if they hurt their feet as they won’t be able to feel pain. The wound will take ages to heal. If the patient does not notice it, it may get infected.
 “If the infection spreads, one may have to amputate the affected part of the foot. Sadly, in some cases, the patient may lose a leg because the infection has become worse and amputation has to be done to save his or her life,” he says.

CONSEQUENTIAL DAMAGE
High blood sugar can also damage blood vessels in the kidneys, heart and eyes. In the kidneys, it will affect its role to filter waste products which is discharged through urine. Over time, the kidneys can no longer process waste from the blood and protein will be leaked into the urine, a major symptom of kidney failure.
Diabetics are also at risk of vision loss because of the damaged blood vessels in the retina. It can lead to blurred vision, sudden loss of vision and in some cases, total blindness.
Dr Mafauzy says diabetics can manage their condition by eating healthy and doing physical activity. If one has the genetic risks of becoming a diabetic, it is really important to manage one’s weight to avoid getting it early.
For the rest of the population, watching sugar consumption and keeping active will go a long way in delaying or avoiding the disease.
“If they look after their weight, they may get diabetes only when they are in their 60s or 70s. Otherwise, they may get diabetes when they are in their 30s or 40s or even younger,” says Dr Mafauzy.
“If they are overweight, their pancreas has to work extra hard to produce insulin to control blood sugar level. This will stress out the pancreas and over time, it can no longer produce enough insulin. When there is not enough insulin, the blood sugar level will rise.
 “When you control your weight, the pancreas does not have to work hard to release insulin since the blood sugar level will not be high. Insulin is stored in the body. If you don’t need to use it much, there will be plenty on those occasions when the body needs extra. If you keep on using it, there will be nothing left.”
 Speaking at the launch of Forxiga, the latest treatment for controlling blood glucose, Dr Mafauzy says he informs his patients on the need to manage weight and the importance of exercise. They will be told of the complications they may face if they don’t manage their blood sugar well.
“The challenge is in controlling one’s diet and to exercise. Some patients will give excuses of not having the time to exercise or that they like to eat. These patients are in denial. Diabetes can kill if you don’t make the effort to control your habits.”
Forxiga works to improve the blood sugar level by removing excess glucose through urine. Studies show that with Forxiga, the amount of glucose excreted in the urine daily may result in significant weight loss which will benefit diabetics who are overweight or obese.
In Malaysia, 82 per cent of type 2 diabetes patients are either overweight or obese.
MANAGING DIABETES
Eat a balanced diet
Seeing a dietitian every one to two years can be helpful if you have diabetes. The dietitian, along with your diabetes health care team, will help you plan a diet that is just right for you.

Exercise
At least three to four times a week for 20 to 40 minutes each session. A regular exercise programme can improve blood sugar, decrease the risk of heart disease and help you lose weight.
Tell your doctor what kind of exercises you want to do, so adjustments can be made to your medicine schedule or meal plan. Remember it is important to check your sugar level prior to and after exercise.

Maintain a healthy weight
Minimal weight loss can have a major positive effect on blood sugar control in the obese diabetic.

Get plenty of sleep
Keeping a regular schedule and getting enough sleep will help keep blood sugar levels under control.

Quit smoking
Taking away the poisonous ingredients in cigarettes will make your body instantly healthier.

Practice good foot and skin care
Check feet daily for callouses, cracks or skin breakdown. If you notice redness, ulcerations, pus or a foul smell from your feet or if you notice that any of the toes have turned black and cold, notify your doctor immediately.
Also, tell your doctor if you have any swelling in your ankles or feet.

Keep to your schedule
Follow medicine schedule prescribed by your diabetes health care provider. Keep a list of your medicines with you at all times. When travelling, bring enough supplies on your trip.
Keep medicines, syringes and blood sugar testing supplies in your carry-on bag. Do not check in these supplies, in case you lose your luggage.
Bring copies of your prescriptions and consider getting a medical alert bracelet.