Diabetes

Diabetes is one of the leading causes of kidney failure in Singapore. It damages the blood vessels in the body and affects the kidneys, eyes, skin, nerves, muscles and heart. The body breaks down carbohydrates that are found in food and converts them to glucose, which is the major source of food for the body cells. Diabetes is a condition wherein the body does not respond to, or does not possess a hormone called insulin. This hormone helps the tissues and organs of the body to use glucose from the blood. When there is a shortage of insulin in the body and/or body resistance to insulin, the blood glucose level remains elevated.

There are three main types of diabetes :

diabetes-1

Type 1 Diabetes Mellitus

Type 1 Diabetes Mellitus is an autoimmune disease. The pancreas produces little or no insulin. It develops most often in children and young adults.

diabetes-2

Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus is the most common form of diabetes. The main defect here is body resistance to insulin where the pancreas produces insulin but the body does not use it properly. This develops mainly in adults and  is associated with obesity.

 

gestational-diabetes

Gestational Diabetes

Gestational diabetes is diagnosed during pregnancy and is not clearly overt diabetes. This is seen in some women late in pregnancy and usually disappears after delivery.

Diagnosis of Diabetes

  • Excessive thirst
  • Frequent urination
  • Constant hunger
  • Nausea and vomiting
  • Blurring of vision

 

  • Sudden/unintentional weight loss (mainly type 1 diabetes)
  • Tingling or numbness in legs, feet or fingers
  • Slow healing of cuts
  • Weakness and fatigue

Symptoms of Diabetics Developing Kidney Disease

Early symptoms:

  • Protein in the urine (bubbles)
  • Weight gain and ankle swelling
  • High blood pressure / hypertension
  • Increased need to urinate, especially at night

 

Advanced symptoms:

  • Nausea and vomiting
  • Loss of appetite
  • Muscle cramps (especially legs)
  • Weakness anaemia
  • Itching 

Among Diabetics, Who Are Most at Risk of Progression to Kidney Disease?

Not everyone with diabetes develops kidney disease. Those at risk are:

  • Patients with poor control of diabetes
  • Patients with high blood pressure, urinary protein or high blood cholesterol
  • People with a family history of diabetes and kidney disease People who are overweight or obese

How Can Diabetics Retard the Progression to End-Stage Renal Disease (ESRD)?

Treatment of diabetic kidney disease involves slowing its progression to irreversible kidney failure by:

  • Maintaining a good blood sugar level
  • Keeping blood pressure in the normal range
  • Controlling blood cholesterol
  • Regular visits to the doctors
  • Taking medication as prescribed

Diabetes and Healthy Eating

Diabetes patients do not need a special diet. A healthy balanced diet can help to keep blood sugar level in good control and maintain overall health.

Do I need to watch my eating habits?

It is essential for diabetics to watch what they eat. Carbohydrates (e.g. bread, rice, noodles, cereals, potato, yam, pumpkin, fruits, sugar, etc) should be taken in appropriate amounts for optimal blood sugar control and adequate nutrients intake. Do not avoid them completely as they provide vitamins, minerals and fibre which are vital for good health.

Can I consume sugar?

It was once a common belief that sugar caused a sudden rise in a person’s blood sugar level. However, new research suggests that this is not the case. Table sugar is thus no longer forbidden for diabetics. Nevertheless, sugar or sugary food and drinks must be “counted” as part of your “carbohydrate allowance” and not simply added as extras. It is advisable to consult your dietitian if you want to include them as part of your diet.

Do I need a Food Plan?

What you eat, how much you eat, and when you eat will affect your blood glucose level. A Food Plan shows the amount and types of food to eat during each meal / snack. Consult a dietitian to help you in planning a suitable diet according to your body needs, daily schedule and diabetes medication. Your Food Plan can comprise the food that you normally eat (including your favourite food).

Benefits of a Food Plan

  • Keeps your blood glucose level within your target range to prevent complications.
  • Maintains a healthy blood cholesterol level.
  • Achieves and maintains a reasonable body weight.
  • Improves your health.

What should I eat?

Your recommended diet should comprise the following:

  • Adequate in starch (rice, bread, noodles, cereals)
  • High in fibre (vegetables, fruits, whole grains)
  • Moderate in protein (meat, fish, chicken, milk, bean products)
  • Low in fats, oil, sugar and salt

Healthy eating complemented with regular exercise will help you to lose excess weight which can help the insulin in your body to function effectively. Your body cells will then be able to use glucose better, resulting in a lower blood glucose level. So follow your Food Plan and test your blood glucose. By keeping accurate food and blood glucose records, you can help yourself and your doctor, nurse and dietitian to understand your condition better.