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Diabetes 101: Symptoms, Causes, Screening Subsidies, & Care Options for Seniors with Diabetes

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The Ministry of Health and the World Health Organization both agree that diabetes is growing alarmingly prevalent in many countries in the world, Singapore included. 450,000 Singaporeans are living with this condition and the trend projects the number will reach 1 million by 2050. 1 out of 3 Singaporean does not know they have this condition and for those who do, a third of them have poor control over their blood sugar levels.

Although prevalent, there are types of diabetes that are temporary and can be reversed and prevented with healthier lifestyle choices. The first step is to know your risk for diabetes and be mindful of its symptoms. The earlier it is detected, the earlier it can be treated and managed.

Diabetes happens when your body fails to effectively use insulin or fails to produce insulin altogether. Insulin is released by the pancreas when sugar (glucose) enters the bloodstream. Its job is to allow glucose to enter the body’s cells so that it can be used as an energy source.

Without enough insulin, high doses of sugar will remain in the bloodstream. If not managed properly, it can lead to serious health problems that may affect your vision, your kidney and even your heart.

Prediabetes

When blood sugar is higher than normal but falls short to be classified as type 2, it is known as Prediabetes. Though it is known as the precursor of type 2 diabetes as it increases the risk for it, Prediabetes can be reversed through regular exercise and a healthy diet.

Type 2

Also known as adult-onset diabetes, the common profile of those who develop this type is over 40 years old, overweight and inactive. It is important to note, however, that the number of young people – children and young adults alike – who develop diabetes have been increasing.

Type 2 makes up about 90-95% of cases of diabetes and occurs when the body fails to produce insulin or becomes insulin resistant. This causes a build-up of glucose in the bloodstream. Mild cases can be reversed through healthy eating, losing weight and engaging in physical activity. However, serious cases may require insulin injections or oral medication to help the body manage blood sugar levels.

Type 1

Type 1 diabetes is assumed to be hereditary and cannot be prevented. It is an autoimmune reaction wherein the immune system destroys insulin-producing cells in the pancreas. This prevents the body from creating the necessary insulin to keep blood glucose levels in check.

10% of people with diabetes have this type and it is commonly diagnosed in children, teens and young adults. Daily insulin injections are necessary for Type 1 diabetes.

Gestational Diabetes

Gestational Diabetes occurs due to hormonal changes in pregnancy that result in cells in the body becoming more insulin resistant. Despite having no history of diabetes, some women experience increased levels of blood sugar as the pancreas fails to produce enough insulin to overcome the resistance. This results in glucose building up in the bloodstream instead of being used as energy.

Gestational Diabetes is temporary and glucose levels return to normal after childbirth. However, women who develop Gestational Diabetes may be at an increased risk of Type 2 diabetes.

It is important to be aware of the symptoms of Diabetes. If any of the following have been a concern for you or a family member, it would be good to go to your doctor for a blood glucose test. Early diagnosis is ideal so that treatment can begin immediately.

  • Frequent passing of urine, at night
  • Increased thirst and hunger
  • Unexplained weight loss
  • Blurred vision
  • Numb or tingling sensation in hands or feet
  • Dry skin
  • Fatigue / often tired
  • Slow healing cuts/sores
  • Infections in areas such as gums, skin, and genitals

The symptoms of Type 2 diabetes take a few years to develop. It is hard to notice so it may go undetected until a diabetes-related problem such as blurred vision or heart issues brings it to light.

The symptoms of Type 1 diabetes develops quickly, from a few months down to just weeks and can be severe. Nausea, vomiting or stomach pains may also occur.

Gestational Diabetes has no symptoms. A test for gestational diabetes is usually conducted between 24 – 28 weeks of pregnancy.

Poor management of diabetes is damaging to nerves and blood vessels. These are crucial to blood circulation and ensuring each organ has enough blood supply. Prediabetes could lead to Type 2 diabetes, while Gestational Diabetes is both harmful to the mother and the child. If unchecked, diabetes can develop the following complications:

  • Kidney diseases – a high blood sugar level can damage the filtering system of the kidney and severe damage may require dialysis or kidney transplant.
  • Food disease – nerve damage to the feet due to poor blood flow increases the risk for infections that will not heal properly if you have diabetes. Serious infections may require limb amputation.
  • Eye damage – diabetes can damage the retina which may lead to blindness and increases the risk for cataracts and glaucoma
  • Nerve diseases – excess sugar in the blood may cause nerve damage, leading to problems such as nausea, vomiting, diarrhoea and erectile dysfunction. It may even cause the loss of sensation in your legs, fingers and toes.
  • Cardiovascular Disease – diabetes increases risks for heart problems such as angina, heart attacks and strokes.
  • Hearing impairment – it is common for people with diabetes to develop hearing problems
  • Depression – people with type 1 or type 2 usually experience depression, which may affect diabetes management.
  • Alzheimer’s Disease – poor blood sugar control increases the risk for dementia
  • Skin conditions – it is common for people with diabetes to have skin problems such as bacterial and fungal infections

Although Type 1 can’t be prevented, healthy lifestyle choices help to control blood sugar levels and prevent the other types such as Prediabetes, Type 2 and Gestational Diabetes. The first steps to prevention are to know your risk for diabetes and adopt healthy lifestyle changes.

1. Know your risk for diabetes. Monitor your health as early detection can help prevent diabetes from developing into serious complications.

For those between 18-39 years old, an online diabetes risk assessment test can give an idea of your risk for developing diabetes. For those aged 40 years and above, it is recommended to have a health screening for diabetes every three years.

2. Healthy diet of high fibre food that is low in fat and calories. Eating sweets do not directly cause diabetes. An unhealthy diet may, however, increase BMI and as such increase the risk for diabetes.

Fruits, vegetables and whole grains are good examples of these. There are a variety of recipes available online that uses these ingredients to make healthy and delicious meals.

3. Exercise regularly. An active lifestyle increases insulin secretion, reduces blood glucose levels and helps with managing healthy body weight.

A diabetes screening would require blood extraction and may consist of tests like Fasting Blood Glucose test, Casual Glucose Test, Oral Glucose Tolerance Test and Haemoglobin Blood Test. If you would like to get a screening, there is the option to go to a general practice clinic or to Screen For Life clinics to get subsidized rates.

For general practice clinics, screening costs can range from $50 -$500.

If you are eligible for subsidized screening, you can expect to pay the following rates:

  • With Pioneer Generation, a health screening is free.
  • With Merdeka Generation, a health screening costs $2.
  • Fees under the Community Health Assist Scheme (CHAS) are:

-For those with a blue or orange card, a screening costs $2.

-For eligible Singaporean citizens and those with green cards, a screening costs $5.

For elderly loved ones who have been diagnosed with diabetes, they may need some help in managing it. There are a variety of options and setups that can provide them with the assistance they might require. Such set-ups are nursing homes, daycares and home care.

Your elderly loved one may opt to stay at a nursing home where they can get 24-hour attention from trained personnel who can assist them should they need help with activities of daily living.

Another option is a daycare centre where a full-day program is provided for their elderly wards. At a daycare centre, they have access to the required assistance as well as the opportunity to socialize with their peers.

Home care for elderly is also a good option. If your elderly loved ones prefer to stay in the comfort of their homes, hiring a live in caregiver Singapore who can care for them will ensure that they get the assistance they need to manage their condition properly.

Conclusion

There is a rising trend of increasing health issues that can be seen in Singapore as more and more people embrace a sedentary lifestyle, among these are Hypertension and Diabetes. The prevalence rate of diabetes went up from 8.8% in 2019 to 9.5% in 2020.

The good news is that the older generation seems to be getting better at recognizing symptoms of diabetes. A 2021 study shows that 83.5% of Singaporeans can correctly identify symptoms of diabetes. The downside is that those between 18 to 34 years old were seen to be less successful at identifying them. This is concerning as the age bracket of diagnosis is also lowering as more and more youth develop diabetes at a young age.

Diabetes is prevalent in Singapore but it can also be treated and managed. Awareness of the symptoms as well as the risks for developing it is a good start to ensure you, your children and your elderly loved ones are one step ahead of this condition and its complications.

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