(Silent killer that creeps on you while you are ‘enjoying’ your life) 

Multisystem chronic disease caused by lack or improper use of insulin with disruption
of carbohydrate, fat and protein metabolism and produced complications affecting kidney (kidney failure), heart (heart attack), brain (stroke), peripheral vascular disease and nerves neuropathy (foot ulceration may result to amputation) and eyes (poor vision and blindness) and increased incidence of cancer.

Disproportionately expensive disease with per-capita cost of health care FIVE time more compare with non-diabetes.

Type 1 DM: inability of pancreas to produce insulin due to autoimmune disease with
genetic component and affect children to adult early 30s.

Type 2 DM: develops when a diabetogenic lifestyle (ie. excessive caloric intake- makan banyak, inadequate caloric expenditure- kurang bersenam and obesity) is superimposed upon susceptible gene. This is supposed to be adult onset DM, however, thanks and no thanks, due to fat and carbohydrate laden mac Donald and junk foods, we are seeing younger and younger patient, even school children with this type of DM. In fact DM and SMOKING is a highly potent combination for having accelerated Heart attack and stroke.

Secondary DM: In individuals with healthy lifestyles, long-term exposure to traffic-related pollution may contribute to the development of DM. This has implications for future generations who may experience increasing exposure to traffic air pollution with rising urbanization trends.Secondary DM may occur in patients taking steroid or when patients have conditions that antagonize the actions of insulin (eg, Cushing syndrome, acromegaly, pheochromocytoma).

Higher risks:
History of big baby (birthweight >=4KG)
Pre-obese BMI >23KG/m2
On hypertension treatment
On prolonged steroid treatment
Older age
Higher BMI (body mass index)- obese
Family history of DM (parents and siblings)
Hpercholestrolemia or hyperlipidaemia

Survey by Ministry of health shows 50% of DM patients did not realised that they have
the disease until they developed complications eg. Renal failure, heart attack, stroke,
blurring of vision or non- healing ulcers. That means they have been suffering from DM
for at least 5-10 years, a real silence killer. Ministry of health recommends annual
screening (fasting blood glucose) starting from age of 35 if you have risk factors or
age of 40 if no risk factor.

Treatment of DM is individualised.

Dr Abdullah Daud







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