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#HEALTH: Putting diabetes in remission

AN almost invisible disease, diabetes can have a devastating impact if left unchecked or uncontrolled and it affects each person differently.

Seven million Malaysian adults aged 18 and older are predicted to be affected by the disease by 2025.

Subang Jaya Medical Centre consultant endocrinologist, Dr Chan Siew Pheng says for many, the term "remission" is more often associated with cancer, thus, it may be surprising to hear it being used for diabetes.

Yet, going into remission can be life-affirming for those who have been dealing with a disease that requires 24/7 attention.

According to a team of experts from Diabetes UK, the American Diabetes Association and the European Association for the Study of Diabetes, remission is when long-term blood sugar levels remain below the diabetic range for at least three months without diabetes medication.

Dr Chan says achieving diabetes remission is no easy task nor is it a quick fix. It is also not for every diabetic.

Studies show that weight loss plays a definitive role. Reducing one's weight by 10 -15 per cent when one is at an unhealthy weight and maintaining it is the foundation of achieving diabetes remission.

However, this will not apply to those who are already below their healthy weight or to a diabetic who is genetically predisposed to diabetes as not every type 2 diabetic struggles with excess weight.

Therefore, weight loss is not the solution for some individuals with diabetes.

"A lifelong commitment to maintaining a certain weight is a must, and as a result, gaining healthy levels of blood glucose, blood pressure and cholesterol.

One is in remission as long as these levels are maintained."

Diabetes remission is not only dependent on dietary changes but also physical activity. With the body typically geared towards regaining weight, it is vital to understand that the recommended 10-15 per cent weight loss is just the beginning of the journey.

To sustain this status, one must be prepared to adopt lifestyle changes for life as regaining weight is inevitable if control is relaxed.

With discipline, monitoring and medical support, one can remain in diabetes remission.

Poor glucose control on the other hand, can lead to devastating complications, especially for the heart and kidney and also the risk of limb amputation.

Subang Jaya Medical Centre senior nurse and diabetes educator, Yong Lai Mee, says there are two components in managing diabetes – the disease itself and the person having the disease.

"It is a complex multifactorial disease. A change in body weight, lifestyle, comorbidity, and even age can change how the disease progresses," she says.

People living with diabetes must do the same tasks daily to achieve and maintain the targeted blood glucose level. Being motivated to do it every single day repeatedly is a challenge. Having self-care knowledge and healthcare professionals to monitor the disease are also vital to avoid complications.

The International Diabetes Federation has set the theme for World Diabetes Day 2022 as "Education to Protect Tomorrow".

Yong says education works to empower people with diabetes to control the disease and stay on track.

Sugar is fuel for cells. It circulates in the blood and is supplied to cells to support normal body function, but in people with diabetes, this process malfunctions. Managing blood sugar levels is a 24-hour challenge for diabetics as their blood glucose levels fluctuate easily and can be affected by food intake, medication, exercise, and illness.

High blood sugar increases the risk (by 2 to 4 folds) of having a stroke, heart attack, kidney damage, blindness, sexual dysfunction, and limb amputation.

Making regular follow up visits to one's doctor helps to detect early disease changes. Two-way communication between doctor and patient is also vital to discuss self-care issues and present sufficient blood glucose monitoring data to healthcare professionals.

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