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Malaysians need to make the right decision to change in order to keep diabetes at bay.

AWARENESS and education are key aspects to help us break down barriers, change, move forward, and ultimately help us live better lives. This could not be more needful for people living with diabetes.

Since knowing what to do may not always result in doing, we need to persevere and continually share insights so we can prompt change among people with diabetes, as well as those at risk.

Today, diabetes is one of the most common non-communicable diseases around the globe. Data from various research show that this prevalence is rising with each passing year, affecting more and more people worldwide.

Based on the data we have, the prevalence of diabetes in Malaysia shows this same worrying trend. In 2006, 11.6% of the Malaysian adult population (those above 18 years old) have diabetes. Over the course of five years, this figure rose to 15.2% in 2011, affecting about 2.6 million people, or one in seven Malaysian adults. Additionally, 43% of Malaysians have abdominal obesity, which indicates high risk of developing type 2 diabetes.

With these staggering statistics, I find myself asking: Why is this scenario prevalent in Malaysia? How aware and knowledgeable are Malaysians when it comes to diabetes? Are we safeguarding our health? Why aren't we doing something before it is too late?

The recent Novo Nordisk Diabetes Awareness Survey in Malaysia conducted by pharmaceutical company Novo Nordisk sheds light on these questions.

Through the recruitment of 1,012 men and women above 18 from all over Malaysia, this representative survey gives us the much-needed localised data to highlight the gap between knowledge and behaviour to combat the rising incidence of diabetes in Malaysia.

It certainly supports the trend that many of my colleagues and I observe in our clinical practice.

According to the survey, the average BMI of the population is 24 (considered as overweight), higher than that of our neighbours such as Indonesia and Vietnam, which have an average of 23 and 22 respectively. Yet, 72% believe their weight is just about right, or even too low, indicating that a majority of those at high risk of diabetes also may deny that their weight is too high!

These findings seem to show the lack of understanding or just denial among Malaysians of the actual state of their health; a cause for worry indeed.

I often ask my patients if they know what diabetes is. In general, many correctly identify its main symptoms and risk factors. They know that being overweight and living sedentary lifestyles increases the risk of developing diabetes.

Also, a majority are aware that the onset of diabetes can be delayed or prevented by practising healthier lifestyle habits, which include eating well and exercising regularly.

Surprisingly, despite this level of knowledge, it doesn't translate into action to commit to healthy habits.

In the survey, diet and exercise are found to be low in priority, especially among those at high risk. Fifty-seven percent of respondents at high risk do not observe 30 minutes of physical activity on a daily basis, while 17% of the general population (out of which 31% are at high risk) do not exercise at all, further increasing their risk of developing the condition.

A common question I am often asked is what are the possible complications of diabetes, even by people who have it.

In a similar vein, 87% of survey respondents with diabetes have not been informed on the possible complications. Fifty-eight percent of respondents agree that diabetes is a manageable condition, and therefore, do not believe it to be as serious as other conditions. This is potentially dangerous as less attention may be given to manage blood sugar levels, which would help avoid debilitating health consequences, including kidney failure, blindness, disability by amputation, and especially, cardiovascular diseases such as heart attacks and stroke. At times, such complications can even lead to death.

Additionally, managing and treating diabetes is also incredibly expensive in the long term. A report published in the American Journal of Preventative Medicine calculates it to be as costly as buying a house. This not only places the burden on the individual, but also on the national healthcare system, as increasingly more people with diabetes will require treatment for the condition, as well as related complications.

In Malaysia, 16% of the national healthcare budget in 2010 was allocated towards diabetes-related expenditure, listing it among the top 10 countries in the world in terms of percentage spent.

Tablets are the most popular way of treating diabetes. Many people are afraid to start injectable treatment, which may indicate why tablets are popular.

People need to know that timely use of insulin can be more effective in preventing or delaying painful complications. Furthermore, with technological advancements, insulin delivery devices such as insulin pens are now more convenient and discreet, and can be easily carried around.

The fine-point needles available have also made the procedure quite painless. So why not accept the little "ant bite", as opposed to the "pain" of footing a staggering healthcare bill or the suffering from disease complications?

Combining these findings and my own clinical experience, I have come to this conclusion: Although the general population in Malaysia knows that diabetes is a prevalent problem, there is a gap between awareness and knowledge in translating into action and healthy behaviours. There is a critical need for healthcare professionals and individuals to aggressively address this phenomenon.

Fellow Malaysians, I encourage you to stand up and take charge of your health. Seek professional advice and healthcare information from proper channels. Be proactive in learning more about diabetes and how it can affect you. Get tested for diabetes especially if you have close family members with the condition, high blood pressure, and/or high cholesterol.

At the end of the day, your health is priceless.

With that, I pose this question to you: Will you learn from this and do something about it today? If I have caused you to sit up and take note, I would have played my part in helping you keep diabetes at bay.

Do the same for your loved one or friend. Don't let them become a statistic!

*Dr Chan Siew Pheng is a consultant endocrinologist.

Sugar havoc on limbs

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Nerve damage due to diabetes can ultimately lead to ulceration and amputation of the toes, feet and lower limbs.

A FEW days ago, the world commemorated World Diabetes Day (WDD), which falls on November 14 every year. The first such Day was introduced in 1991 by the International Diabetes Federation (IDF) and the World Health Organization in response to the alarming rise in diabetes cases around the world.

In 1985, 30 million people worldwide were thought to have diabetes. A little over a decade later, the estimate rose to over 150 million.

Today, according to IDF figures, it exceeds 250 million. Unless action is taken to implement effective prevention and control programmes, the total number of diabetics will reach a staggering 380 million by 2025.

According to the 2011 National Health and Morbidity Survey (NHMS) conducted by the Health Ministry, one in five Malaysians are diabetic, which means diabetes afflicts up to a staggering 22% of the country's population.

Diabetes 101

Diabetes is a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. Insulin is a hormone that enables cells to take in glucose from the blood and use it for energy.

Diabetes is one of the leading causes of amputation of the lower limbs throughout the world – up to 50% of all amputations! In fact, the risk of a leg amputation is 27.7 times greater for a person with diabetes. – Reuters

Failure of insulin production, insulin action, or both, leads to raised glucose levels in the blood (hyperglycaemia). This is associated with long-term damage to the body and failure of various organs and tissues.

Diabetes is a chronic, life-long condition that requires careful monitoring and control. Without proper management, it can lead to very high blood sugar levels. Complications include cardiovascular disease, kidney disease, eye disease and nerve disease, which can ultimately lead to ulceration and amputation of the toes, feet and lower limbs.

Remember: Do not ignore the signs of nerve damage!

Diabetic neuropathy

Peripheral nerves are responsible for the sensations you feel, such as touch, pain and temperature. There are literally millions of these nerve endings in your fingers, hands, toes and feet, and they keep you out of danger and away from the things that are hot, cold, sharp, etc.

In peripheral neuropathy, you may have loss of feeling, tingling, numbness or burning sensations in your feet and hands. Nerve damage starts even before a person is diagnosed with diabetes. Even somebody with pre-diabetes may have neuropathy.

Although tingling, numbness, or burning sensations in the extremities are common signs of neuropathy, others may experience no symptoms at all. Nerve damage can also occur in internal organs, such as the heart or digestive tract. People who develop diabetic neuropathy are typically those who have trouble controlling their blood glucose levels, blood pressure, cholesterol, and body weight.

How can you tell if you have nerve damage? Doctors diagnose nerve damage on the basis of symptoms and a physical examination. During the assessment, your doctor may check blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature or light touch.

Scary amputation statistics

Up to 70% of diabetics have nerve damage, which can lead to foot or leg amputations due to reduced blood flow and sensation to the feet. Experts recommend that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams.

Diabetes is one of the leading causes of lower limb amputation throughout the world – up to 50% of all amputations! In fact, the risk of a leg amputation is 27.7 times greater for a person with diabetes.

Bringing blood sugar levels to within normal range is the first step to prevent further nerve damage. Regular blood sugar monitoring, meal planning, physical activity, oral medication or insulin will help control blood glucose levels.

It may take some time, but generally, the symptoms will improve when there is good glucose control. Good blood sugar control can also help prevent or delay the onset of further problems.

Besides regular foot examinations, Japanese scientists have discovered that damaged nerves can be regenerated with a specific nutrient known as mecobalamin.

Mecobalamin is the active form of vitamin B12, which helps promote healthy nerves and protects against the degeneration process of the nervous system.

*This article is courtesy of Live-well Nutraceuticals. For more information, please consult your pharmacist or call Live-well INFOline: 03-6142 6570 or e-mail info@livewell2u.com. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

Movember: What's all the fuzz about, man?

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It's Movember, when men cultivate moustaches to raise money for men's health. But could facial hair have year-round health benefits?

DOES a moustache maketh the man? Movember co-founder Justin Coghlan reckons so. "I have seen it bring on a great new persona in guys so many times," he explains. "It's almost like Clark Kent turning into Superman."

Movember (a portmanteau word from moustache and November) is an annual, month-long event involving the growing of moustaches during the month of November to raise awareness of men's health issues, such as prostate cancer and other male cancers.

Coghlan, an Australian who helped to pioneer the global charity campaign that asks men to grow a moustache during November to raise funds for men's health, says the confidence that a little facial fuzz gives most men is infectious. "They have this out-of-this-world experience for 30 days where they challenge themselves," he says. "It gets everyone in a really good mood, which is awesome to see, and more importantly, gets a conversation going about Movember."

But while the aim is to raise money for – and awareness of – men's health issues such as testicular cancer, could cultivating face furniture possibly be healthy, as well as hip and altruistic?

Research from Australia suggests there is indeed more to men's facial hair than fashion and a lackadaisical attitude to personal grooming.

A study by professors Barnaby Dixson and Robert Brooks of the University of New South Wales, published in the journal Evolution And Human Behaviour in April, found that beards may be seen as a sign of physical fitness. Their research showed that while women perceived men with heavy stubble as the most attractive, men with full, bristling beards were considered healthier and better potential parents, despite (or perhaps because of) being seen as more aggressive.

One explanation for this could be that facial hair may indicate a better immune system. In a paper in Behavioural Ecology by Dixson and Paul Vasey in 2012, the authors point to a connection between beards and immunity. Because, as the paper put it: "Hair on the face and body are potential localised breeding sites for disease-carrying ectoparasites", it is argued that any man able to grow and maintain a beard must be more resilient to illnesses – "advertising their superior immune system through possessing a trait that is immunologically costly".

Of course, the power of facial hair to attract or repulse the opposite sex may come as no surprise to the moustachioed hipster, but other than finding a potential partner with a fetish for fuzz, are there other tangible health benefits?

Yes, say scientists at the University of Southern Queensland. They claim beards can help to block out the sun's harmful rays. The study published in the journal Radiation Protection Dosimetry found that a full bushy beard offered protection levels similar to factor 21 sunscreen – a reduction in the UV of 50-95%.

But before you throw out the Ambre Solaire and the razor, Prof Alfio Parisi, a member of the team that conducted the study in the scorching Australian outback using mannequins and fake beards, admits that, while a hairy face provides more protection from the sun's UVB rays, its effectiveness against the dangerous, cancer-causing UVA is "much lower".

Dr Bav Shergill of the British Association of Dermatologists also warns against growing a beard as a substitute for proper sun protection, but the skin cancer specialist does admit that for some people, facial hair can be extremely beneficial.

Folliculitis barbae, a type of skin rash, is a common condition in Afro-Caribbean men, Dr Shergill says. He claims many of today's black pop stars have grown carefully shaped beards, precisely to stop them having to shave around their chins.

Dr Shergill explains: "For those patients (with folliculitis barbae), I would encourage them to grow a beard. They can then close-crop it without actually scraping their skin, which leads to inflammation of the hair follicles."

Without proper maintenance and care, even the most carefully trimmed beard or twizzled moustache can be a detriment to a man's health, rather than a boon.

Dr Sunil Chopra of the London Dermatology Centre gives little credence to other scientists' claims that beards bring health benefits, insisting there is actually more chance of infection with a beard than a clean-shaven face. Facial hair is more likely to trap bacteria and food – the increased risk to hygiene is why British surgeons are advised to cover their beards when operating.

And while a well-kept beard can prevent the common bacterial infections men get from shaving, general practitioner Dr Bram Brons of HealthExpress.co.uk says neglected fuzz can lead to more than just a tangled mess.

"One of the biggest disadvantages is pubic lice, also known as crabs, that can live in beards," he says. "If you don't care for your beard, it will begin to smell in a similar way to a sweaty and unwashed armpit. The smell can be a sign that bacteria are living in the beard, and they could eventually cause a number of ailments."

The solution? Treat the hair on your face with as much care as the mop on your head. That means washing daily, using conditioner and applying beard oil to soften the hairs and avoid itching and discomfort.

But while some of the physical health benefits of facial hair remain up for debate, growing a mo' this month might not only make you feel good – it could save another man's life.

In a survey of more than 1,200 Movember participants last year, 67% recommended someone else see a doctor as a result of the campaign and 43% became more aware and educated about the health risks they face.

Whether you sport a handlebar or an Errol Flynn pencil moustache, that's worth chucking away a razor for. – Guardian News & Media

Kredit: www.thestar.com.my

Ahad, 17 November 2013

The Star Online: Lifestyle: Health

The Star Online: Lifestyle: Health

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