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Diabetes Specialist
In Singapore
Diabetes is a chronic medical condition characterised by elevated levels of glucose in the blood. It occurs when the body is unable to produce or effectively use insulin, a hormone that regulates blood sugar.
Are your symptoms affecting your quality of life? Consult our MOH-accredited endocrinologist for a detailed consultation & personalised treatment plan today.
Dr Daphne Lee
MBBS
MRCP(UK)
FAMS
Types of Diabetes
Diabetes is broadly categorised into several types, each with distinct causes and characteristics.
Type 1 Diabetes
This autoimmune condition results in the body’s immune system attacking and destroying the insulin-producing cells in the pancreas. It’s usually diagnosed in children and young adults but can develop at any age. Individuals with Type 1 diabetes require lifelong insulin therapy.
Type 2 Diabetes
The most common form of diabetes, Type 2, is often related to lifestyle factors and genetics. It develops when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. Type 2 diabetes can sometimes be managed with lifestyle changes, oral medications, and, in some cases, insulin.
Gestational Diabetes
This type occurs in some women during pregnancy when the body becomes less sensitive to insulin. Gestational diabetes usually resolves after childbirth, but it increases the risk of developing Type 2 diabetes later in life.
Prediabetes
A condition where blood sugar levels are higher than normal but not high enough to be classified as diabetes. Prediabetes is a risk factor for the development of Type 2 diabetes.
Other Specific Types
There are other less common forms of diabetes resulting from specific genetic conditions, surgery, medications, infections, and other illnesses.
Complications of Diabetes
Unmanaged diabetes can lead to a range of both short-term and long-term complications.
- Cardiovascular Diseases: Diabetes increases the risk of various cardiovascular problems, including coronary artery disease, heart attack, stroke, and atherosclerosis.
- Nerve Damage (Neuropathy): Excess sugar can injure the walls of the tiny blood vessels that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain.
- Kidney Damage (Nephropathy): Diabetes can damage the kidneys, potentially leading to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
- Eye Damage: Diabetes increases the risk of serious eye diseases, such as diabetic retinopathy, cataracts, and glaucoma, and can lead to blindness.
- Foot Damage: Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can develop serious infections, which often heal poorly and may ultimately require toe, foot, or leg amputation.
- Skin Conditions: Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
- Hearing Impairment: Hearing problems are more common in people with diabetes.
- Alzheimer’s Disease: Type 2 diabetes may increase the risk of dementia, such as Alzheimer’s disease.
Symptoms
The symptoms of diabetes vary depending on how much blood sugar is elevated. In Type 2 diabetes, symptoms often develop slowly and can be subtle; sometimes there are no symptoms at all. Common symptoms include:
- Increased thirst and frequent urination: Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues, leading to thirst.
- Fatigue: Insufficient sugar entering your cells might make you feel tired and irritable.
- Blurred vision: High blood sugar levels can lead to blurred vision.
- Slow-healing sores or frequent infections: Diabetes affects your ability to heal and resist infections.
- Unintended weight loss: This occurs more commonly in people with diabetes type 1.
Diagnosis
Diagnosis of diabetes involves evaluating symptoms and conducting blood tests, which include:
Glycated Haemoglobin (A1C) Test
This blood test measures the average blood sugar level for the past two to three months. An A1C level of 6.5% or higher indicates diabetes.
Fasting Blood Sugar Test
A blood sample is taken after an overnight fast. A fasting blood sugar level of 7.0 mmol/L or higher suggests diabetes.
Oral Glucose Tolerance Test
Blood sugar is measured before and two hours after drinking a sugary drink. A reading of more than 11.1 mmol/L after two hours indicates diabetes.
Random Blood Sugar Test
A blood sample is taken at a random time. A blood sugar level of 11.1 mmol/L or higher suggests diabetes.
Treatment Options
Treatment strategies differ depending on the type of diabetes.
Type 1 Diabetes Treatment
- Insulin Therapy: People with Type 1 diabetes require insulin therapy to replace the insulin their bodies are unable to produce. Insulin is usually administered through injections or an insulin pump.
- Blood Sugar Monitoring: Regular blood sugar monitoring is necessary for insulin management.
- Carbohydrate Counting and Healthy Eating: Dietary management helps to control blood sugar levels.
- Regular Physical Activity: Exercise helps insulin regulation and overall health.
Type 2 Diabetes Treatment
- Healthy Eating and Weight Management: A diet rich in fruits, vegetables, and whole grains is beneficial. Weight loss can improve blood sugar control.
- Physical Activity: Regular exercise helps to lower blood sugar levels and boosts insulin sensitivity.
- Oral or Other Medications: Some people with Type 2 diabetes need medications to help manage their blood sugar levels. These may be oral tablets or injections.
- Blood Sugar Monitoring: Although less frequent than in Type 1 diabetes, monitoring blood sugar levels can help.
Gestational Diabetes Treatment
- Blood Sugar Monitoring: Monitoring blood sugar levels helps manage gestational diabetes.
- Healthy Eating and Exercise: Dietary changes and physical activity are first-line treatments.
- Medication: Insulin or other medications might be necessary if blood sugar levels remain high.
Lifestyle and Dietary Considerations
Effective management of diabetes extends beyond medical treatments to include lifestyle and dietary choices.
Dietary Considerations
- Carbohydrate Monitoring: Carbohydrates affect blood sugar levels. Choose high-fibre carbohydrates like whole grains, fruits, and vegetables.
- Portion Control: Eating appropriate portion sizes helps regulate calorie intake and blood sugar.
- Balanced Meals: Incorporate a balance of lean proteins, carbohydrates, and fats in meals.
- Limiting Sugars and Refined Carbs: Avoiding foods high in sugar and refined carbs can help control blood sugar levels.
- Regular Meal Times: Consistent meal times help keep blood sugar levels steady.
Lifestyle Choices
- Regular Physical Activity: Exercise helps lower blood sugar levels, increases insulin sensitivity, and can aid weight management.
- Weight Management: Losing weight can improve blood sugar control in people with Type 2 diabetes.
- Stress Management: Stress can affect blood sugar levels, so managing stress can help.
- Avoid Tobacco Use: Smoking increases the risk of type 2 diabetes and its complications.
- Regular Health Check-ups: Regular check-ups are needed to monitor and manage diabetes.
Dr Daphne Lee
MBBS
MRCP(UK)
FAMS
Dr Daphne Lee has special interests in the comprehensive management & treatment of diabetes, adrenal and pituitary conditions.
Qualifications
- MBBS (National University of Singapore, Singapore) 2006
- MRCP (Royal College of Physicians, United Kingdom)
- Fellow, Academy of Medicine, Singapore (FAMS)
- Registered with Specialist Accreditation Board (SAB)
- Registered with Singapore Medical Council (SMC)
Before private practice, Dr Daphne Lee was a consultant endocrinologist at Khoo Teck Puat Hospital. During her time there, she also ran the pituitary and adrenal clinics.
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Mount Elizabeth Novena Specialist Center
38 Irrawaddy Road, #07 - 63,
Singapore 329563
Gleneagles Medical Centre
6 Napier Road, #03 - 10,
Singapore 258499
Frequently Asked Questions (FAQ)
Can diabetes be cured?
Currently, there is no cure for diabetes, but it can be managed. People with Type 1 diabetes require lifelong insulin therapy, while those with Type 2 diabetes may be able to manage their condition with lifestyle changes and medication.
What are the risk factors for diabetes?
Risk factors for Type 2 diabetes include being overweight, leading a sedentary lifestyle, having a family history of diabetes, and being over the age of 45. Type 1 diabetes is often linked to genetic and environmental factors.
Can eating too much sugar cause diabetes?
Eating sugar in itself does not cause diabetes. Excessive sugar intake can lead to obesity, which is a risk factor for Type 2 diabetes.
Does diabetes affect pregnancy?
Women with pre-existing diabetes need careful management during pregnancy. Gestational diabetes, which develops during pregnancy, usually resolves after childbirth but requires management to avoid complications for the mother and baby.
Are there different kinds of insulin?
Yes, there are various types of insulin, categorised by how quickly they work and how long their effects last. The choice of insulin depends on individual needs.
Can Type 2 diabetes turn into Type 1?
No, Type 2 diabetes does not turn into Type 1. They are different conditions with different underlying mechanisms.