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Diabetes

Diabetes is a disease that has affected an estimated 140 million people worldwide, 90% of whom suffer from Type 2 diabetes. This type of diabetes is a leading cause of heart disease, adult blindness, kidney failure and non-traumatic limb loss. Type 2 diabetes is characterised by high blood sugar levels due to the body’s inability to use and / or produce insulin leading to patients eventually requiring insulin injections.

Type 2 Diabetes	Type 1 Diabetes
What happens
In some people, the pancreas starts to produce less insulin which impairs blood sugar from entering the cells. Usually, insulin resistance makes it more difficult for blood sugar to enter the body's cells. The pancreas still produces insulin, but the body can't use it effectively. Insulin resistance is an underlying problem in type 2 diabetes. This means that the body produces insulin but cannot use it effectively. Eventually, insulin-producing cells can no longer perform properly. This is when glucose levels rise and diabetes develops.	The body destroys insulin-producing cells in the pancreas, resulting in the inability to produce insulin.
Who develops it
Generally people who are over age 45 and significantly overweight.	Generally children or young adults, but can occur at any age.
Risk factors
Family history of diabetes Lack of regular exercise High blood pressure and/or high concentration of fats in the blood History of gestational diabetes, a form of diabetes occurring during pregnancy	Immediate family member with type 1 diabetes
Treatment
Diet and exercise Many people also need oral medication and insulin injections or both	Diet, exercise, and insulin injections

Symptoms and Complications

Type 2 diabetes can develop slowly and many people are unaware that they are suffering from it because there are few or no symptoms.

Common type 2 diabetes symptoms:

Type 2 diabetes can cause problems with the kidneys, legs and feet, heart, nerves and blood vessels. Left untreated, these can lead to eye, kidney and heart disease; nerve damage; stroke; gangrene and amputation.

There’s no cure for diabetes, but you can reduce the risk of serious complications by maintaining blood-sugar control and having a healthy lifestyle. Some sufferers will have to go on medication and/or insulin injections.

Types of medication

GSK has developed medication classified under the class of Thiazolidinediones (TZD), rosiglitazone. It works by enhancing the body’s ability to utilise its own insulin more effectively by reducing insulin resistance and preserving beta cell function.

Medications Available

Drug Type	Brand/Generic Names
Thiazolidinediones Improves insulin sensitivity.	Rosiglitazone maleate
Sulfonylureas Lowers blood glucose levels by pushing the pancreas to produce and release more insulin.	Glimepiride tablets Chlorpropamide Glibenclamide Gliclazide Glipizide
Alpha-Glucosidase Inhibitors Reduces the breakdown of food into glucose, causing glucose to enter the blood more slowly.	Acarbose tablets
Biguanides Slows the liver's release of stored glucose.	Metformin hydrochloride tablets
Other Insulin Secretagogues Stimulates the pancreas to secrete insulin (i.e. Meglitinides).	Repaglinide

Benefits of exercise

One of the best ways to help control diabetes is to lead a healthy lifestyle and exercise.

"Exercise is a pillar in the control of diabetes," says Dr Alex Fok, an endocrinologist at Singapore's Mt. Elizabeth Medical Center. "One cannot expect to control diabetes adequately unless exercise is incorporated into the daily schedule. Studies show that regular exercise three times a week can reduce the risk of developing type 2 diabetes by as much as 40 percent.”

According to Dr Leslie Charles Lai Chin Loy, Professor of Internal Medicine, Dean of Postgraduate Studies and Endocrinologist at the International Medical University in Kuala Lumpur, exercise helps lower blood sugar levels by making the body tissues more sensitive to insulin, a hormone that acts to lower blood sugar levels, particularly after meals. Exercise helps a person lose weight and this also makes the body tissues more sensitive to insulin.

Being overweight makes it harder for your cells to use insulin, and you need insulin to use sugar for energy. Without insulin, sugar will build up in your blood leading to kidney and eye problems, among other things. Studies indicate that those who are severely overweight may need to lose just 20% of their excess poundage in order to see significant improvement in their insulin response. Losing weight also helps you avoid other health problems, such as heart disease.

"There have been a number of large, well-conducted studies published recently which confirm that weight loss, a low-fat, high-fibre diet, and regular exercise will help prevent the development of diabetes in high risk individuals," Dr Lai says.

A rigorous exercise program may help some people with type 2 diabetes decrease - or even stop - insulin or oral medication use. For others, diet and exercise aren't enough to control their blood sugar. If that is the case for you, your doctor may prescribe an oral drug that helps your body make and use insulin.

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