TENDING TO YOUR BLOOD SUGAR HEALTH

By: Sabrina

According to the National Health and Morbidity Survey 2019, it has been documented that approximately 3.9 million of individuals in Malaysia aged 18 years and above have diabetes, which is almost equivalent to 1 in every 5 individuals of the Malaysian population. 

Generally, diabetes, more formally known as diabetes mellitus, is a chronic disease which happens when the blood glucose levels rise above normal or healthy levels due to either the pancreas not producing insulin, the body is deficient of insulin or the body cells are not able to utilise the insulin in blood glucose uptake effectively. Insulin is a crucial element in blood glucose management as they are the hormones which assist the glucose to enter the body cells to be utilised for body functions or to be stored for future usage. 

There are several types of diabetes. The three main types of diabetes are Type 1 diabetes, Type 2 diabetes and gestational diabetes. Type 1 diabetes is known as an autoimmune response which affects the beta cells in the pancreas, compromising the pancreas’ ability to produce insulin, thus resulting in no or only small amounts of insulin being produced. Therefore, individuals with Type 1 diabetes require daily insulin injections to control their blood glucose levels. On the other hand, Type 2 diabetes is more commonly known as it is considered as the most prevalent type of diabetes. Contrary to Type 1 diabetes, Type 2 diabetes is not an autoimmune response but is caused by unhealthy lifestyles. It is mainly due to the cells not being able to respond to insulin in an effective manner, thus adversely affecting the cell uptake of glucose. Aside from that, gestational diabetes happens in pregnant women as their insulin production may not be able to fulfil or meet the needs of pregnancy. It may also be due to the presence or elevated levels of other pregnancy hormones affecting the insulin sensitivity in the body. Even though gestational diabetes is said to retreat some time after delivery, it is fairly important for the pregnant mother to control and manage a healthy blood glucose level to ensure the foetus in the womb develops healthily in a safe environment.

While the numbers of diabetes cases are rising, many people do not understand the adverse effects and the major consequences it brings about to one’s daily life. Depending on the types and the seriousness of diabetes which varies from individual to individual, one may suffer from development or further progressions of other complications. For example, diabetic retinopathy due to damage of blood vessels, which may lead to blurred vision, vision loss and even blindness; diabetic nephropathy which compromises the kidney’s functions in filtering out waste products and in the worst case scenario may lead to kidney failure; etc.

In our daily lives, a healthy lifestyle is of the utmost significance in managing our blood glucose levels. Physical activities and diets are two major components of our lifestyles. In terms of physical activities, the movement of muscles will utilise the glucose as an energy source and can also improve the sensitivity of cells towards insulin. According to the CDC, they have suggested getting involved in a minimum of 150 minutes of moderate-intensity exercise each week for diabetic individuals. 

As for diets, healthier food alternatives can be chosen. For instance, rice is a household staple in Malaysia. Instead of eating the conventional white rice, basmati rice and brown rice may be healthier options in controlling blood glucose levels as they possess lower Glycemic Index (GI) values. Glycemic Index (GI) values serve as an indication of how fast the food can lead to blood glucose increase. The lower the GI, the slower the food releases glucose, thus the blood glucose does not spike instantaneously. 

Apart from opting for food with lower GI values, Mediterranean diet may also serve as a good option in management of blood glucose levels. This diet contains mainly plant-based food such as legumes, fruits, nuts, vegetables and so on, with olive oil as the main source of fats. Poultry and seafood like fish are taken moderately whereas other animal-based foods such as red meats are only taken occasionally. A review has shown that adopting the Mediterranean diet provides beneficial effects to Type 2 diabetes by reducing the HbA1c levels ¹. The risk of Type 2 diabetes development increases with higher HbA1c values. HbA1c test is a measurement of the amount of haemoglobin attached with sugar in the red blood cells, which can be used in the diagnosis of prediabetes and diabetes as shown in the table below:

Source: CDC (“All About Your A1C”)

In a nutshell, we should all take care of our blood glucose health by managing blood sugar levels well. We can start by adopting a wholesome lifestyle through having nutritious and healthy diets and carrying out physical activities frequently. 

References:

1. Martín-Peláez S, Fito M, Castaner O. Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review. Nutrients. 2020 Jul 27;12(8):2236. doi: 10.3390/nu12082236. PMID: 32726990; PMCID: PMC7468821.
2. Kawasaki E. Type 1 diabetes and autoimmunity. Clin Pediatr Endocrinol. 2014 Oct;23(4):99-105. doi: 10.1297/cpe.23.99. Epub 2014 Nov 6. PMID: 25374439; PMCID: PMC4219937.
3. Lim AKh. Diabetic nephropathy - complications and treatment. Int J Nephrol Renovasc Dis. 2014 Oct 15;7:361-81. doi: 10.2147/IJNRD.S40172. PMID: 25342915; PMCID: PMC4206379.