Just in case you've been spending too much time on Instagram and missed the news, Singapore has declared a war on diabetes in 2017.
Why? Well, for the simple reason that we have 440 000 diabetics, the second highest proportion of diabetics in the world (1st place belongs to the USA). If this rate keeps up, we'll have 1 million diabetics by 2050.
Beyond using diabetes as a running gag about eating too much desserts, I’m frequently astounded by how little my patients and friends know about diabetes.
We've all joked about that one friend, myself included.
If you think you're young so diabetes won't affect you, think again. This Asian diabetes study showed that 3 in 10 diabetics in Singapore are less than 40, the highest proportion in the region.
Here are 5 non-sugar coated consequences of diabetes:
1. Permanently f***ed-up nerve and blood vessels, ruined sex life
High sugar concentration damages the blood vessels supplying nerves all around your body.
As a result, poorly controlled diabetes causes a wide spectrum of nerve damage. This can range from complete loss of sensation, to constant body aches and pains.
Nerve damage is extremely debilitating - I've had patients on a potent cocktail of painkillers, and yet still be unable to go about their daily routine due to severe chronic pain.
One of the more bothersome side effects that patients always complain about is how diabetes has destroyed their sex life – Unfortunately, diabetics are 3 times more likely to suffer from erectile dysfunction, and the onset also tends to be much earlier than non-diabetics.
2. Your skin rots away
Remember that scene in the film Cabin Fever, where the infected character realizes with horror that her skin is peeling away in the bathtub?
It's something like that, except that diabetics frequently don't even realize their skin is rotting.
What happens is that because of nerve damage and loss of sensation, diabetics often suffer foot injuries such as burns or cuts without realizing it.
Over time, these injuries become badly infected, which can lead to rotting and (even) maggot infestation. Poor blood supply due to damaged blood vessels means that these wounds do not heal well either.
The sad part is, many diabetics with bad skin wounds are either unaware, or delay/refuse further treatment. Which results in 3.
3. Limb amputations and death shortly after
Four amputations happen every day Singapore due to diabetes - the highest rate of lower limb amputations in the world.
Worse still, studies have shown that more than 1 in 5 Singaporean diabetics die just 1 year after a limb amputation.
Diabetes results in amputations due to 2 reasons:
Firstly, poorly looked after skin wounds (or even seemingly minor toenail injuries) fester and eventually lead to overwhelming infections. Amputations are then required to stop the further spread.
Secondly, damaged blood vessels mean that the blood supply to your limbs is cut off, which then turn gangrenous and die.
Breaking the news to patients that they have to lose a limb is one of the most difficult things I've had to do as a doctor.
4. Blood vessels in your eyes burst suddenly, and you go permanently blind
Diabetes is the number 1 cause of blindness in Singapore.
How this happens is that diabetes causes the formation of thinner and weaker blood vessels in your retina. This process happens insidiously, and if left unchecked can result in the vessels spontaneously bursting and bleeding out, resulting in instant blindness.
Furthermore, diabetes also massively accelerates the development of cataracts in younger people – normally only a disease of the old.
5. Your kidney shrivels up and dies, and you need to be hooked onto dialysis machines 3 times a week, 4 hours per session
In Singapore, a whopping 70% of kidney failure is caused by diabetes.
The NKF is a non-profit organisation that does a great job of providing heavily subsidised dialysis treatment, but if this keeps up, we will simply not have enough resources to treat kidney failure caused by diabetes in the near future.
1 in 3 Singaporean diabetics do not know they suffer from diabetes - because diabetes does not cause any symptoms initially.
So if you are diabetic, please watch your blood sugars, and if you aren't, please spread the knowledge that all it takes is changes to two lifestyle factors - Diet and exercise. In combination, these 2 lifestyle changes will greatly lower your risk of diabetes.
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