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Diabetes

Diabetes is a metabolic condition that affects the body’s ability to process glucose, the primary energy source for cells. In diabetes, the body either does not produce insulin or cannot use it effectively, leading to high blood sugar levels. This chronic condition impacts multiple organ systems and requires ongoing management to reduce the risk of complications involving the heart, blood vessels, eyes, kidneys, and nerves.

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Dr Adrian Mondry
Physician (FRG) | MD (HHU Düsseldorf) | MRCP (London) | IM Specialist (ÄKNo) | Hypertensiologist (DHL)
Symptoms Causes Types Diagnosis Treatment Prevention FAQ
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Symptoms
Causes
Types
Diagnosis
Treatment
Prevention
FAQ

Symptoms of Diabetes

Diabetes symptoms can vary between individuals, but several common signs may indicate the condition.

  • Increased Thirst and Urination

    High blood sugar levels prompt the kidneys to expel excess glucose through urine, leading to dehydration and heightened thirst.

  • Unexplained Weight Changes

    When cells cannot access glucose for energy, the body breaks down fat and muscle, causing weight loss despite normal eating habits.

  • Fatigue

    An energy deficit caused by insufficient glucose uptake by cells results in persistent tiredness and weakness.

  • Blurred Vision

    Elevated blood sugar levels can temporarily swell the lens of the eye, impairing visual clarity and focus.

  • Slow-Healing Wounds

    High blood sugar damages blood vessels and nerves, hindering the body’s ability to heal cuts and infections.

  • Numbness or Tingling

    Poor circulation and nerve damage can cause numbness or tingling sensations, particularly in the hands and feet.

Causes and Risk Factors

Several factors contribute to the development of diabetes and may indicate a need for earlier screening or preventive measures.

  • Age

    The likelihood of type 2 diabetes rises with age, particularly after 45, as the body becomes less efficient at managing blood sugar.

  • Family History

    A family history of diabetes increases the risk due to inherited genetic traits affecting insulin production or response.

  • Physical Inactivity

    A sedentary lifestyle reduces muscle cell sensitivity to insulin and impairs glucose regulation.

  • Obesity

    Excess body fat disrupts insulin function, releasing hormones and substances that promote insulin resistance.

  • Medical Conditions

    Issues such as polycystic ovary syndrome, high blood pressure, or gestational diabetes increase the risk of type 2 diabetes due to related hormonal or metabolic changes.

Types of Diabetes

The types of diabetes differ in their underlying causes, progression, and required management approaches.

Type 1 Diabetes

This autoimmune condition occurs when the immune system attacks and destroys the insulin-producing cells in the pancreas. It most commonly develops in childhood or adolescence but can occur at any age. Individuals with Type 1 diabetes require lifelong insulin therapy, as their bodies are unable to produce insulin.

Type 2 Diabetes

This is the most common type of diabetes, characterised by insulin resistance and a gradual decrease in pancreatic insulin production. This type develops over time and is often associated with lifestyle factors. While the body continues to produce some insulin, it is insufficient to regulate blood glucose effectively.

Gestational Diabetes

A temporary condition that arises during pregnancy in women without a previous history of diabetes. Hormonal changes during pregnancy can reduce insulin sensitivity. Although gestational diabetes usually resolves after childbirth, it increases the risk of developing type 2 diabetes later in life.

Diagnostic Methods

  • Fasting Plasma Glucose Test: This test measures blood glucose levels after fasting for at least 8 hours. A result of 7.0 mmol/L or higher indicates diabetes. It offers a quick snapshot of blood sugar control and is useful for monitoring treatment progress.
  • Random Plasma Glucose Test: A random blood glucose level of 11.1 mmol/L or higher is considered a sign of diabetes. A random blood glucose level of 7.8 mmol/L or higher, but less than 11.1 mmol/L, could indicate prediabetes.
  • Oral Glucose Tolerance Test (OGTT): After fasting, the patient drinks a glucose solution, and blood sugar levels are measured two hours later. A reading of 11.1 mmol/L or higher confirms diabetes. This test evaluates how effectively the body processes glucose.
  • HbA1c Test: This test assesses average blood glucose levels over the past 3 months by measuring the percentage of glucose-bound haemoglobin. An HbA1c level of 48 mmol/mol (6.5%) or higher indicates diabetes. Regular HbA1c testing helps monitor long-term blood sugar control

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Treatment Options

Diabetes management aims to maintain blood glucose levels within target ranges while reducing the risk of complications.

Blood Glucose Monitoring

Regular blood sugar testing with a glucose meter helps track daily fluctuations, enabling adjustments to medication, diet, and activity levels. Continuous glucose monitoring systems provide real-time data on glucose trends for more precise management.

Oral Medications

Several medication classes are available for managing type 2 diabetes. These improve insulin sensitivity, reduce glucose production, or stimulate insulin release. Medications may be used individually or in combination, depending on patient needs.

Dietary Management

A balanced meal plan with controlled carbohydrate intake supports stable blood sugar levels. Proper meal timing and portion control are key components of daily diabetes management.

Prevention and Management

Effective blood glucose control combines lifestyle adjustments with medical supervision. Regular physical activity enhances insulin sensitivity and supports a healthy weight. A balanced diet with consistent carbohydrate intake helps stabilise blood sugar levels, aided by meal planning and portion control. Routine medical check-ups allow early detection and treatment of complications. Managing stress through techniques like mindfulness or relaxation exercises also helps minimise blood sugar fluctuations.

Frequently Asked Questions (FAQ)

How often should blood glucose be tested?

Testing frequency depends on the type of diabetes and the treatment plan. People using insulin typically test 4–10 times daily or use a continuous glucose monitor, while those managing diabetes with diet or oral medications may test less frequently. Your healthcare provider can recommend a personalised testing schedule.

Does having diabetes mean eliminating sugar completely?

No, sugar can be part of a balanced diet for people with diabetes, but it must be included in the total carbohydrate count. A dietitian can help create a meal plan that incorporates occasional treats while maintaining good blood glucose control.

What are the long-term effects of uncontrolled diabetes?

Persistently high blood glucose levels can lead to complications such as heart disease, kidney damage, vision loss, and nerve damage. Regular medical check-ups and effective management can help detect and address these issues early.

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Dr Adrian Mondry

Physician (FRG)|MD (HHU Düsseldorf)|Specialist for Internal Medicine (ÄKNo)|Hypertensiologist (DHL)|MRCP (London)

Dr. Mondry has over 30 years of experience as an internal medicine & hypertension specialist.

  • Previously a Senior Consultant in the Department of Medicine at the National University Hospital and Ng Teng Fong General Hospital, where he is currently a visiting consultant.

  • Hypertension Specialist accredited by the German Hypertension League (DHL)

  • Contributed to the latest Singapore ACE Clinical Guidance on “Hypertension – Tailoring the Management Plan to Optimise Blood Pressure Control” as a committee member.

Read Full Bio

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