Diabetes that You Don't See Everyday

Diabetes is one of the most common metabolic disorders around the world, including in Asia. However, despite being very common, there are still misconceptions and a lack of awareness about different aspects of the condition. Considering that the numbers of diabetes cases seem to reduce over the years, there is no doubt to how anyone can be vulnerable to developing the disease. And not being informed about the condition can increase your risk of being a victim to diabetes.

As World Diabetes Day is upon us, it is the best time to increase more awareness of this disease that keeps affecting many people worldwide. In this article, we will talk about how diabetes in Asia is considered high-risk and why Asians are more prone to diabetes. More importantly, we will discuss the extreme health risk the condition brings and how you can prevent developing it. But before we go through those, here are some clarifications you need to know about diabetes.

What Do You Need to Know About Diabetes?

Diabetes is characterized by an excessive amount of sugar in the bloodstream. That is a common fact that everyone knows about the disease. With that said, the metabolic condition is more complex than people usually think it is.

One fact about diabetes that people often miss out on is that there are two types of diabetes- aptly called Type 1 and Type 2 diabetes. It is easy for people to clump the two types and refer to it generally as diabetes.

In some ways, these two share some common points. One similarity is their interaction with the hormone insulin. Insulin helps move glucose from your blood to your cells. The sugar is then turned into an energy source used by the body. Insulin is also responsible for balancing blood sugar levels. It signals the liver to store glucose when there is too much of it in the bloodstream.

Once the body’s insulin gets disrupted, it causes improper regulation of sugar in the blood, which can lead to developing diabetes.

Even so, Type 1 and Type 2 diabetes have distinct characteristics differentiating them from one another.

For type 1 diabetes, a person’s immune system mistakes the body’s healthy cells as foreign and harmful invaders. As one might know, the immune system is responsible for fighting off foreign invaders like viruses and bacteria away from the body. In other words, the body destroys insulin-producing beta cells in the pancreas. Once these beta cells are attacked, the body is incapable of insulin production. The lack of insulin then causes high sugar levels in the blood, thus developing into type 1 diabetes.

On the other hand, type 2 diabetes develops due to insulin resistance. It means that the body still produces insulin, but the body’s cells are not able to respond to it as well as they should. As the cells respond poorly to insulin, sugars in the body are not broken down. In its later stages, type 2 diabetes may also cause the pancreas to not produce enough insulin, which in turn leads to high sugar levels in the blood.

The main cause of diabetes, whether it’s type 1 or type 2, is still unknown. There is not enough scientific research that pinpoints the root of the condition, but there are several factors that may contribute to developing it. It may have something to do with genetic and environmental factors. For example, a person may develop type 1 diabetes due to exposure to viruses that affect their immune system.

With that said, most experts point to several lifestyle factors that lead to developing diabetes, such as being inactive and carrying excess weight. That’s why most people diagnosed with diabetes- specifically type 2 diabetes- in Asia are often overweight or obese.

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80% of overweight and obese people worldwide are diagnosed with type 2 diabetes. Excess weight leads to the accumulation of fat in organs like the pancreas, which then leads to insulin resistance. Fat can also affect the liver’s ability to store sugar, allowing for excess amounts of it to remain in the bloodstream, thus leading to greater risk. The link between obesity and diabetes has been so common that the term “diabesity” was coined.

So, it is not surprising that cases of diabetes are also soaring in places where obesity and weight problems have become an epidemic. As we alluded to earlier, Asia has become somewhat of a hotspot of victims of diabetes.

Credits: Worldatlas

Higher Risk of Diabetes in Asia

As mentioned earlier, lifestyle factors such as being inactive and carrying excess weight are great precursors to developing diabetes. Most cases of diabetes are due to the said reasons. However, genetic and environmental factors are overlooked factors as well. What many might not realize is that their race and ethnicity can also put them at higher risk of developing diabetes.

So far, many researchers are still trying to work out the link of getting diabetes to a person’s place of origin. With that said, most studies boil it down to three factors: body type, diet and lifestyle, and genes.

Credits: Shutterstock

Body Type

Most Asians are known for their lean or petite figure. As the common image of a diabetic person is obese or overweight, many might find it surprising that Asians have a higher risk of developing the condition.

Studies have revealed that Asians are more likely to develop diabetes even at a lower Body Mass Index (BMI). BMI is derived from the mass and height of a person and is often an indicator of obesity. In other words, even if some Asian populations have a lower prevalence of overweight and obese individuals compared to the West, they have a disproportionately high percentage of people with diabetes.

Furthermore, the body composition of people of Asian descent also factors into this conversation. According to the World Health Organization (WHO), Asians tend to have slightly more body fat than those of European ancestry with the same height and weight. South Asians, more specifically, tend to have less muscle and more abdominal fat.

Accumulation of fat in the belly or abdomen is more harmful than gaining fat under the skin in the buttocks or thighs. Belly fat makes the body more resistant to insulin, thus destabilizing a person’s blood sugar levels. As the amount of glucose in the blood increases, so does the risk of having diabetes. Imaging technology that measures fat in humans also shows that Asians with a healthy BMI still have more fat around organs and in the belly area than Europeans with the same BMI.

Diet and Lifestyle

With that being said, obesity and diabetes is not only a matter of “nature”, but it is also about “nurture”. The environment and culture in which Asians live also pose a great risk to one’s weight problems, which also extends to diabetes-related issues.

As many trendy food and health websites may tell you, Asian foods are healthy diet options because of their use of vegetables and natural ingredients. While that is true to a great extent, if not controlled, there are aspects of Asian cuisine that can be detrimental to a person’s weight.

For instance, white rice and other refined grains are the centres of many Asians’ meals, making up a large proportion of daily energy intake in Asian diets. Moreover, a lot of classic Asian dishes often use unhealthy trans fats and saturated fats, such as palm oil, as cooking oils.

Asides from the traditional aspects of Asian food customs, changes brought by global urbanization and modernization also affects Asians’ relationship with their lifestyle.

Credits: Campaign Asia

Fast foods- a mostly Western concept of dining- has become much more common and widely available all across Asia. A big factor why the West has a big prevalence of obesity is due to its fast-food diet, which is high in refined carbohydrates, sugary beverages, or fatty food items.

Asians, who tend to have more body fat, gain more risk of weight problems once they adapt these food habits. That’s also why many Asian-Americans are more at risk of being diabetic than those living in rural Asia. Those who consume fast food more often are more likely to develop diabetes than those who are eating little or no fast food.

Urbanization also brought about the idea of convenience through digital gadgets and machinery. Yes, it does make people’s lives easier. However, it also leads to a more stagnant lifestyle. People now are doing less walking, less biking, and less daily physical activity. Considering Asia is at the forefront of technological advancements, it is not surprising that most Asians are no longer committing to an active lifestyle.

Combine that with its growing insistence on unhealthy eating habits, it makes Asia a location of alarming diabetic risk.

Genes

Lastly, a high risk of developing diabetes can be boiled down to genetics. Diabetes due to genetics does not only apply to people with Asian ancestry. Genes play a role in diabetes risk regardless of race and ethnicity. This factor combines both “nature” and “nurture” aspects.

Diabetes, specifically type 2 diabetes, can be hereditary. Research shows that several gene mutations have been linked to the development of type 2 diabetes. The said gene mutations can interact with the environment and cause further risks. People who are diabetic commonly have one or more of these mutations.

With that said, a family history does not mean an automatic diagnosis. Not everyone who carries a gene mutation will get diabetes. It is possible that both your mom and dad have type 2 diabetes but do not end up developing the disease. Although, you still have a greater chance of diabetes than those without a family history.

It does not mean that you can blame genetics alone when it comes to developing diabetes. To repeat, “nature” and “nurture” go hand-in-hand.

Most of the way we approach our lifestyle is informed from a very young age. Our family and the people around us influence our food and exercise habits. For instance, parents who practice nutrient-dense and balanced eating habits are most likely to pass that habit to their children. The same goes for parents who do not practice a healthy lifestyle. Again, this can be the case across different races and ethnicities.

Finally, a reason why there’s a high risk of diabetes in Asia is because of its population size. Asian regions account for a significant portion of the world population. As the population in these countries increase, the worldwide prevalence of diabetes will also continue to increase.

Credits: Telegraph India

Death by Diabetes

If you have ticked a few boxes of the risk factors of obesity, it is normal to start to be frightened about it, right?

Because diabetes is (unfortunately) such a normal occurrence, many people tend to brush off the severity of the condition. Of course, a part of that is optimism that being diagnosed with diabetes is not the end of life, and there is still hope. However, do not confuse such optimism with downplaying the effects of diabetes on a person’s health. If left untreated, diabetes can lead to serious consequences.

As a metabolic disorder, diabetes is not contained in one aspect of your body. It also affects several other parts of it. All parts of your body are connected to build one full functioning system. Once a part is destroyed, it can inevitably cause great harm to the rest of the system. That’s why developing diabetes means a great threat is posed to your overall health.

Here are some of the health complications brought by diabetes:

  • Cardiovascular issues such as heart attack, stroke, high blood pressure, high cholesterol, and narrowing of the arteries
  • Nerve pain and damage 
  • Kidney damage and kidney failure
  • Eye damage including blindness, cataract, and glaucoma 
  • Foot damage such as nerve damage and amputation
  • Skin infections
  • Erectile dysfunction
  • Hearing loss
  • Depression
  • Dementia
  • Dental problems
  • Pregnancy issues

The mentioned are only a few of the possible complications brought about by diabetes. Two other common life-threatening issues led by the disease include diabetic coma and amputation.

Diabetic coma

A diabetic coma is a diabetes-related complication that causes unconsciousness. Due to the issues with insulin, a diabetic person’s blood sugar levels often fluctuate drastically. Dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can both lead to a diabetic coma.

Three dangerous conditions can lead to diabetic coma:

    • Diabetic ketoacidosis. It is caused by high blood sugar and ketones. Ketones are toxic acids that are a product of breaking down fat storage when muscle cells become starved for energy. Diabetic ketoacidosis is most common in type 1 diabetes, and when left untreated can lead to a diabetic coma.
    • Diabetic hyperosmolar syndrome. It happens when severe high blood sugar turns the blood into a thick and syrupy consistency. The excess sugar passes from blood to urine, triggering a filtering process that draws tremendous amounts of fluid from the body. It can lead to extreme dehydration and diabetic coma.
    • Hypoglycemia. It can be caused by too much insulin or not enough food. Extreme exercising and alcohol consumption may also cause the same effect. These factors can lead to low blood sugar, which then causes a person to pass out.

Credits: Phillyvoice

During a diabetic coma, a person can’t awaken or respond purposefully to sights, sounds, or other types of stimulation. They are still alive, but when left untreated, a diabetic coma can be fatal. It can cause permanent brain damage or, at worst, death.

Credits: US News Health

Amputation

It is common for us to hear stories of people getting amputated due to diabetes. Why does it happen?

In some cases, diabetes leads to peripheral artery disease (PAD), causes the blood vessels to narrow and reduces blood flow to your legs and feet. The condition can then cause peripheral neuropathy, nerve damage that prevents one from feeling pain.

As your feet and leg become numb to pain, you may not realize any wound in the area. You end up continuing to put pressure on the affected area, worsening its condition. Furthermore, the reduced blood flow slows down the healing process of wounds. It also makes the body less capable of fighting infection. Severe infection can lead to tissue damage, which can spread to the bones. Once the infection becomes untreatable, amputation is done to stop it from further spreading.

Sadly, amputation does not guarantee recovery. Some studies show that patients with diabetes have a high rate of mortality once they have undergone amputation.

Diabetes Prevention: What Can You Do?

As mentioned earlier, while there is no known cause of diabetes, there are ways you can prevent it from developing. One major way of doing so is losing and maintaining a healthy weight.

Credits: Healthline

You can never go wrong with a healthy diet. Incorporate more foods rich in fibre and healthy carbohydrates such as fruits, non-starchy vegetables, and whole grains. It helps to keep your blood sugar levels balanced. Also, go for low-fat dairy, low-fat meats, and fish. Furthermore, olive oil or canola oil are healthier options for cooking. With that said, the type of food is not enough. Manage the portions of your meals. Smaller portion sizes lead to fewer calories

Credits: Freepik

Of course, once you eat, you also need to burn off most of what you have consumed. Exercising is a vital part of losing and maintaining weight. Include 30 minutes of aerobic exercise a day or 50 minutes a week. It may include either walking, swimming, biking, or running. Once your body has settled into an active lifestyle, slowly incorporate more intense workouts. Add two to three sessions of resistance exercises, like weightlifting and yoga, each week. The point is to limit your inactivity.

However, some people struggle to lose weight from mere diet and exercise, especially those who have been overweight or obese for a long time. Luckily, there are alternative solutions that they can take, including medical-assisted weight loss.

Credits: Doctor Bariatric

Some people choose to undergo bariatric surgeries such as gastric bypass and sleeve gastrectomy. These are invasive surgeries that create changes to the digestive system (ex. decreasing the size of the stomach) to assist with weight loss. These changes let people minimize food intake, which then causes low-calorie consumption. However, the results of these operations are irreversible. For people diagnosed with diabetes, medication or insulin therapy also helps manage their blood sugar levels.

If you are unwilling to go under such permanent change, then weight loss balloons might be the option for you. Weight loss balloons are non-invasive temporary procedures that can help you lose weight. Here, a balloon is placed inside the stomach. As the balloon takes up space, it creates the feeling of fullness and minimizes the urge to eat more food. As you feel full for longer, you get to control the portion of food calories you consume.However, there are 2 types of weight loss balloon, endoscopy balloon and swallowable weight loss balloon. For more information on the types of weight loss balloons, you can read here!

By now, you already understand that diabetes is not something you should turn away from. By starting to live healthy as soon as now, you are lowering your risk of developing the disease. If you tick the boxes of a person susceptible to being diabetic, that is your go signal to create changes for the better.