Diabetes Mellitus Treatment in Singapore

Diabetes mellitus is a condition where the body cannot regulate blood sugar levels effectively. This occurs when the pancreas produces insufficient insulin or when the body cannot use insulin properly. Over time, high blood sugar levels can lead to complications affecting blood vessels, nerves, and organs. With appropriate management, individuals can maintain their health and reduce the risks associated with the condition.

Dr Ben Ng

Senior Consultant Endocrinologist

Dr Donovan Tay

Senior Consultant Endocrinologist

Symptoms of Diabetes Mellitus

Symptoms can develop gradually, and some people may not notice any signs initially. Common symptoms include those related to blood sugar imbalance, and individuals experiencing them may consider professional evaluation and Diabetes Mellitus Treatment in Singapore:

Increased Thirst and Urination

High blood sugar leads to excess glucose being excreted in the urine. This results in frequent urination and dehydration, which can increase thirst.
Unexplained Weight Changes

When cells cannot absorb glucose, the body may break down fat and muscle for energy, leading to weight loss despite normal or increased food intake.
Blurred Vision

High blood sugar can cause temporary swelling of the eye’s lens, which affects focus and clarity.
Fatigue

Insufficient glucose uptake by cells can reduce energy levels, causing persistent tiredness.
Numbness or Tingling

High blood glucose can damage nerves throughout the body, particularly in the feet and hands, causing sensations of numbness, tingling, or burning.
Slow Healing Wounds

High glucose levels can impair blood flow and immune responses, delaying the healing of cuts or sores.

Causes and Risk Factors

Several factors can contribute to the development of diabetes, ranging from genetic predisposition to lifestyle choices.

Family History

Having a first-degree relative with diabetes increases the likelihood of developing the condition due to shared genetic factors.
Age

The risk increases with age, particularly after 45 years, as the body becomes less efficient at processing glucose.
Obesity

Excess body fat, especially around the abdomen, can lead to insulin resistance where cells do not respond effectively to insulin.
Physical Inactivity

Regular exercise helps cells use insulin more efficiently, while a sedentary lifestyle increases the risk of insulin resistance.
History of Diabetes During Pregnancy

Women who had diabetes during pregnancy are at an increased risk of developing Type 2 diabetes later in life.

Types of Diabetes Mellitus

Diabetes mellitus is categorised into two main types, each with distinct causes and treatment approaches. Identifying these differences helps in selecting effective management strategies.

Type 1 Diabetes

Type 1 diabetes is an autoimmune condition where the immune system attacks and destroys the insulin-producing cells in the pancreas. This results in little to no insulin production, requiring external insulin to regulate blood sugar levels. While it is commonly diagnosed in childhood or adolescence, it can develop at any age.

Type 2 Diabetes

Type 2 diabetes develops due to insulin resistance, where the body’s cells do not respond effectively to insulin, or when the pancreas does not produce enough insulin to maintain normal blood sugar levels. This type is more likely to develop gradually over time and is strongly linked to lifestyle factors such as diet, physical inactivity, and obesity.

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Diagnostic Methods

Fasting Plasma Glucose (FPG) Test

This test measures blood sugar levels after fasting for at least 8 hours. It provides a baseline measurement of how the body manages glucose in the absence of food. A fasting blood sugar level higher than 7.0 mmol/L on two separate occasions is diagnostic of diabetes.

Oral Glucose Tolerance Test (OGTT)

The OGTT evaluates how the body processes glucose over time. After an initial fasting blood sample is taken, the individual consumes a glucose solution, and blood sugar levels are measured at regular intervals, typically after two hours. This test is particularly useful for detecting impaired glucose tolerance and diagnosing diabetes in specific cases.

HbA1c Test

This test provides an average blood sugar level over the past 3 months by measuring the percentage of haemoglobin with attached glucose. An HbA1c result of 48 mmol/mol (6.5%) or higher confirms a diagnosis of diabetes. This test is also useful for monitoring the effectiveness of diabetes management over an extended period.

Treatment Options

Managing diabetes involves regulating blood sugar levels and reducing the risk of complications. Common approaches include:

Insulin Therapy

Involves regular injections or use of an insulin pump to replace the insulin the body cannot produce. Different types of insulin work for varying durations, allowing for personalised treatment schedules based on individual needs.

Oral Medications

Help lower blood glucose through various mechanisms, such as increasing insulin sensitivity or insulin secretion. Some medications can promote weight loss and protect against known heart and kidney complications with diabetes. These medications often work in combination to achieve better control.

Blood Glucose Monitoring

Regular testing helps track how well treatment works and allows for adjustments when needed. Monitoring includes newer technology with continuous glucose monitoring, daily finger-prick tests and periodic HbA1c measurements.

Prevention and Management

Managing diabetes is not limited to maintaining stable blood sugar levels, but also normal blood pressure and cholesterol through sustainable lifestyle changes and regular medical care. Lifestyle changes are the cornerstone for good diabetes management. A balanced diet with consistent carbohydrate portions, spread evenly across meals, helps stabilise glucose levels and prevent sharp fluctuations. A diet low in salt will help with blood pressure control. A diet that is low in saturated fat, low in processed food but high in fibre will help lower cholesterol levels.

Regular physical activity enhances insulin sensitivity and aids in maintaining a healthy weight, contributing to better blood sugar control. Ongoing collaboration with healthcare providers ensures that treatment plans are tailored to individual needs, allowing for effective monitoring and adjustments as required. Together, these strategies support long-term diabetes management and reduce the risk of complications.

Frequently Asked Questions

How often should blood glucose levels be checked?

Monitoring frequency depends on the type of diabetes and treatment plan. People using insulin often check finger prick tests 1 to 7 times daily, while those managing with diet and oral medications or whose condition is stable may monitor less often. Healthcare providers can recommend a schedule tailored to individual needs as part of Diabetes Mellitus Treatment in Singapore. Newer technology is available that allows for a wearable sensor to monitor glucose trends in real time.

Can diabetes resolve on its own?

Type 1 diabetes requires lifelong management, as the body cannot produce insulin. Individuals with type I diabetes will need to self-inject and monitor their blood sugars on a long-term basis. Knowledge of insulin and the impact of lifestyle factors such as diet, exercise and stress and its impact on the individual’s body is key in managing this condition.

The answer for type II diabetes is more complex. With proper diet and lifestyle management, this condition is often manageable with medication. Some individuals may achieve remission but this depends on the age and recency of onset of diabetes, degree of weight loss and control of diabetes.

Does having diabetes mean eliminating sugar completely?

No, it is important that the focus on diet is not on the elimination of sugar but to focus on eating what is right and healthy. Many individuals with diabetes can still enjoy the food in a balanced diet.

Dr Ben Ng

Senior Consultant Endocrinologist

As a senior consultant endocrinologist with over 20 years of clinical experience, Dr Ben Ng provides comprehensive care for patients managing various endocrine conditions. His expertise includes the diagnosis and treatment of diabetes, thyroid disorders, obesity, and a range of other metabolic and endocrine conditions.

Dr Ben Ng Jen Min graduated from the Queens University of Belfast Northern Ireland, United Kingdom (UK).
He completed his postgraduate training with the certificate of completion of training (CCT) from the Royal College of Physicians (UK) with dual accreditation in diabetes and endocrinology and in general internal medicine.
In 2010, he was awarded an MD with honours by the University of Hull, UK, in recognition for his research in diabetes mellitus

Dr Donovan Tay

Senior Consultant Endocrinologist

As a senior consultant endocrinologist with over 20 years of clinical experience, Dr. Donovan Tay provides comprehensive care for patients managing various endocrine conditions. His expertise includes the diagnosis and treatment of diabetes, thyroid disorders, osteoporosis, and a range of other metabolic and endocrine conditions.

Dr. Donovan Tay graduated from the National University of Singapore (NUS) and obtained his membership in the Royal College of Physicians (UK), Master of Medicine (NUS), and Master of Clinical Investigation (NUS).
After completing training in endocrinology, he was conferred as a Fellow of the Academy of Medicine, Singapore (FAMS).
He further specialised in endocrinology with a fellowship at the prestigious Columbia University Medical Centre in New York City.

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