Seven diabetes myths dispelled
Despite being relatively widespread, disease is often misunderstood
Did you know that you could have type 2 diabetes and not show any symptoms? If your answer is yes, you're part of a tiny minority in Hong Kong, according to a recent poll by a health care service provider.
Only 3 per cent of the city's white-collar population knows that diabetes could be asymptomatic, found the survey commissioned by Drs Anderson & Partners and carried out by Baptist University. The researchers interviewed more than 500 white-collar workers aged 18 years and above by phone in July and August.
More than half of the respondents possessed high-risk factors for the disease, such as middle age (40 or above), lack of regular exercise, immediate family members having a history of diabetes mellitus, obesity, hypertension, hyperlipidemia, or women giving birth to overweight infants. Yet, most of those not diagnosed with diabetes did not consider themselves to be in a high-risk group.
Results of a study by researchers at King's College London published last year in the journal Diabetologia found that 62 per cent of type 2 diabetics in developed countries did not have any apparent symptoms when diagnosed.
Type 2 diabetes accounts for more than 90 per cent of diabetes cases. It develops when the pancreas stops producing enough insulin - a hormone that allows the body to use sugar from carbohydrates in food for energy - or becomes resistant to insulin. Genetics and lifestyle factors, such as unhealthy diet, obesity and lack of exercises, contribute to the development of the condition.
Government statistics show that one in 10 people in Hong Kong has diabetes mellitus. Ahead of World Diabetes Day on November 14, we asked endocrinologists Dr Norman Chan, a private doctor who practises in Hong Kong and Shanghai, and Dr Ace Lee of Quality HealthCare Medical Services, to debunk several common diabetes myths and misconceptions.
Myth: if I have diabetes, I'll show symptoms
Studies show that only about 40 per cent of diabetic patients have symptoms at the time of diagnosis, says Lee. "That's why we often suggest that people with a high risk for diabetes have a follow-up blood test every year after they reach 40," adds Lee. Healthy people should have the first screening at age 40 to 45. "If the result is negative, you can repeat the blood test around three years later."
Myth: eating too many sweets will cause diabetes
It's not so straightforward. "In the short term, if you drink 10 cans of cola a day, you're not going to develop diabetes the next day," Chan explains.
"But if you always have Coke, that's a lot of calories. Over time, you could develop obesity, and that's when you develop insulin resistance." Research has shown that drinking sugary drinks is linked to type 2 diabetes, according to the American Diabetes Association.
Lee cautions that while sugary food should be avoided, sugar is actually not the food that produces the highest glucose rise in the body. That is common carbohydrate-rich food, such as white rice, congee and white bread.
Myth: okra water and bitter melon juice are effective at lowering blood-glucose levels
Uncertain. Some type 2 diabetics use these as alternative treatments for their condition. "Many patients ask for my opinion on it," Lee says, "but data on their efficacy is very sparse. We are unsure from the Western medicine perspective whether they're effective or not. I'm concerned about the long-term side effects if patients take these drinks for months or years - everything, if taken in excess, will have a side effect."
Myth: diabetics on insulin don't live for very long
Chan explains that insulin therapy is often used with type 2 diabetes when oral diabetic drugs are not having the desired effect, and this is because the disease has been around for a long time, and so pancreatic function has drifted close to zero. In other words, insulin is meant to help get the condition under control.
The reason why the lifespan of patients who've had type 2 diabetes for a long time is decreased, says Chan, is usually because such patients are likely to have other complications, such as kidney disease and coronary heart disease. "Many people refuse to use insulin until complications begin, but by then it's too late," he says.
Myth: anti-diabetic medication isn't effective in the long term
"People think that our bodies get used to regular anti-diabetic medicine and the drugs won't work any more," explains Chan. "This is wrong: anti-diabetic medication works for a very long time."
Chan says the reason that the drugs' effectiveness seems to dim is because pancreatic function declines with age, and therefore less insulin is produced by the body. "It happens to most people," says Chan. Over time, the dosage of medication therefore needs to be increased.
One solution is to control diabetes aggressively right from the early stages. "The medicine will work really well because the pancreatic function will be preserved," says Chan.
Apart from following a strict schedule of drugs, diabetics must manage their condition with frequent self-monitoring of blood glucose, dietary modifications and exercise.
Myth: the most common diabetic complication is amputation
While it is the most alarming complication, it's not the most common, Lee says. The most common complication is heart disease and stroke. "Diabetics have double the risk of non-diabetics for heart disease or stroke," says Lee.
Further, he notes that among Chinese patients, diabetic kidney disease is more common than in Caucasians because of genetic reasons.
Myth: diabetics should only do aerobic exercises and avoid resistance exercises
Many diabetics also suffer from hypertension and some people think resistance exercise may increase blood pressure. "This is an old concept," says Lee. "We know that both forms of exercise are beneficial for glucose control in diabetic patients."
He recommends exercising for 30 minutes, five days a week, performing both forms of exercise in the same session or alternating them each day.
"Some studies find that shorter durations of 10 to 15 minutes at a high intensity also achieve the same benefit."
Lee suggests patients consult their doctor before starting on an exercise regimen as some people may have health complications.