Managing diabetes: Having faith in insulin

Nearly two million Malaysians suffer from diabetes with about 4,000 of them dying annually due to complications related to the disease.

Diabetes is the country’s third leading cause of death after cardiovascular and lung related diseases.

Kon Khen Meng, Senior Medical Manager at a diversified global healthcare company, Sanofi, revealed this somber data at the pharaceutical company’s Media Club Launch recently.

The data provided by Kon mirrors the findings of the National Health and Morbidity Survey III (NHMS III) conducted in 2006 where an 80 per cent increase in the prevalance of diabetics was recorded in the above 30 years of age group compared with the earlier study under NHMS II in 1996.

This exponential trend has surpassed the International Diabetes Federation’s (IDF) estimation and is seen in tandem with the doubling of overweight and obesity problems in the society over the last decade.

“One in every five Malaysians is obese nowadays,” noted Kon while stressing that Malaysian eating habit is among the contributing factor for this negative trend.

“Nearly 50 per cent of the diabetic patients suffer from multiple complications,” said Kon. He listed the five common complications faced by diabetics – coronary heart disease, cerebrovascular disease, retinopathy or cataract, diabetic foot and nephropathy.

Studies have shown that 42.9 per cent of diabetics suffer from either one or two complications listed above.

Additionally, five per cent of the diabetics suffer three or more types of complications.

“One can be affected by the listed complications, even without diabetes. However by having diabetes, it makes them more vulnerable to the complications,” said Kon.

The NHMS III also indicated that 4.3 per cent of the diabetics had to undergo lower limb amputation, 3.4 per cent of them sufferred stroke and 1.6 per cent had to go for dialysis treatment or kidney transplant.

Kon highlighted that NHMS III was conducted five years ago and looking at the exponential trend, it is most likely that the number of diabetics has increased significantly in 2011.

There are two types of diabetes. Type One (T1) and Type Two (T2). T1 is due to an autoimmune disorder caused by genetics that destroys the pancreas and effectively ends the production of insulin in the patients’ body.

Only 10 percent of diabetics suffer from T1. Without insulin more glucose enters the blood, causing Hyperglycemia (excessive sugar in blood), resulting in less glucose going to the peripheral tissues.

At the end, these glucose is excreted through urine and this symptom is called Glycosuria. “Insufficient insulin may prove to be fatal for a diabetic.

In such situation, patients are left with no other option than undergoing insulin theraphy,” said Kon.

Meanwhile, T2 diabetes is due to the increasing resistance of a person’s body cells to the effects of insulin.

During the early period of disease, pancreas may compensate this by producing more insulin.

As the body develops more resistance towards insulin, patient’s pancreas could not longer cope up to the demand to produce more insulin for the cells. The only way to go about it is via insulin therapy.

It is important for patients to understand the disease pathway so that they can consider treatment option that suits their requirement.

“The challenge is, many patients prefer to rely on oral medication and have a great fear towards insulin treatment. This mentality deserves a change,” said Kon.

Among the main reasons that engender stigma towards insulin therapy is the fact that patients need to inject themselves with insulin.

For many, that is a very bad sign on their state of health.

“Many patients on insulin therapy come from the older age group, with about eight to 10 years of diabetic record.

Thus it makes it harder to change their perception, mentality and acceptance on the treatment,” said Kon.

In conjunction with World Diabetes Day celebrated every Nov 14, Sanofi wants to increase the level of awareness among the public on the reality of insulin therapy.

“It is hoped that with better understanding about the treatment, medical practitioners can provide better option to the patients and educate them with the reality of insulin treatment, so they (patients) will cooperate and play their role for their own benefit,” said Kon.

– Bernama