What is Diabetes Mellitus, Prediabetes and Insulin Resistance?

What are the symptoms and causes of Diabetes, Prediabetes or Insulin resistance? Can thiese lifestyle diseases and chronic health conditions be reversed? What are the health risks of being hyperglycemic?

What is Diabetes Mellitus?

Diabetes occurs when the body has difficulty processing sugar normally, due to issues with a hormone called insulin.

There are two types of diabetes :

• Type 1 diabetes is usually diagnosed early in life and is due to a lack of insulin production.
• Type 2 diabetes is much more common and is usually diagnosed later in life.

In type 2 diabetes, there are usually deficits in both the production and response of the body to insulin. Genetics does play a role in the development of type 2 diabetes, but lifestyle and particularly the amount of sugar and carbohydrates in the diet, are very important.

What is Prediabetes?

Because type 2 diabetes develops over the course of many years, there is a phase called prediabetes, in which the body’s insulin response to sugar is still present, but not as efficient as normal. When the cells in the body do not respond as well to insulin as they should, this is called “Insulin resistance”.

During prediabetes, if we test the blood, we will find higher levels of sugar than normal, even a long time after eating, but not at high enough levels to be called diabetes yet. This is called “impaired fasting glucose”.

The reason that it is important to identify people with prediabetes is that there is still time to reverse the illness before it becomes full diabetes. Even if it does not develop fully into diabetes, someone with prediabetes is at a much higher risk of heart disease.

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Causes & Risks of Insulin Resistance

Insulin resistance is part of the “metabolic syndrome”, which involves high blood pressure, heart disease, liver disease and weight gain.

Weight loss and healthy diet are able to return the blood glucose back to normal and this can be demonstrated with follow up with your family doctor.

Type 2 diabetes affects 1 in 10 people in Singapore and is on the rise. It is caused by a reduction in the body’s ability to process sugar, which is controlled by a hormone called insulin.

When there is not enough insulin, or it doesn’t work properly in the body, this results in high blood sugar levels. Diabetes develops over a long time and there is a period where there is evidence of higher blood sugar than normal, but not at high enough levels to be diabetes (Prediabetes).

What does the HbA1c test in your blood test results mean?

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It is also called HbA1c glycated hemoglobin test or glycohemoglobin. People who have diabetes need this test regularly to see if their levels are staying within range.

Long Term Risks & Complications of Diabetes on your body

Angiopathy - Disease of the arteries, veins, and capillaries. The most prevalent angiopathy is diabetic angiopathy, a common complication of chronic diabetes.

Peripheral Vascular Disease (PVD) - This blood circulation disorder causes the blood vessels outside of your heart and brain to narrow, block, or spasm. This can happen in your arteries or veins. PVD typically causes pain and fatigue, often in your legs, and especially during exercise.

Retinopathy - This is a disease of the retina which results in impairment or loss of vision. Diabetic Retinopathy is caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). This can eventually lead to blindness. The longer you have diabetes and the less controlled your blood sugar is, the more likely you are to develop this eye complication.

Nephropathy - This is a disease of the kidneys caused by damage to the small blood vessels in the kidneys that clean the blood. People who have had diabetes for a long time may develop nephropathy.

Neuropathy - Neuropathy is damage or dysfunction of one or more nerves that typically results in numbness, tingling, muscle weakness and pain in the affected area. Neuropathies frequently start in your hands and feet, but other parts of your body can be affected too.

Diabetic Infections - The most common sites are the skin and urinary tract. Dermatologic infections that occur with increased frequency in patients with diabetes include staphylococcal follicular skin infections, superficial fungal infections, cellulitis, erysipelas, and oral or genital candidal infections.

High blood sugar from diabetes can affect the body's immune system, impairing the ability of white blood cells to come to the site of an infection, stay in the infected area, and kill microorganisms.

People with high blood sugar from diabetes can be more severely affected by common infections, such as influenza and pneumonia caused by Streptococcus pneumoniae. This is why immunizations for influenza (the flu) and pneumococcal disease (ie PCV) are recommended for people who have diabetes. Refer below for the National Adult Immunization Schedule (NAIS) Singapore.

What can you do if you have Prediabetes or Diabetes? Click here to learn more.

Complications of Diabetes

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Diabetes Symptoms, Monitoring, Diet, Treatment & Health tips

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Pain Management

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Diabetic Neuropathy Easy Self Assessment

Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerves throughout your body. Diabetic neuropathy most often damages nerves in your legs and feet.

You may use a piece of stiff fishing line string to do this easy Diabetic foot self test. If you have lost sensation in any of the spots indicated in the above diagram, seek medical advice from your family doctor to get a professional diagnosis and medical intervention.

'An ounce of prevention is worth a pound of cure.'

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Health Assessment & Screening Packages

Part of the National Influenza Sentinel Surveillance programme with MOH. If you have a fever of > 38 degrees with a cough, our clinic is able to test for COVID-19. For children below 12 years old with clinical diagnosis of HFMD (eg fever, oral ulcers, rash), our clinic can test for Hand Foot & Mouth Disease (The tests are for surveillance purposes only).

How a Gluten-free Diet can Improve your Chronic Illnesses

Healthy Diets for Optimal Health

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Risk Factors of COVID-19 Complications

Source : Observer Research Foundation

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Lung, Neurological, Liver & Kidney Diseases

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Sinopharm COVID-19 Vaccine in Singapore

Sinopharm COVID-19 Vaccine is now available @ MD International Medical Centre. Make a Vaccination or Booster Appointment at Tel: 6694 1661. Learn more about Sinopharm here.

Sinopharm BBIBP-CorV vaccine has now been approved for use by private clinics in Singapore against the COVID-19 virus under the Special Access Route. It is the first China-made vaccine to be approved by the World Health Organisation (WHO).

To date, more than a billion doses of the Sinopharm BBIBP-CorV have been administered. The vaccine has also been approved for use in over 50 countries around the world.

Inactivated vaccines are a tried-and-tested form of vaccine technology which is used in other well-established vaccines, such as the Flu and Hepatitis B vaccines.

If you would like to receive the Sinopharm vaccine or booster, please make your appointment at MD Int'l Medical Centre at Tel: 6694 1661.

Effects of COVID-19 on the Brain

Ministry of Health Recommendation :

• For persons who have already completed their Primary series with mRNA vaccines and are recommended to get a booster, but are unable to take another dose of mRNA vaccines for medical reasons, they may boost using one dose of Sinopharm vaccine. The booster should be taken six months after mRNA dose 2 (M-M-S).

• For persons who are unable to take the the 2nd dose of mRNA vaccines for medical reasons, they may complete their vaccination with the Sinopharm vaccine. 2 doses of the Sinopharm vaccine is recommended to complete the Primary series. The 2nd Sinopharm dose  should be taken 28 days after the 1st Sinopharm dose (M-S-S).

For recovered persons who had not completed a primary series before infection:

• For persons who have recovered from a COVID-19 infection but received 1 dose or none of COVID-19 vaccination prior, they may receive 2 doses of the Sinopharm vaccine (28 days interval between doses), 3 months after the date of infection to complete a primary vaccination series (Recovered-S-S or S-Recovered-S-S or M-Recovered-S-S).

• For persons who have recovered from a COVID-19 infection and had received 2 doses of Sinovac or Sinopharm vaccines prior, they may receive 1 dose of Sinopharm after 3 months from the date of infection to complete a primary vaccination series (S-S-Recovered-S).
  

Co-infection of COVID-19 with other infectious diseases is possible.

Reduce your risk of getting sick with COVID-19

• Make sure your vaccinations are up-to-date. People older than 65 years, and those with many underlying conditions, such as those who are immunocompromised or with significant liver disease, are recommended to receive vaccinations against influenza (Flu 2021/22) and pneumococcal disease (PCV). Click here for Vaccination schedules (NAIS/NCIS).
  
• Do not delay getting medical care for your underlying condition because of COVID-19. MD International Medical Centre has contingency MOH infection prevention protocols to protect you from getting COVID-19 if you need care for your underlying condition.
• Continue your medications and do not change your treatment plan without talking to your doctor.
• Make sure that you have at least a two-week supply of your chronic disease medications.
• Call MDIMC @ Tel: 6694 1661 for a medical appointment if you have any concerns about your underlying medical conditions or if you get sick. Our clinic is a PHPC-accredited medical clinic. Under the MOH Swab & Go Home programme, our doctors can do a COVID-19 PCR Swab test if you meet the MOH medical crtieria.

Asymptomatic patients may not display no symptoms of illness. Vulnerable people should get vaccinated against Influenza as the stop gap until the COVID vaccine is found. The Flu vaccine would protect susceptible people from, as well as exclude the Flu and H1N1 viruses should they start to show URTI or ARI symptoms.

- Latest Influenza Vaccine

The latest Influenza Vaccine is now available. It protects against the Flu and H1N1 Viruses. In the event that a person displays flu-like symptoms after the Flu vaccination, both Flu and H1N1 may be excluded in his diagnosis, and treatment can be sought quickly should the patient have contracted COVID-19.

Ministry of Health Safety protocols are adhered to at all times for the safe vaccination of you and your family.

* Latest COVID-19 Updates & Health Tips

* Importance of Keeping your Vaccinations Up-to-date

Singapore is free from vaccine-preventable diseases like poliomyelitis, diphtheria, tetanus and pertussis (whooping cough) because of our successful immunisation progamme.

Up to $400 per Medisave Account per year can be used for Vaccinations under the National Adult & Childhood Immunisation Schedule - Influenza, Pneumococcal (PCV13/PPSV), Human Papillomavirus (HPV2/HPV4), Hepatitis B, Tetanus, Diphtheria & Pertussis (Tdap), Measles, Mumps & Rubella (MMR) and Chickenpox (Varicella).

National Adult Immunisation Schedule (NAIS) Singapore @ MD International Medical Centre. Make your vaccination appointment at Tel: 6694 1661.

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MD International Medical Centre

Medical Services available :

• General Medicine / General Practice
• Minor Surgical Procedures
  
• Dermatology - Skin Problems (Eczema, Acne, Rash, Boils, Dermatitis, Pigmented or Dry Skin, Mole/Skin Tag/Wart Removal)
  
• Dermoscopy - Non-invasive Detection of Skin Cancer, Pubic lice & Scabbies
• Treatment of Insect Bites & Stings
• Infectious diseases & Virology (COVID-19. Dengue, Flu, Hepatitis B)
• Respiratory Medicine - Cough, Wheezing, Shortness of breath
  
• Obesity / Weight control
• Stomach ache
  
• Respiratory Lung Diseases
• Liver Diseases
• Kidney disease / Kidney stones
  
• Eye Health / Opthalmology
  
• Ear Nose Throat / ENT -
  Nose Bleed-Epistaxis /Snoring & Sleep Apnoea /Verigo & Dizziness
• Removal of Ear Wax
• Personal Health
• Allergies Test & Management
• Treatment of Allergic Rhinitis
  
• Asthma Management
• Vaccinations / Immunization (eg Flu vaccination)
• Depression / Anxiety / Stress Management
• Management of Chronic Diseases (eg Diabetes / Hypertension)
• Treating Prediabetes, Diabetes & Insulin Resistance
  
• Heart Disease / High Cholesterol Management
• Health Management
• Men's Health
• Women's Health - Osteoporosis, Heavy Periods, Breast lumps, Urinary Tract Infection, Anaemia, Tremors
  
• Child Health & Nutrition / Pediatrics
• Elderly / Senior Health
• Dementia Screening
• Neurological Disorders
  
• Treatment of Gout
• Pain Management (eg Arthritis, Back Pain, Migraine)
• Sports Injuries
  
• Travel Health (eg Vaccinations / Travellers' Diarrhoea)
  
• Health Screening / Blood tests
• Pre-Employment check-up
• Work Permit / Employment Pass / Student Pass / Driving License Check-up
• Blood Disorders
  

Public Health Preparedness Clinic

National University Health System Primary Care Network

Singapore Ministry of Health Chronic Disease Management Programme (CDMP)

The information provided in this website is for knowledge purposes only. It does not constitute medical advice.

Should you encounter any medical problem that you are unsure of, always consult your doctor or health care provider for assistance and medical advice.

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MDIMC Medical Team

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Doing Our Best in the COVID-19 Pandemic!

“Do all the good you can,
By all the means you can,
In all the ways you can,
In all the places you can,
At all the times you can,
To all the people you can,
As long as ever you can.”
― John Wesley

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Get your Sinopharm Vaccine / Booster or Latest Flu Vaccine - Make your appointment at Tel: 6694 1661.

Risk Factors of COVID-19 Complications

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COVID-19 Singapore Public places visited by cases in the community

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COVID-19 : Country cases, Deaths, Recovered & Vaccinated

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For Medical Professionals

Learn from the China Experience on COVID-19 Prevention and Treatment

9 Taman Serasi #01-11, Botanic Gardens View

Tel : 65-6694-1661  Fax : 65-6694 1771

Email : contact@mdimc.sg

Clinic hours:

Monday to Friday: 9am-12.30pm / 2pm-6.30pm    Saturday: 9.30am-1pm

*Last registration is 30mins before the closing time

Closed on Sundays & Public Holidays

- Cashless service with most International Insurance companies and Insurance Medical cards are accepted

- Japanese & Mandarin-speaking Doctors and Medical staff

Please contact us at Tel: 6694 1661 to make an appointment.

OUR MEDICAL TEAM

Dr Don Lau – Medical Director

MBBS (Monash), B Med Sc (Hons) (Monash), Dip Pract Derm (Wales, UK)

Fujiwara Takanori DC

The Chiropractic Association Singapore, Japan Chiropractic Register, American Chiropractic Association, California Chiropractic Association

Physiotherapy-trained NBCE The National Board of Chiropractic Examiners

YAMAGATA Chihiro 山懸千尋

Registered Psychologist

Dr Lee Sao Bing – Opthalmologist (in-house Specialist)

MBBS, MMed(Ophth), FRCSEd(Ophth), MD, FAMS

Dr Pang Yoke Teen – ENT (Visiting Consultant)

FRCS (ORL), FRCS(EDIN), (FRCSGLASG), FAMS, MBBS

MD International Medical Centre

Medical Services

• General Practice Family Medicine
• Minor Surgical Procedures / Laser Treatments
• Management of Chronic Diseases (Diabetes / Hypertension / Heart Disease / High Cholesterol Management)
• Pain Management (Joint pains, Knee Pain, Back Pain, Migraine, Sports Injuries)
• Shockwave Treatment / Deep Muscle Stimulator DMS Therapy
• Dermatology Treatments - Skin Problems (Eczema, Acne, Rash & Hives, Boils, Dermatitis, Pigmented or Dry Skin, Moles, Skin Tags, Corns & Calluses, Wart, Treatment of Insect Bites & Stings)
• Dermoscopy - Non-invasive Detection of Skin Cancer
• Allergies Test & Management / Treatment of Allergic Rhinitis / Asthma Management
• Vaccinations / Immunization (National Adult Immunisation Schedule / National Child Immunisation Schedule / Influenza)
• Infectious diseases & Virology (COVID-19, Dengue, Flu, Hepatitis B)
• Respiratory Medicine - Cough, Wheezing, Shortness of breath
• Eye Health / Ophthalmology (Conjunctivitis, Foreign body in the Eye)
  
• Ear Nose Throat / ENT Rhinoscopy (Nose Bleed-Epistaxis, Snoring & Sleep Apnoea, Vertigo & Dizziness, Removal of Ear Wax)
• Audiogram – Hearing test
• Personal Health (Stomach ache, Irritable Bowel Syndrome, Heartburn, Treatment of Gout)
• Elderly / Senior Health (Arthritis)
• Men's Health
• Women's Health (Osteoporosis, Heavy Periods, Breast lumps, Urinary Tract Infection, Anaemia, Tremors)
• Child Health & Nutrition / Paediatrics
• Travel Health (Vaccinations / Travellers' Diarrhoea)
• Health Assessment, Screening & Management / Blood tests
• Pre-Employment check-up / Work Permit / Employment Pass / Student Pass / Driving License Check-up
• Obesity / Weight control
• Neurological Disorders / Dementia Screening
• Depression / Anxiety Management
  
• Insomnia & Stress Management

Minor Surgical Procedures :

·       Injection for Supraspinatus or Bicipital Tendonitis / Epicondylitis / Trigger finger / Plantar Fasciitis

·       Tendon Sheath Injection

·       Excision of small Skin tumours / Lipomas / Nail bed / Ear lobe cysts / Meibomian cyst

·       Removal of Skin sutures / Skin tags / Sebaceous cysts / Various foreign bodies / Corneal foreign body

·       Liquid Nitrogen Therapy

·       Treatment of Plantar Warts / Calluses / Corns / Ganglions

·       Splinters under nails

·       Olecranon and Pre-patellar Bursitis

·       Ear syringing

·       Embedded earring stud

Medical Conditions Treatable with Therapy:  

• Head & Neck – Neckaches/ Spondylosis/ Wry Neck/ Whiplash/ Headaches/ Migraine/ Facial Palsy
• Back – Back Strain/ Slipped Disc/ Scoliosis/ Sciatica/ Spondylosis/ Spondylolisthesis/ Spondylolysis
• Shoulder – Frozen Shoulder/ Rotator Cuff Tear/ Impingement Syndrome
• Elbow – Tennis Elbow/ Golf Elbow
• Hip / Knee – Anterior Knee Pain/ Runner’s Knee/ Meniscus Injury/ Ligament Injury
• Foot – Plantar Fasciitis/ Heel Pain/ Metatarsalgia
• Joint – Arthritis/ Cartilage Wear & Tear/ Osteoarthritis
• Ligament – Sprains/ ACL Laxity/ Ankle Sprain
• Muscle – Strains/ ITB Tightness/ Hamstring Tear
• Tendons – Tendonitis/ Repetitive Strain Injury/ Tendinopathy
• Sports Injuries
• Obesity – Exercise & Meal Planning 
• Post Operation/ Hospitalization
• Fibromyalgia

OUR MEDICAL TEAM

Dr Don Lau – Medical Director

MBBS (Monash), B Med Sc (Hons) (Monash), Dip Pract Derm (Wales, UK)

Fujiwara Takanori DC

The Chiropractic Association Singapore, Japan Chiropractic Register, American Chiropractic Association, California Chiropractic Association

Physiotherapy-trained NBCE The National Board of Chiropractic Examiners

YAMAGATA Chihiro 山懸千尋

Registered Psychologist

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