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.

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

Diabetes Symptoms, Monitoring, Diet, Treatment & Health tips

Sinopharm COVID-19 & Latest Influenza Vaccines (Protects against Flu and H1N1 Viruses) / Pre-Departure COVID-19 PCR  Swab & Serology Tests for Travellers, Serology Testing to Certify Vaccination status and Pre-Event COVID Testing. Make your Appointment at Tel: 6694 1661

Flu Subsidy Scheme eligible for Singaporeans & PRs (Pay subsidized rate of $10 for Consultation and Treatment) & Merdeka Generation /Pioneer Generation seniors (Pay subsidized $5) for patients with Acute Respiratory Infections (ARIs).

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.'

Health Assessment & Screening Packages

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).

Part of MOH's Swab & Go Home programme. Our clinic can carry out the COVID-19 Swab test for anyone who meets the MOH medical criteria. All individuals aged 13 and above, diagnosed with ARI will be COVID Swab-tested. Cost of Swab test to be borne by Ministry of Health Singapore.

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).

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Risk Factors of COVID-19 Complications

Source : Observer Research Foundation

Lung, Neurological, Liver & Kidney Diseases

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.

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.

MD International Medical Centre

Medical Services available :

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.

MD International (Singapore) Pte Ltd

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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

- Doctor of Chiropractic

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

Physiotherapy-trained NBCE The National Board of Chiropractic Examiners

Medical Conditions Treatable with Chiropractic:  

  • 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

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

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

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