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By Salma Khalik
If you are 40 years or older and have never checked your blood sugar level, do it now. It could save you years of suffering.
It does not matter if you feel fine now. Most diabetics do - until it is too late.
That is why half the diabetics around the world, including in Singapore, do not know they have the disease.
In Singapore, close to 200,000 people are walking time bombs, unaware of the health risk they face.
According to data from the Health Promotion Board, more than 500 diabetics lose the use of their kidneys every year and will need either dialysis for the rest of their lives or a transplant. Diabetics are much more likely to suffer from heart attacks and strokes. Many go blind, suffer from kidney failure that requires transplant or dialysis, or need to get one or more limbs amputated following incurable gangrene.
This is because high blood sugar levels damage organs, nerves and blood vessels. The longer blood sugar level is left untreated, the greater the damage - and the destruction is permanent.
In the past, it was thought that once diabetics were treated, their risk of suffering from heart attacks, strokes or other problems associated with the disease diminished. That is true, but not as much as believed.
More recent information has found that late intervention is just not good enough. What happens in the early years matter.
Doctors call it the "legacy effect": What happens in the early years of the disease lives on to haunt patients later on.
Diabetics who were able to keep their blood sugar levels down in the early years of their illness will fare much better in later years, even if by then they have difficulty keeping sugar levels low.
A large study - the United Kingdom Prospective Diabetes Study - which followed several thousand patients for 30 years found that half had good control for the first 20 years. The other half had treatment but still had less than ideal levels of blood sugar.
In the last decade, the sugar levels of both groups were similar.
Yet, the group that had fared better in the early years remained significantly better off, with fewer deaths and disabilities.
At a recent diabetes congress in Europe, 17,000 doctors from around the world heard that there have to be changes in the way diabetics are being managed.
Instead of trying to just get patients with mild diabetes to lower their blood sugar levels through exercise and diet - still the most effective and cheapest solution - doctors are now urged to put these patients on medication from day one.
This is to prevent even the minimal damage mild diabetes will do to their organs and blood vessels.
But more significantly, the UK study underscores the importance of knowing one has the disease as early as possible.
Unfortunately, no symptoms are seen in the early years of diabetes. However, a relatively cheap and easy screening method, the fasting blood test, which costs about $10 to $15, can tell you if you have it.
For healthy people, this can be done every three years from the age of 40. But for those with a family history of diabetes, are obese or suffer from high blood pressure, it would be prudent to start much younger and to do a check annually.
With more than 8 per cent of adults here suffering from diabetes and another 12 to15 per cent in the pre-diabetes stage, the chances of someone over 40 finding themselves at risk is fairly high.
More than 8% of adults in Singapore suffer from diabetes
This story was first published in Mind Your Body, The Straits Times, on Oct 16, 2008.
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