Dr Yue Photo: Courtesy of UFH

Diabetes mellitus is a chronic disease related to insulin, the hormone that regulates blood sugar in the body. When the pancreas does not produce enough insulin or the body cannot effectively use the insulin it produces, diabetes appears. Diabetes is divided into type 1 (lack of insulin) and type 2 (ineffective use of insulin).

In recent decades, the prevalence of type 2 diabetes has seen a significant increase worldwide, becoming one of the main diseases endangering human health. In China, the prevalence of diabetes in people over the age of 20 has gone from 0.67 percent in 1980 to 9.7 percent in 2008, with the total number of adults diagnosed with diabetes reaching 92.4 million. At the current growth rate, it is expected that by 2030, 500 million people worldwide will have diabetes.

The dangers of diabetes

The major risks of diabetes are complications in small blood vessels (microvascular) and in large blood vessels (macrovascular). These can include complications that cause retinopathy (damage to the retina of the eye), diabetic nephropathy (a progressive kidney disease), diabetic neuropathy (affecting all peripheral nerves and organs), hypertension, cerebrovascular disease, cardiovascular disease and lower extremity disease. Diabetic retinopathy is the main cause of adult blindness; diabetic nephropathy is a common cause of chronic renal failure. The medical expenditures needed to combat these complications account for the most significant portion of the health care costs of diabetes.

Populations at risk for developing type 2 diabetes 

Certain ethnic groups are genetically more predisposed to developing diabetes. People of African descent, Latinos, Native Americans, people of Asian descent and Pacific Islanders are all at increased risk. Additionally, those with the following risk factors should be screened:

Obesity and lack of exercise

First-degree relatives (parents and siblings) with diabetes

Cardiovascular disease

History of gestational diabetes

History of delivering large for gestational age (LGA) babies

Hypertension or dyslipidemia

Impaired fasting glucose

Suffering from polycystic ovarian syndrome (PCOS) 

Diagnostic criteria for diabetes 

The diagnostic criteria of the American Diabetes Association (ADA) in their 2012 guide are: glycosylated hemoglobin (A1C) ≥ 6.5 percent or fasting blood glucose (FBG) ≥ 7.0mmol / L, or glucose tolerance test postprandial blood glucose 2 hours (OGTT2hPG ) ≥ 11.1mmol / L, or typical symptoms of patients with unregulated blood glucose ≥ 11.1mmol / L. Of course, if the patient does not clearly present signs of hyperglycemia, the above results must be reviewed and repeated.

The treatment of diabetes 

More and more treatment options for diabetes have become available in recent years, including new medications. The cornerstone of all treatment is always a strict diet and appropriate exercise. Certain medications are also very effective, including six types of oral hypoglycemic agents, GLP-1 receptor agonists and a wide range of insulin injections. Weight loss surgery can be effective in the treatment of obese patients with type 2 diabetes. Blood glucose monitoring serves as the basis for treatment options, either through patient-collected data or continuous glucose monitoring systems.

In summary, diabetes is an increasingly serious health and societal problem. Overcoming diabetes requires a coordinated effort between patients and doctors to balance diet, exercise, diabetes education, medication and blood glucose monitoring.

For more information: please visit www.ufh.com.cn.

Yue Xin, MD

Endocrinologist

Originally from China, Dr Yue completed her medical degree at Peking University Health Science Center and then interned at Beijing Jishuitan Hospital. She went on to another internship at Beijing Pediatrics Institute before becoming a resident in the Internal Medicine Department at Peking Union Medical College (PUMC) Hospital. Upon completion of her residency, Dr. Yue achieved "attending physician" status in the Department of Endocrinology at PUMC Hospital.

Dr. Yue, who joined BJU in February 2011, has published some medical papers and has plentiful international medical experience.