2 Diabetes Mellitus

Understanding the Complications of Type 2 Diabetes Mellitus (T2DM)

Type 2 DM, or diabetes as it is commonly known in the community, is a significant health concern in Singapore, affecting approximately 1 in 11 Singaporeans (1). This chronic medical condition does not just impact one’s blood sugar levels. Rather, it can result in many complications if it is not effectively managed. Understanding these complications and their causes is crucial for prevention and early intervention. There are other forms of diabetes as well but they are comparatively less common and outside of the scope of this article.

What are some of the complications of T2DM?

Diabetes can lead to several serious health issues, including but not limited to the following:

  1. Cardiovascular Disease: Individuals with diabetes are at a higher risk of heart diseases such as coronary artery disease, heart attack, and stroke (2) and vessel problems.
  2. Kidney Damage (Diabetic Nephropathy): High blood sugar levels can damage the kidneys’ filtering system, potentially leading to kidney damage and thereafter kidney failure eventually (3).
  3. Eye Damage (Diabetic Retinopathy): Diabetes can harm the blood vessels in the retina, increasing the risk of blindness (4).
  4. Nerve Damage (Diabetic Neuropathy): Excess glucose can injure the walls of tiny blood vessels that nourish nerves, leading to tingling, numbness, and pain (5).
  5. Foot Problems: Nerve damage in the feet or poor blood flow increases the risk of foot ulcers and infections (6).
  6. Compromised Immune System

What causes the complications associated with T2DM?

The main cause of diabetic complications is the poor control of diabetes. Over time, elevated glucose levels can result in damage blood vessels and nerves throughout the body. Patients who have well controlled T2DM are still able to continue with their daily lives with minimal issues. Lifestyle factors such as sedentary habits and diets high in sugar and saturated fats significantly contribute to the rise in diabetes and its complications (7).

The Importance of Early Screening for T2DM

Early detection is vital in preventing or delaying complications. Here’s why screening is essential:

  • Timely Intervention: Early diagnosis allows for prompt management, reducing the risk of complications.
  • Lifestyle Modification: Identifying prediabetes or early-stage diabetes provides an opportunity to implement lifestyle changes that can reverse or control the condition.
  • Cost Savings: Managing diabetes early reduces long-term healthcare costs associated with treating complications.
  • Early Detection of Complications: If a diagnosis of T2DM is made, further and regular screenings help to monitor for disease control and complications. For example, in patients with known T2DM, kidney function tests, foot screenings and eye screenings are routinely performed.

Regular diabetes screening is crucial for early detection and effective management, particularly for individuals who fall into higher-risk categories such as (8) (9):

Individuals aged forty and above: As we age, the risk of developing T2DM increases, making T2DM blood test screening a key preventive measure.

Those with a family history of diabetes: Genetics are known risk factor in the likelihood of developing T2DM.

Overweight individuals: Being overweight is one of the major risk factors for diabetes, and managing your weight through a balanced diet and regular exercise can significantly reduce your risk.

By taking proactive steps—such as regular screening and adopting a healthier lifestyle—you can detect diabetes early, manage it more effectively, and minimise the chances of severe complications. Take control of your health today!

References

  1. Roystonn K, Lau JH, AshaRani PV, Kumar FDS, Wang P, Sum CF, et al. Recognition of diabetes and sociodemographic predictors: results of a cross-sectional nationwide population-based survey in Singapore. BMJ Open [Internet]. 2022 Mar 1;12(3):e050425. Available from: https://bmjopen.bmj.com/content/12/3/e050425 
  2. CDC. Your Heart and Diabetes [Internet]. Diabetes. 2024. Available from: https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-your-heart.html 
  3. Kumar M, Dev S, Muhammad Usman Khalid, Sowmya Manjari Siddenthi, Muhammad Zaeem Noman, C. Lieske John, et al. The Bidirectional Link Between Diabetes and Kidney Disease: Mechanisms and Management. Cureus [Internet]. 2023 Sep 20;15(9). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588295/ 
  4. CDC. Vision Loss and Diabetes [Internet]. Diabetes. 2024. Available from: https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-vision-loss.html 
  5. National Institute of Diabetes and Digestive and Kidney Diseases. What Is Diabetic Neuropathy? | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2018. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/what-is-diabetic-neuropathy 
  6. CDC. Your Feet and Diabetes [Internet]. Diabetes. 2024. Available from: https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-your-feet.html 
  7. Kolb H, Martin S. Environmental/lifestyle Factors in the Pathogenesis and Prevention of Type 2 Diabetes. BMC Medicine [Internet]. 2017 Jul 19;15(1). Available from: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0901-x 
  8. Pippitt K, Li M, Gurgle HE. Diabetes Mellitus: Screening and Diagnosis. American Family Physician [Internet]. 2016 Jan 15;93(2):103–9. Available from: https://www.aafp.org/pubs/afp/issues/2016/0115/p103.html
  9. HealthHub. Diabetes Mellitus Risk Factors [Internet]. Health Promotion Board. Available from: https://www.healthhub.sg/programmes/diabetes-mellitus#riskfactors

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