Diabetes Myths: Yay or Nay
- Dr Chooi Kheng Chiew
- Feb 16, 2021
- 4 min read
It is not fake news that the number of people with diabetes is increasing. In the year 2000 there were 151 million people with diabetes and the number is expected to reach or exceed 552 million people by 2030. From our Malaysian Ministry of Health’s National Health and Morbidity Survey findings in 2019, there were an estimated 3.9 million adults aged 18 and above with diabetes, which is about 1 in 5 adults. 49 percent of these people had never been examined for or diagnosed with diabetes.
It is important to detect the disease early as patients can start to manage the disease earlier and this can potentially prevent or delay the serious complications of diabetes.
There are a multitude of sources that claim to provide information regarding diabetes, however not all of them are accurate and misrepresentations may lead to suboptimal treatment of the condition and even potential harm to patients. I would like to shed some light on a number of the common questions I had been asked in clinic before.
1. Is it true that the more expensive the blood glucose lowering medications/drugs, the better?
-Not necessarily. There are good medications which are cheap as well, but the choice of medication is individualized, meaning that there are some medications that are better for certain groups of patients. For example, there are medications that are more suitable for overweight or obese patients, and some that are more suitable for patients who have had a history of heart disease or stroke. To get the best advice on the most suitable medication for a patient, you can consult an endocrinologist who will take a proper history and conduct a complete examination before giving you the required advice.
2. Do diabetes medications like metformin damage the internal organs?
-This is a common misconception among the public, that medications hurt or damage the internal organs. This had unfortunately led to many patients stopping important medications by themselves, without the knowledge of or against the advice of their doctors. The truth is that poorly controlled diabetes leads to damage to the internal organs, for example kidney failure. Medications like metformin actually help to control blood glucose, thus preventing deterioration to the internal organs, hence the importance of early detection and treatment of diabetes. When diabetes is too advanced and the internal organs have already been damaged by diabetes, this may cause some medications to be no longer suitable for patients and therefore limit the treatment options available to the patient.
3. Can I increase the dose of my diabetes medications by myself, and reduce the dose of medicine when the blood glucose is stable?
-It depends on the type of medication. For example, if a patient is on insulin treatment, the dose of insulin can be adjusted based on the carbohydrate content of the meal and increased if necessary. However, it is imperative to get advice and education from your doctor before making such decisions.
4. Do blood glucose lowering drugs need to be taken for a lifetime?
-Type 2 diabetes mellitus is a chronic disease, and the ability of our pancreas to carry out its normal functions (like other organs) will deteriorate with increasing age. Therefore, it is likely that a patient with Type 2 diabetes will need to be on long-term treatment.
5. Are health products better than blood glucose lowering drugs?
-Blood glucose lowering drugs have gone through years and years of extensive non-clinical and clinical research and safety testing before being approved to be used to treat patients with diabetes. On the other hand, many ‘health products’ do not have robust or established research data on their long-term benefits to health. If taken, they should be taken with the mindset of them being a complementary product and not the sole treatment for diabetes. If in doubt, please consult your endocrinologist for more advice.
6. Can you eat as much sugar-free food as you like?
-In the end, a balanced meal is the key to a healthy diet. It is crucial to watch the quantity of food you take in and maintain a health weight. Advice from a trained dietician can be helpful in guiding your food choices.
7. Will taking insulin for a long time cause stroke or blindness?
-No. Insulin is one of the treatment options for diabetes. If the disease is well-controlled, the risk of developing complications from diabetes is reduced to a significant degree. In fact, it is poorly controlled diabetes that leads to complications like stroke or blindness.
8. Can you control diabetes by quitting sweets and starchy foods?
-One of the ways diabetes mellitus can be controlled, in addition to medications, is to control the diet. It will be easier to control blood glucose if a patient reduces the intake of unhealthy sweets and carbohydrates. However, there are various factors that contribute to a poor or inadequate control of diabetes. Thus, it would be best to regularly consult your endocrinologist to get an individualized opinion on the best management plan for your condition.
This article had previously been published in The Star.
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