Change your lifestyle to change your life
A November 2020 study done by The University of Manchester mentions that even well-managed Type 2 diabetes patients have a 21 per cent higher risk of cardiovascular disease, and a 31 per cent higher risk of hospitalisation for heart failure compared to those without diabetes.
Explains Dr Lim: “It means that when compared to non-diabetic people, those who have well-controlled diabetes, but nevertheless have elevated glucose levels, still have a higher risk of cardiovascular disease.
“However, further studies will be required to verify the conclusions,” says Dr Lim.
Dr Lim shares some tips for people with diabetes to stave off atherosclerotic disease, also known as the build-up of fats, cholesterol and other substances in and on the artery walls. This condition could lead to high blood pressure, and ultimately, cardiovascular disease.
The key is to maintain an ideal weight and to eat small, frequent meals of foods that have a low glycaemic index so that your blood sugar will not spike.
Regular exercise is also important: Start with 150 minutes of moderate exercise a week, and build up to 300 minutes of moderate exercise a week; three days of aerobic exercise, two days of resistance training, and stretching after the completion of every exercise session.
Also, monitor your blood sugar levels regularly. “A glucose patch with a sensor can allow continuous glucose monitoring and help the patient understand how their food choices affect their glucose levels,” adds Dr Lim.
Managing Type 2 diabetes with medication
Medication can also be used to manage Type 2 diabetes. However, Dr Lim says, for the elderly, there is data to suggest that the glucose should not be brought to “normal” levels as this may increase the risk of complications such as hypoglycaemia (low blood sugar) which can lead to comas.
Insulin is also something you need to consult your health practitioner about, as it is not given to those who have Type 2 diabetes as they may have insulin resistance especially if they are obese, adds Dr Lim. Plus, traditional diabetic medications function mainly to reduce blood glucose levels and often cause weight gain.
There is a new generation of medication that could help reduce glucose levels as well as reduce weight, says Dr Lim.
“One such class of drugs is the Glucagon-like Peptide-1 Receptor Agonist, or GLP-1 RA. It not only improves blood glucose control, but also brings potential benefits such preserving insulin secreting cells in the pancreas (beta-cells), as well as helping with weight loss and increasing insulin sensitivity,” he says.
Dr Lim notes that the safety and efficacy of GLP-1 RA has been demonstrated in multiple trials and is now recommended to Type 2 diabetes patients as one of the first-line therapy medications.
He adds: “Studies have shown that beyond better glucose control, GLP-1 RAs reduce the risk of stroke in individuals with Type 2 diabetes due to their beneficial effects on the cardiovascular system and markers of inflammation.”
While most of the GLP-1 RA are given via injections, an oral version is currently available. Dr Lim says it’s best to start the patient on the lowest dose possible and gradually increase the dose as the patient could experience nausea and vomiting on a higher dose.
While there are ways to manage diabetes and its associated health risks, it is ultimately up to you to do your part and take charge of your health. Go for regular health screenings, manage your lifestyle and seek your doctor’s advice before health issues become a bigger problem in the future.