Diabetes can cause problems with the heart and kidneys, but experts believe that risks can be reduced with appropriate treatment and lifestyle modifications. Diabetes, formerly considered a hidden disease, is now widely recognized as a public health risk. Globally, the disease claimed the lives of 6.7 million people in 2021. In Singapore, 430,000 persons between the ages of 18 and 69 are classified as pre-diabetic, while over 400,000 people have the illness.
About one million Singaporeans are expected to have diabetes by 2050 if treatment is not received, according to Dr. Kevin Tan, a consultant endocrinologist at the Kevin Tan Clinic for Diabetes, Thyroid, and Hormones. “The financial burden of diabetes could increase from S$1 billion in 2010 to an estimated S$2.5 billion annually by the same year.”
Diabetes is a chronic, progressive illness in which the body either cannot use insulin efficiently enough or does not create enough of it. The pancreas produces the hormone insulin, which is essential for controlling blood sugar levels. Excess glucose builds up in the bloodstream in cases of insulin resistance or insufficient insulin secretion, which can have negative effects on the kidneys, blood vessels, eyes, and nerves.
Obesity is one of the risk factors linked to type 2 diabetes, which is the most prevalent kind of the disease in this area. Obesity is thought to be responsible for 80–85% of the risk of Type 2 diabetes, according to Dr. Tan. Age, a family history of the illness, physical inactivity, high blood pressure, high cholesterol, smoking, and gestational diabetes are additional risk factors for the disorder.
“Diabetes can lead to a number of serious health complications, including kidney failure, heart attacks, strokes, and non-healing foot ulcers that may become infected and require amputation of the affected limb,” Dr. Tan stated.
Because the cardiovascular, renal, and metabolic systems are intricately intertwined, problems resulting from diabetes in one system can quickly affect the others and lead to the development of cardio renal metabolic syndrome (CRM syndrome).
Dr. Low Lip Ping, chairman emeritus of the Singapore Heart Foundation and cardiologist of the Low Cardiology Clinic, clarified, saying, “Uncontrolled high blood sugar can damage blood vessels and the kidneys over time, resulting in elevated blood pressure levels.”
Dr. Jason Choo, a senior consultant in the Department of Renal Medicine at Singapore General Hospital, emphasizes further that high blood pressure and diabetes, either separately or in combination, are the main causes of adult end-stage kidney failure (CKD), which accounts for about 80% of all kidney failure cases globally.
The progressive and irreversible loss of kidney function in removing waste and fluids from the blood is the hallmark of chronic kidney disease (CKD). When CKD reaches an advanced stage, the body may accumulate hazardous amounts of fluid, electrolytes, and waste, the doctor stated.
A study projects that 20 to 40 percent of those with diabetes may eventually develop diabetic kidney disease (DKD). Remarkably, diabetes continues to be Singapore’s primary cause of end-stage renal failure, accounting for 67% of newly diagnosed cases.
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