Most of my patients have type 2 diabetes! A whooping 85-90% of people with diabetes have type 2 diabetes. Patients and their families often ask me who will get it or when it will occur. I usually tell them that if you have a family history of type 2 diabetes or if you are from certain ethnic backgrounds, such as Chinese, then you are at risk of having type 2 diabetes later. Most of my patients are middle-aged or older. However I have been surprised by the increasing number of children, adolescents and young adults that come through my workplace.
I would strongly recommend my patients to look into their lifestyle factors (such as being overweight, lack of physical activity, poor diet, excess weight around the waist and high blood pressure) which significantly increase their risk of type 2 diabetes.
Many remain undiagnosed until they experience a diabetes complication, such as blurred vision, a foot ulcer or a heart attack! Often patients do not know why they have type 2 diabetes. During my consultation, I would tell them that it occurs due to the following reasons. It is either due to a lack of insulin when the pancreas does not produce enough insulin or insulin resistance when cells of the body do not respond to insulin efficiently.
For newly diagnosed type 2 diabetes, I generally recommend them to increase their physical activity regularly, encourage them to eat healthier and think about weight reduction. Most patients will need blood glucose lowering medications as well as lifestyle modifications as their type 2 diabetes progresses. Many usually start with oral tablets but some may require insulin later.
I want to reinforce that using insulin is not a treatment failure nor “end of the road” as some of my patients have told me. It is the natural progression of the condition and using medications as soon as required can minimise possible complications in the long run.
I have Dr Mark Forbes’ permission to quote him from a lecture I have attended last year “Most patients who started on insulin actually felt a lot better and wondered why they did not start it earlier”
Dr Mark Forbes is the Clinical Director of Gold Coast Hospital and Health Service. He is also one of the endocrinologists in Gold Coast University Hospital.