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NAME : NOR ASHIKIN ISMAIL

ID : A2863
TITLE : DIABETES ONE MAJOR CAUSE OF DEATH
Malaysia make a paradigm shift to a developed country and hope to achieve developed nation
status by 2020. Among the problems associated with the developed countries is the imbalance
in food intake and can affect the health of the population. The emergence of various diseases
such as obesity, diabetes, heart disease and cancer in line with the country's development. In
Malaysia, the observed trend is the same. One of the leading causes of death in Malaysia is
diabetes. Diabetes is a chronic disease caused by an inherited or acquired deficiency in
production of insulin by the pancreas, or by unproductiveness of the insulin produced.
Diabetes is divided into two primary diabetes and secondary diabetes. Primary diabetes refers
as type 1 and type 2. According to World Health Organization, type 1 diabetes, formerly
known as Insulin Dependent Diabetes Mellitus, (IDDM) or child-onset diabetes is
characterized by a lack of insulin production. Meanwhile, Type 2 diabetes, formerly known
as Non-Insulin Dependent Diabetes Mellitus (NIDDM) or adult-diabetes is caused by the
body's unproductive use of insulin. It is often the result of excess body weight and physical
inactivity. Secondary diabetes, is the result of other pancreatic diseases, abnormal demand on
the pancreas as in diabetes during pregnancy, and those caused by drugs and toxins. Oftenly,
women will have gestational diabetes their during pregnancy and will develop diabetes in
their later life.
In Malaysia, diabetes is a growing anxiety. Diabetes is a common disease causing significant
humanity and illness. It is an acute incapacitating and deadly disease that has now reached
epidemic proportions and the prevalence rates are expected to go even higher in the
foreseeable future. Newly accumulated data show that approximately 150 million people
have diabetes global, and that this number may well double by the year 2025. Abundant of
this rise will occur in developing countries and will be due to aging, obesity, population
growth, sedentary lifestyles and

unhealthy diets. By 2025, whereas most people with

diabetes in developed countries will be aged 65 ages or more, in evolving countries most will
be in the 45-64 year age bracket and altered in their most productive years. Based on, Second
National Health and Morbidity Survey the overall prevalence of diabetes (known and newly
diagnosed) was 11.6% in those above 18 years and 14.9% in those above 30 years. There was
an increasing trend in prevalence with age, from 2% in the 18-19 year olds to an alarming

prevalence ranging between 20.8 26.2% among the 50 64 year olds. The prevalence was
significantly higher among urban compared to rural areas ( 12.1% vs 10.5%). No gender
difference in the prevalence was perceived. Based on civilization, the Indians had the highest
prevalence of diabetes (19.9%), followed by Malays (11.9%) and Chinese (11.4%). Those
with a primary education or less, have a higher prevalence of diabetes. There was no change
in the commonness of diabetes by income status. The national prevalence of identifying
diabetes, recently diagnosed diabetes and IFG between Malaysians above 18 years was 7.0%,
4.5% and 4.2% correspondingly. The whole prevalence of diabetes among adults above 30
years increased by 80% over a decade ( 8.3% in NHMS II vs 14.9% in NHMS III )
representing an average 8% rise per year . The prevalence of known diabetes in the same
group increased by 66% from 5.7% (NHMS II) to 9.5% (NHMS III). The prevalence of
newly diagnosed diabetes increased from 2.5% (NHMS II) to 5% (NHMS III), a rise of 12%
per year. These comparisons have to be done in cognizance of the methodological differences
in both the surveys (2 hours post glucose load performed in NHMS II vs fasting glucose in
NHMS III). In conclusion , the diabetes prevalence rate in Malaysia has risen much faster
than predictable, approximately doubling in magnitude over the last era. In view of this,
efforts in prevention and control of this chronic disease should be stepped up.
There are several risk factors for diabetes. Among them is the food pattern. Excessive intake
of food and not balanced with insulin secretion in sufficient amounts can cause blood sugar
levels to rise and will certainly lead to diabetes. Many argue that eating only include sugar
diet alone. Although sugar intake should be blocked, this does not mean that other foods can
be eaten as much. Apart from sugar, carbohydrates also should be reduced. Furthermore,
obesity factor. Nine out of ten obese people have the potential to attack diabetes. Obesity can
lead to diabetes as the cause of insulin resistance in which insulin produced by the pancreatic
beta cells less effective in lowering blood glucose levels. Based on the research from the
Malaysian Diabetes Association, the sugar level in blood people that are underweight are
more easily controlled. In addition, genetic factors. Diabetes can be passed from parent to
child. Genes cause diabetes will be brought by the child if the parents suffer from diabetes.
This inheritance can reach her grandchildren even though the risks are very small squeak.
Moreover, chemicals and drugs. The chemicals can irritate the pancreas that causes
inflammation of the pancreas. Inflammation of the pancreas will result in decreased
pancreatic function so there is no secretion of hormones including insulin metabolism
process. All types of drug residue that accumulates in a long time can irritate the pancreas.

According to National Institutes of Health, medication to prevent diabetes is still at an


experimental level in the United States. Drugs such as metformin found to reduce the
percentage of diabetes by 31%. Finally, the pattern of life also greatly influences the factors
that cause diabetes. People who are too lazy to exercise at a higher risk to infect with diabetes
because exercise will burn excess calories in the body. Calories accumulated in the body is
the main factor causing diabetes as well as dysfunction of the pancreas. Exercise is also
important but it should be started gradually and with the advice of a doctor.
Based on World Health Organization, insulin is a hormone that is produced by specialized
cells (beta cells) of the pancreas. (The pancreas is a deep-rooted organ in the abdomen
located behind the stomach.) Moreover to assisting glucose arrive the cells, insulin is also
vital in firmly regulating the level of glucose in the blood. Subsequently a mealtime, the
blood glucose level increases. In reaction to the raised glucose level, the pancreas usually
releases more insulin into the bloodstream to help glucose enter the cells and lower blood
glucose levels afterward a mealtime. After the blood glucose levels are decreased, the insulin
release from the pancreas is turned down. It is significant to note that even in the fasting state
there is a low steady release of insulin than fluctuates a bit and helps to maintain a steady
blood sugar level throughout fasting. In ordinary individuals, such a regulatory system
assistances to keep blood glucose levels in a tightly organized range. As defined above, in
patients with diabetes, the insulin is either non-existent, relatively inadequate for the body's
requirements, or not used appropriately by the body. All of these factors cause raised levels of
blood glucose (hyperglycemia).
In addition to the symptoms, diabetes can cause long term damage to our body. Firstly,
diabetes effect on the heart. Diabetes contributes to high blood pressure and is linked with
high cholesterol which significantly increases the risk of heart attacks and cardiovascular
disease. Secondly, diabetes affects the eyes. The major eye complication of diabetes is called
diabetic retinopathy. Diseased small blood vessels in the back of the eye cause the leakage of
protein and blood in the retina. Spontaneous bleeding from the new and brittle blood vessels
can lead to retinal scarring and retinal detachment, thus impairing vision. Then, diabetes
effects on the kidneys. Kidney damage from diabetes is called diabetic nephropathy. The
beginning of kidney disease and its development is tremendously variable. In the beginning,
diseased small blood vessels in the kidneys cause the leakage of protein in the urine.
Afterward, the kidneys miss their capability to cleanse and filter blood. Furthermore, diabetes
effects on the nerves. Nerve damage from diabetes is called diabetic neuropathy and is also

caused by disease of small blood vessels. Basically, the blood stream to the nerves is
inadequate, leaving the nerves exclusive of blood flow, and they get impaired or die as a
result (a term known as ischemia). Signs of diabetic nerve damage consist of aching, burning,
and numbness of the feet and lower extremities. Moreover, diabetes affects the skin. Diabetes
effect on the skin is usually a result of its effect on the nerves and circulation which can lead
to burns, dry skin, wounds, slow healing of cuts, fungal and bacterial infections and loss of
feeling in the foot. Apart from the physical effects, diabetes also has psychological and social
effects. That is the more reason why you need to take charge of your life and make your
health a priority.
There are various treatments for the diabetes. Firstly, insulin therapy. People who are infected
with diabetes require multiple insulin injections each day to maintain safe insulin level. Using
an insulin pump is an alternative to injections. Insulin is delivered through a small tube
(catheter) that is placed under the skin (usually in the abdomen). According to the UCFS
Medical Center, there are four main types of insulin which are rapid-acting, short-acting,
intermediate-acting and long-acting. Your doctor will determine your dose and how often you
need to take insulin. Then, oral medications. Sometimes blood sugar levels remain high even
though they eat in a healthy manner and physical activity. When this occurs, medications
taken in pill form may be prescribed. The medications job in some altered ways. These
consist of improved the efficiency of the body's natural insulin, trim down blood sugar
production, intensification insulin production and prevent blood sugar absorption. Oral
diabetes medications are occasionally taken in combination with insulin. Next, pancreas
transplantation. Kidney failure is one of the most common hitches of diabetes, and getting a
new pancreas when you receive a new kidney may actually improve kidney persistence. In
addition, after a successful pancreas transplant, a lot of populaces with diabetes no longer
required to use insulin. Furthermore, according to Los Angeles Chinese Learning Centre,
alternative therapies are treatments that have been studied to manage diabetes include
acupuncture, biofeedback, guided imagery, and vitamin and mineral supplementation.
Acupuncture is a method in that a practitioner inserts needles into designated aims on the
skin. Certain Western scientists trust that acupuncture triggers the release of the body's
natural painkillers. Acupuncture is sometimes used by people with neuropathy, the painful
nerve damage of diabetes. Biofeedback is a skill that helps a person become more aware of
and learn to deal with the body's response to ache. This alternative therapy stresses relaxation
and stress-reduction methods. Guided imagery is a relaxation procedure that some

professionals who use biofeedback do. With guided imagery, an individual thinks of peaceful
mental imageries, for example ocean waves. A person may also embrace the images of
controlling or curing a chronic disease, such as diabetes. People using this method believe
their condition can be relieved with these positive metaphors.
Last but not least, health is the most important element in life. Without good health,
daily tasks may not be completed properly. Proactive measures need to be taken by the
government and non-government with a more effective way as to enhance the awareness
campaigns. Therefore, we must be prepared to face and this is consistent with the Malay
proverb, "prepared for a rainy day". Failure to act promptly will see our society for diseaseprone diseases can also have an adverse impact. Finally, I want to stress here that a healthy
lifestyle should be a culture to ensure happiness in our lives. So, every individual must take
proactive measures to stay alive with happy because health symbolizes happiness. If steps are
not taken, of course, the desire to create a healthy and vibrant community will not be realized.
(1991 words)

REFERENCES :
1. World Health Organization, 2013. Diabetes, [online] Available at :
http://www.who.int/topics/diabetes_mellitus/en/ [Accessed 10 March 2013]
2. NHMS III Diabetes Study Group of Ministry of Health, Malaysia and Universiti Sains
Malaysia, 2006, PREVALENCE OF DIABETES MELLITUS IN MALAYSIA IN
2006 RESULTS OF THE 3RD NATIONAL HEALTH AND MORBIDITY
SURVEY (NHMS III). [e-journal] 1(1), Available at :
http://www.crc.gov.my/documents/abstract/prevalenceOfDiabetes.pdf [Accessed 9
March 2013]
3. Mafauzy M., (2006) Diabetes Mellitus in Malaysia. Medical Journal of Malaysia, 61
(4). pp. 397-398. ISSN 0300-5283, Universiti Sains Malaysia. Kampus Kesihatan.
4. Waspada News, 2010. Pengendalian Faktor Risiko Diabetes Mellitus [online]
Available at : http://waspadamedan.com/index.php?
option=com_content&view=article&id=3709:pengendalian-faktor-risiko-diabetesmellitus&catid=59:opini&Itemid=215 [Accessed 10 March 2013]
5. University of California San Francisco, 2002. Diabetes Mellitus Treatment [online]
Available at :
<http://www.ucsfhealth.org/conditions/diabetes_mellitus/treatment.html> [Accessed
12 March 2013]
6. Los Angeles Chinese Learning Centre, 2001. Diabetes Treatment [online] Available at
: <http://chinese-school.netfirms.com/diabetes-treatment.html> [Accessed 13 March
2013]
7. U.S. National Library of Medicine, 2012. Diabetes. [online] Available at :
<http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/> [Accessed 14 March
2013]
8. GS Vision Sdn Bhd, Malaysia. 2001, Diabetes [online] Available at :
<http://www.efarmasi.com.my/contents/selfcare/selfcare.asp?sfcrb=diabetes.htm>
[Accessed 14 March 2013]
9. Aminah Abdullah, 2012. Makanan dan Sensori [online] Available at :
http://www.ukm.my/penerbit/fx_009-2.html [Accessed 14 March 2013]

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