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KENCING MANIS / DIABETES: ask your questions here...

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Author: ipes2       Show all posts   Read mode

Post time 24-5-2015 09:15 PM | Show all posts
Salam doc,

Pada umur i 33 i masuk hospital sbb asthma attacked, dan masa tu baru i tau i ada diabetes 2 , berat badan i 80kg masa tu i tak kuat mkn tapi i suka mkn malam dan minum pepsi...dalam sehari imblh habiskan 2 litre pepsi...the keje very stressful sbb tu i selalu keluar supper dgn kawan2..

Dokto bg treatment utk kawan my diet n gula dlm darah...i hv my personal trainer utk trained i turunkan berat badan...alhamdulilah i've lost 10kg dan gula dlm darah terkawal...dan asthma i pun dah beransur pulih..

Umur 37 ii was pregnant n gula i naik mendadak sehingga terpaksa injek insulin kat perut sampai kandungan i lahir tak cukip bulan dan mengalami kompikasi jantung..selepas bersalin gula i kembali normal bawah 10 selepas makan dan i kerap mengigil sbb gula turun 3-4..

Masa umur i 38 hingga skrg 41,  i stop makan ubat diabetes sbb rasa mcm dah boleh kawal pemakanan i....i selalu chck gula i so far bawah 10 bila lepas makan dan kalau i puasa gula i 5-6, tp selalu i dpt 3-4 sampai mengigil badan i....thats why i stop amik ubat diabetes dr doktor..

Now berat badan i 60kg tinggi 158cm, i selalu kawal pemakanan i , aktif dgn aktiviti marathon, fun run dgn kawan2 yg sewaktu dgnnya, minum air masak yg sejuk sekurang2nya 3 litre sehari tapi selalu lebih dan satu je masalah i , i ketagih air Coke!!! Utk hilangkan rasa ketagih i minum air sejuk2!! tapi sekali i minum coke i blh habiskan 1 liter coke sehari .... Lepas tu i menyesal and minum air masak byk2!!

Please help me doc!! Should i take the diabetes med or i continue with my diet n trying my best to avoid COKE!! Minuman lain i boleh tak de selera but not COKE!

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Post time 25-5-2015 03:34 PM | Show all posts
salam doctor @ ipes

bersyukur nya saya dapat jumpa doctor k.mnis ni d forum
saya ada banyak soalan doc...

masa saya preggy lepas mnum air gula tu bacaan gula sy 7.1
tapi kenapa ye doctor...bila kena puasa n cek bacaan darah saya semua bawah 5...
ada sekali tu sampai 3.4..nurse tanya saya...ada rasa pening ke?tapi memang xde rasa apa pon

lagi pulak, lepas bacaan gula saya 3.4 tu...saya trus buat kajian
g beli soya bean dlm tin tu n mnum n makan nasi...
tapi sy guna beras faiza tajmahal...yang memang tulis utk diabetic tu
n cek darah utk petang pon 4.9 masa tu

lepas bersalin saya xpergi cek lagi bacaan gula saya...huhuhu...takut plus kerja tengah banyak masa tu
saya nak tanya doctor kan...kalau saya buat full medical check up
kena minum air gula x? kenapa ye kena minum air gula tu
saya risau betul....kenapa time minum air gula aje bacaan gula saya tinggi...tapi bila xminum xde apa pulak ye doctor?

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 Author| Post time 25-5-2015 05:06 PM | Show all posts
kiahbosan replied at 24-5-2015 09:15 PM
Salam doc,

Pada umur i 33 i masuk hospital sbb asthma attacked, dan masa tu baru i tau i ada dia ...

waalaikumussalam Kiah, maaf delay sikit sebab weken tadi sebok potong rumput kat belakang rumah yg dah jadi macam hutan; rumput i ni perennial..summer je naik 3-5 cm seminggu.. takpelah, tu masaalah saya.. Now, masaalah awak.

Asthma improved togetehr with T2DM / weight: memang; i baru buat research dalam ni and dah publish.. tapi kami guna Victoza
Masa awak ngandung tu mmg lah DM akan jadi..gestational DM ie GDM; kat sini kita bagi insulatard dan control the blood sugar levels (BSL) very tightly.. sampai hypo-hypo mothers kat sini (ie BSL <4!!).. dan bila naik sket je kita bawak masuk spital... semuanya demi utk elak kerosakan pada foetus; im very sorry to hear that in your case, they maybe wasnt too strict so that the BSL was higher and impacted on the baby.

u kata bila u dah post-partum (after-pregnancy punyer interval) that your BSL was 3-4; these are hypoglycaemic episodes and this is dangerous. you kena continue makan ubat DM especially metformin, tetapi you maybe tak boleh makan gliclazide sebab this can cause hypoglycaemia. however, you shouldnt be happy with BSL 'below 10'; try to main in near nomal range as much as possible. sugar ni tak boleh dibiar dalam urat darah..dia bleh rosakkan urat darah tu, esp yg halus halus eg in brain, kidney, heart, nerves.. cuba u bayangkan 8 jam u tido, sugar yg level 7-8 tu dok rosakkan urat urat darah u dlm 8 jam tu... org lain dok tido sedap je 8 jam.

summary: congratulations on the weight loss down to 60kg, maintain it please. keep BSL near normal, avoid hypos; continue DM meds tho probably without gliclazide; exercise daily eg 30 mins fast walking utk bakar sugar yg dalam darah u tu

there is so much sugar sugar in Coke, u mcm tak caya if u tgk..i baru je delete pics nyer.

Request: Please give me 7 pre-breakfast BSLs u in the last 7 days (jgn tipu); please give me your last 2 HbA1C.

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 Author| Post time 25-5-2015 05:23 PM | Show all posts
yayangmama replied at 25-5-2015 03:34 PM
salam doctor @ ipes

bersyukur nya saya dapat jumpa doctor k.mnis ni d forum

waalaikumussalam Yayang,

First thing first, bila doctor check gula kita, BSL kita di ambil before and after sugar load (look at Kiah's answer above for BSL).
This is called an Oral Glucose Tolerance Test (OGTT). How we do it: u fast from midnight, u come to the clinic and we take your Fasting Blood Glucose (FBG). Terus we give you 75g sugar diluted in water: u minum; 2 hours after, we will chekc your FBG again.

If reading macam u ni ie fasting within normal limit and after sugar load it is less than 7.8mmol/l, then this is normal lah.

May I ask if u have Diabetes? U kata '..lepas bersalin...'; kenapa? BSL u tinggi ke masa tu? if so, this is called GDM (see Kiah's answer); if ada GDM, the risk for u to become a full Diabetic patient is a lot higher lah.

In any case, i kena let u know that hypogflycaemia ie BSL <4.0 is dangerous and u sepatutnya ada symptoms eg tremor, confusion, hunger, sweating; these are called neuroglycopenic symptoms.

Rice: apa apa pon ni Carbohydrate and is a major source for energy which, in humans, is in the form of glucose... jadi, ini perlu dikurangkan.

So, u ni ada DM ke GDM?

Ipes BMedSc MB BCh BAO DipCVS&StrokeMed MSc AFRCS MRCS MRCP

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 Author| Post time 25-5-2015 05:28 PM | Show all posts
kiahbosan replied at 24-5-2015 09:15 PM
Salam doc,

Pada umur i 33 i masuk hospital sbb asthma attacked, dan masa tu baru i tau i ada dia ...

..also Kiah, jgn mkn malam malam; energy dari makanan mlm ini tak di bakar, nnt bersepah sepah energy tu, dalam bentuk glucose, dalam darah awak semasa awak tido; after 8pm, no more carbs / or really any food... biscuits sekeping dua boleh la; also; cut off the coke... or, buat sendiri je coke tu: ie u ambik about 8-10 sudu besar gula, masuk kan dalam cawan, bancuh dalam air, masukkan sesudu dua sarsaparilla nyer perasa, letak sikit baking soda suruh buih, then u minum: lebih kurang coke la tu (DONT DO THIS!)
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Post time 26-5-2015 10:17 AM | Show all posts
ipes2 replied at 25-5-2015 05:23 PM
waalaikumussalam Yayang,

First thing first, bila doctor check gula kita, BSL kita di ambil befo ...

hehe....thanx a lot doc

saya lepas bersalin xpernah cek lagi...
tapi masa preggy yg mnum air gula...MGTT tu ye nama dia doc...7.1
risau sangat doc sebab kulit saya sekarang ni asik lah berkudis....
since preggy lagi....ingat lps bersalin da ok...
tapi jadi lagi...gatal yang amat...saya garu bekas jadi kudis n hitam2...
masa preggy saya pernah pegi cek kat doc swasta...
dia tnye saya u ni ada k.manis ke?huhuhuh...
sekarang ni memang ada niat nak pegi cek....tapi nak tunggu one sweet time la doc...
sebab masih xbersedia lagi nak dengar doc kata saya ada penyakit tu...huhuhu
tapi saya jaga juga makan...rajin mkn ulam semua...
dah lama sangat xminum air bergas...4-5 tahun ade kot...sebab sy memang xsuka sangat
cuma time kecik2...memang mak saya bagi saya glucose...
itu salah satu sebab juga ke doc?


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 Author| Post time 27-5-2015 06:06 PM | Show all posts
yayangmama replied at 26-5-2015 10:17 AM
hehe....thanx a lot doc

saya lepas bersalin xpernah cek lagi...

kudis kudis kecik kat kulit ni kadang kadang tanda diabetes tau.
ala, gi la check dgn doctor kat OPD.
ada je clinic kerajaan yg free kan? gi fasting satu hari..biar dia buat fasting blood glucose, HbA1c, cholesterol profile, kidney profile.
tu je.
sy amik sendiri je darah sy.. amik jarum, cucuk, dan tube kan kedalam botol

glucose load mmg boleh increase risk diabetes, if byk sgt; maybe amount yg mak u kasi masa kecik tu sikit je kot
gi chekc BSL tuh

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Post time 27-5-2015 09:42 PM | Show all posts
sekiranya seseorang itu masih ditahap terkawal, adakah boleh mengamal kaedah tanpa mengambil ubat? maksudnya dgn mengamalkan permakanan yg sihat dan senaman.
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 Author| Post time 27-5-2015 11:37 PM | Show all posts
musliadiadnan replied at 27-5-2015 09:42 PM
sekiranya seseorang itu masih ditahap terkawal, adakah boleh mengamal kaedah tanpa mengambil ubat? m ...

yes of course.. inilah aim kitorang di eu ie screen early dan keep pts as diet-controlled diabetics for as long as possible.
cheaper for healthcare, healthier for pts
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Post time 28-5-2015 10:50 AM | Show all posts
thanx ye doc @ ipes

saya bukan xnak pergi...
baru2 ni saya bawa husband saya check full body kt swasta baya rm300
haha...saya bawa dia...tapi saya xnak pegi...
belum bersedia lagi la doc...takut nak terima kenyataan

betul tu doc...saya ada baca tentang penyakit ni...n
memang ada tulis pasal kua gatal2 kan...

adui doc....ini yang buat saya lagi takut nak pegi...hehe

saya ada alat yang cek glucose tu doc...
beli masa preggy las year
tapi nya...bila x minum air gula...
bacaan maintain below...paling tinggi pon kalau time pagi tu after fasting 4.5

anyway thanx a lot ye doc...
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Post time 28-5-2015 02:30 PM | Show all posts
saya salah seorang pengidap diabetes
setuju dgn doc.
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 Author| Post time 30-5-2015 07:41 PM | Show all posts
yayangmama replied at 28-5-2015 10:50 AM
thanx ye doc @ ipes

saya bukan xnak pergi...

Yayang,


eh pegi la chek; saya paham la semua ada rasa reticent pegi jumpa doctor ni; saya sendiri pon bila kena pegi jumpa doctor saya, memang tak suka; nnt dia ngomel pasal FBG saya (6.1, slightly elevated; chol 5.2 hampir tak normal).. tapi u kene la do this

(RM300 ye?? fuhhh!! kaya kaya docs in mesia nnt!); pegi je buat..ok worst case scenario, ialah docs bagi tau u ni Diabatic.. so what; millions daiabetics kat Nusantara tu; also, if u know, u tak lagi takut. gi je buat; do FBG, HbA1c, U&E, LFT, TFT. free je la semua ni.

... oh sorry..u ada glucometer ek? ok lah gitu..so your capilary blood glucose(CPG) pepagi (ie fasting, ie u tak mkn apa apa from midnite till time buat CPG tu ) is very good. normal tu; buat lah sekalai FBG, HbA1c; im sure they will be normal. sorry lambat balas i postcall.. baru balik n tido n bangun and now pening where am i what time is this bla bla (1245 tgh hari)

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 Author| Post time 30-5-2015 07:43 PM | Show all posts
damia189 replied at 28-5-2015 02:30 PM
saya salah seorang pengidap diabetes
setuju dgn doc.

nk u damia; alah, DM jugak ke? jaga berat badan dan jada pemakanan OK?
sorry lambat balas i postcall tgh tak sure pukul berapa and therefore cstarted commenting on songs in my youtube accounts ha ha
have a good day
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Post time 31-5-2015 09:39 AM | Show all posts

Insyaallah doctor....i will pegi check....
hehe...million thanx ye doctor..
kalau baca2...u ni mesti rajin ber holiday ye doctor


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 Author| Post time 31-5-2015 07:48 PM | Show all posts
yayangmama replied at 31-5-2015 09:39 AM
Insyaallah doctor....i will pegi check....
hehe...million thanx ye doctor..
kalau baca2...u ni m ...

tak berholiday byk pon la.. mahal Sis (i dpt modal pakai sis ni sbb dalam thread 'Isu Semasa>Maradona Buka Emas Di NU Sentral' depa dok greet i dgn Sis... agaknya ada nampak tali bra dalam avatar i tu )

ari tu bercutilah ke Malaysia 3 minggu; maju Malaysia. memang sgt best!
ari ari lain tu maybe sebab ada conference so terpaksa la pergi hu hu pergi tanpa rela
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Post time 11-6-2015 09:55 PM | Show all posts
Diabetes ni boleh berlaku dekat orang muda tak doctor? Dalam umur 20-30an macam tu.
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 Author| Post time 12-6-2015 12:09 AM | Show all posts
ice_sky92 replied at 11-6-2015 09:55 PM
Diabetes ni boleh berlaku dekat orang muda tak doctor? Dalam umur 20-30an macam tu.

yes, budak kecik pon bleh dapat
babies pon
jugak, kucing, anjing..
..so kekadang u tgk anjing tuan dia bagi insulin injection etc..
..cute je
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Post time 12-6-2015 12:25 AM | Show all posts
ipes2 replied at 12-6-2015 12:09 AM
yes, budak kecik pon bleh dapat
babies pon
jugak, kucing, anjing..

Thanks for the reply. Actually, dulu masa studi dekat U ada kena acid dalam lab. Kena sikit dekat tangan. Kesan melecur dia lambat sembuh (skg dah ok). Tu yang risau ada kencing manis ke. Kadang-kadang selalu kencing malam gak.

Nak check kat klinik segan pulak sebab muda lagi. Hopefully xde apa-apa la. Saya jarang joging pulak tu sebab takde masa sangat. Huhu.
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 Author| Post time 12-6-2015 12:55 AM | Show all posts
ice_sky92 replied at 12-6-2015 12:25 AM
Thanks for the reply. Actually, dulu masa studi dekat U ada kena acid dalam lab. Kena sikit dekat  ...

Type 1 Diabetes:
org yg diabetes ni byk glucose dlm darah depa (hyperglycaemia).
'pekat' lah darah depa
nnt dalam buah pinggang, sebab 'pekat', maka byk la air yg masuk dalam tubes yg akan buang kan air dlm tubes tu sebagai air kencing, alah mcm osmosis gitu.
jadi, org yg DM ni, if not treated, akan kencing banyak lah (polyuria)
mlm mlm kan sunyi, jadi sedikit ganguan pon akan bangunkan kita.. juga dalm bladder ade satu area yg senstitive nama trigone.
bila u baring, trigone ni akan kena air kecing tadi jadi u rasa nak kencing.
jadi, u pon bangun malam utk kencing (nocturia)
bila byk air keluar dari badan, maka kita dahagalah, lalu kita minum byk byk (polydipsia)
sebab glucose yg kita amik ni asek dibuang je, byk la sugar dalam urine (glycosuria)
jadi sel badan tak dapat la guna glucose ni, letih la badan (lethargy)
nnt sel pon korbankan tissue tissue bdn yg lain utk dapatkan energy, maka, keciklah muscles, fat etc.. makan kuruslah org tu (cachexia & weight loss)
tissue tssue tadi bukan bleh buat glucose pon, dan saki baki bakarn dia ialah ketones, maka byklah ketones (ketosis)
ketones ni bleh jadi gas lalu bleh dinafaskan keluar (sikit je).. bau dia mcm manis manis gitu (ketotic foetor)
ketones ni acid, sekejap je, penuh acid lam darah (acidosis)
maka org tu pon becomes really unwell dna bleh dapat seizures dan pengsan (diabetic ketoacidosis, DKA)
jap je DKA, terus coma, dan mati lah.
hyperglycaemia, glycosuria, nocturoa, polyuria, polydipsia, cachexia, ketosis, ketotic foetor, acidosis, DKA, DKA coma: ni lah mcm mana org tu bleh mati

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Post time 12-6-2015 01:10 AM | Show all posts
ipes2 replied at 12-6-2015 12:55 AM
Type 1 Diabetes:
org yg diabetes ni byk glucose dlm darah depa (hyperglycaemia).
'pekat' lah da ...

Huhu. Bahaya type 1 diabetes ni ye. Insyaallah lepas ni akan rajin bersenam dan tukar permakanan. Ada masa nanti nak check kat klinik. Btw, thanks doc for the explanation. Really appreciate it.


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