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

ipes2

dmerahjambu posted on 11-10-2014 03:14 AM
salam doktor...mj nak tanya boleh tak pesakit diabetis nak pregnant...peluang utk mengandung tu ada  ...

of course..cuma risiko agak tinggi
risiko to both mom (eg for worsening diabetic control) and fetus (eg macrosomia etc; there are some evidence that even the chance for fetal malformation is higher if maternal sugar control is poor)
here, we keep the blood sugar levels (BSL) in a very narrow band, ie really strict control; we put then on medium acting insulin BID (bis in die; ie twice a day)

so, no problem with fertility, yes you can get pregnant
but there are risks to both if the mom doesnt look after the sugar better

dmerahjambu

ipes2 posted on 11-10-2014 05:49 AM
of course..cuma risiko agak tinggi
risiko to both mom (eg for worsening diabetic control) and fet ...

thanks doktor...takpe lah ade risiko pun takpe janji mj nak baby...anak mj pun dah nak masuk 4 tahun...mj kesian tgk dia sorang2....perempuan pulak tu...takut esok dia akan jadi sebatang kara seperti mj...anak tunggal sungguh sunyi dan sepi ....doktor ada tips tak utk mj pregnant...selain menjaga kandungan gula....selepas gugur pada tahun 2012...mj masih lagi berusaha untuk mengandung....kesian pada encik suami die teringin sgt nak anak....

ipes2

dmerahjambu posted on 12-10-2014 04:59 PM
thanks doktor...takpe lah ade risiko pun takpe janji mj nak baby...anak mj pun dah nak masuk 4 tah ...

if you have had a successful pregnancy, your chance of getting another is good.
do take folic acid before you decide to conceive to prevent spina bifida
do look after your Diabetes
check that you dont have hypertension or thyroid problems
where i live, these are very strict and people with hypothyroidism are kept in a very narrow TSH (we prefer TSH <2.5)
good luck; ada rezeki nanti insyaAllah you will get another child.

azie_fariza

Risaunya....suami saya tiba2 jadi kurus kering, pucat, nampak sakit fizikalnya. bila cek di klinik, diabetes rupanya.
Bacaan 22. Doc klinik bagi ubat. Since then, dia makan ubat dan nampak sihat dan segar walaupun badannya masih kurus.

NAmpaknya saya kena study banyak bende nie utk uruskan pemakanan dia....
Hari2 saya blender peria katak campur dengan epal hijau bagi hubby minum.
Gula pun guna pengganti gula yg bentuk titis tu.

ipes2

azie_fariza posted on 13-10-2014 04:48 PM
Risaunya....suami saya tiba2 jadi kurus kering, pucat, nampak sakit fizikalnya. bila cek di klinik,  ...

In this country if your blood sugar is 22, we will admit you immediately.
How old is your hubby?
What is the meds given?
Was it insulin? If so, what type.

Give me these readings; ask from your doctor, kata kawan yg keje doctor nak tau:
Fasting blood glucose
Blood glucose yg dia check guna glucometer from the fingers first thing dia bgn pagi pagi.
HbA1C
Urae
Creatinine

Tu dulu buat masa ni.
BSL 22 ni is too high to let pts go home again. Ngarut je.

monreyes

ipes2 posted on 29-9-2014 04:21 PM
Innalillah, im very sorry to here your mum kene amputation.
If surgeons kata kena buat lagi sampa ...

kalau urat darah kat kulit rosak, apa efek dia doc?
adakah pesakit akan dapat kegatalan etc..?

ipes2

monreyes posted on 15-10-2014 01:33 PM
kalau urat darah kat kulit rosak, apa efek dia doc?
adakah pesakit akan dapat kegatalan etc..?

...

bila the small capilaries in the skin dah rosak eg due to diabetes or smoking, the skin will have little nutrition delievered to it (chekc google image).
nanti nerve yg supply that skin area pon gets less nutrition.
that skin will then: lose its hair, nmpk shiny, u get pins and needles, u will get dysthaesia, rata gatal2, kekadang u get discolorations; then skin jadi thin and mudah luka; then u will get ulcer that just wont heal; nak heal camaner blood supply dah tak ade..dah tak ade la building materials yg dtg ke situ. infections pon sets in; ambik antibiotiks pun, tak smapai kat ulcer tu sebab blood supply dah takde utk bawak antibiotics molecules kat situ; letak topical antibiotics pon tak jalan gak sebab no more blood capillaries yg boleh absord that antibiotics..when melarat dan tak jga sembuh, it will spread to the muscles and tissue planes or bones and will need amputation

HARRIER28

Salam doc,sy Nk tanya,kalau ada kencing manis tgh pregnant,apa jadi kat Baby dgn ibu KAlau hypo.

ipes2

HARRIER28 posted on 21-10-2014 08:31 PM
Salam doc,sy Nk tanya,kalau ada kencing manis tgh pregnant,apa jadi kat Baby dgn ibu KAlau hypo.

wslm h28,

sebenarnya, the state of preganancy kicks start a whole lotta hormonal and metabolic changes designed to increase maternal blood sugar so that this will cross the placenta to nourish the growing fetus. so, pregnancy, most of the time is associated with worsening and challenging hyperglycaemia. tapi, hypo bleh gak jadi esp in first trimester..mainly affecting mom..fetus are often not majorly affected.

if hypo terjadi jugak to the mom somehow instead of hyper, then elok di manage of an endocrinologist sebab really bahaya to mom; if mom dapat hypoglycaemic seizures, maka bleh jugak affect the fetus. kene makan meals frequently eg 7-8 kali sehari. also, if the mom tu is on OHA ie oral hypoglycaemic agents then these have to be reviewed; if on insulin then insulin regime tu have to be modified by an endocrinologist.

baby pon boleh dapat hypoglycaemia..especially bila the mother had poorly controlled blood sugar masa pregnant. This high maternal blood sugar will cross the placenta into the foetus's blood..the fetus then will try to protect itself from the damaging high blood sugar; it protects itself by producing a lot its own insulin; when the fetus is born as a neonate, it suddenly loses the maternal high blood sugar and its still elevated insulin in its body will then cause neonatal hypoglycaemia about 2 days after delivery.

where I live, the management of a diabetic pregnant women is very strict

HARRIER28

ipes2 posted on 22-10-2014 03:32 AM
wslm h28,

sebenarnya, the state of preganancy kicks start a whole lotta hormonal and metabolic  ...

If mama not feeling well and xberapa lalu Nk mkn,kena mkn jugak lah yer utk mengelakkan hypo ye?!anyway tq doc

ipes2

HARRIER28 posted on 22-10-2014 06:53 AM
If mama not feeling well and xberapa lalu Nk mkn,kena mkn jugak lah yer utk mengelakkan hypo ye?!a ...

yes exactly... cuma, jarang sikit rasa tak lapar if pregnant; the brain dan enzyems and hormone systems in our body always activated towrds eating more bila pregnant. if yg sebaliknya berlaku, then kena check dgn doctors; adakah thyroid ada problems, liver enzymes ok ke tak; ada gastritis atau acid reflux ke yg causing appetite kurang..

hantu_poyos

Doc org diabetis leh exercise yg hardcore mcm main gym ke?

storyboard

Doc, apa bacaan normal sugar untuk orang yang healthy? I memang kurang sket knowledge pasal diabetes ni but would like to know about it..

As far as i know (pembacaan) ada 3 type of diabetes,kan? Type 1, Type 2 dan GDM (Gestational Diabetes)...

Type 1 juga dipanggil juvenile onset diabetes - terjadi kesan dari auto-immune reaction bila sistem pertahanan badan diserang oleh sel yang menghasilkan insulin. Mengapa ini terjadi tidak diketahui sehingga sekarang.Pesakit yang menghidap type 1 ini mungkin ada sedikit saja atau tiada sama sekali insulin dan type 1 ini biasanya menyerang kanak-kanak atau remaja. Penghidap type 1 totally bergantung pada suntikan insulin setiap hari untuk kawal kadar glukos dalam darah mereka. Ketiadaan insulin boleh menyebabkan kematian

Type 2 adult onset diabetes - 90% dari kes diabetes tergolong dalam type 2. Yang ini very straight forward. Terjadi disebabkan obesity dan tiada pengawalan dalam pengambilan gula. Type 2 ini boleh dicegah dan dikawal melalui cara hidup sihat (senaman dan diet yang betul).

GDM - Terjadi semasa hamil (bagi wanita). Komplikasi boleh berlaku pada kedua ibu dan anak. Tetapi kebiasaannya GDM akan hilang selepas kelahiran. Walaubagaimanapun, si anak dan si ibu berisiko tinggi untuk menghidapi type 2. Kebiasaannya type 2 menyerang dalam masa 5-10 tahun selepas kelahiran..

Just nak share, ada kenalan saya yang sihat walafiat semasa bujang tetapi semasa kehamilan,dia disahkan ada GDM, selepas deliver, dia disahkan mengidap type 1. Memang kejutan hebat sebab dia bukannya seorang yang gemar minuman manis dan tiada masalah obesiti langsung. Ini semua dugaan dariNya..

Wallahualam..

ipes2

storyboard posted on 27-10-2014 02:15 AM
Doc, apa bacaan normal sugar untuk orang yang healthy? I memang kurang sket knowledge pasal diabetes ...

SB, normal is 4-6; some says 4-5.9; americans sentiasa nak reduce this range further.
betul, T1DM memang gitu. Tapi ada juga late onset T1 ie omo dah 30-40 tetiba dapat T1DM.
Tapi ada jugak MODY (Maturity Onset Diabetes of the Young); MODY1, MODY2,MODY3. Lain nih.
Also ada LADA (latent Autoimmune Diabetes of Adults); ni jugak lain.
Yes, T2DM memang camtu. Tapi ramai gak T2DM nnt kene guna insulin
Also, some meds can increase sugar in blood and can brings out DM in susceptible people eg steroids, pasireotide etc etc
Yep, GDM pon gitu lah.
Bagus SB; kita kene tahu diseases ni. Ramai org tak tau pon Darah Tinggi tu amende.

storyboard

Thanks for the good info doc. Now I'm a bit clear. I pun pada awalnya ingatkan amik banyak gula, kena kencing manis..

ipes2

storyboard posted on 28-10-2014 04:31 AM
Thanks for the good info doc. Now I'm a bit clear. I pun pada awalnya ingatkan amik banyak gula, ken ...

exactly; ramai org kita di mesia minum air the or kopi tanpa gula and they think that defines healthy living;..padahal minum air tu dgn Nasik lemak sepinggan besar dgn sambal ikan bilis penuh minyak..( actually sedap kemain he he..cuma not healthy)

ipes2

hantu_poyos posted on 25-10-2014 06:11 PM
Doc org diabetis leh exercise yg hardcore mcm main gym ke?

hmm.. boleh je..malah amat digalakkan.. especially if you buat resistance exercise eg angkat berat guna heavy books 10minits tgn kira then 10 minits tgn kanan everyday; byk bakar extra gula camni

storyboard

ipes2 posted on 29-10-2014 04:51 AM
exactly; ramai org kita di mesia minum air the or kopi tanpa gula and they think that defines heal ...

tul tu doc.. glucose bukan hanya dalam bentuk gula atau krimer manis.. nasi tu pun ada gula, mee kuning tu pun ada gula.. cuma dia tak rasa manis macam gula.. orang malaysia nie kurang layan air masak.. nak abiskan segelas sehari pun kadang-kadang susah.. apa pendapat u doc, if amik gula dan pada masa yang sama, everyday buat weight training dan exercise? is it help to avoid you from getting diabetes?

ipes2

elok di elak glucose overload ni sebab beta islet cells dalam pancreas tu ada finite lifespan; nanti dia kene work very hard producing insulin utk cuba handle the glucose-laden intake tu. if ada adipose tissue extra sikit je, terus bertambah kerja pancreas tadi (because adipose tissue provides resistance to insulin). overall, kita guna, maybe the equivalent of , dunno 20-30 unit insulin sehari? the more u ambik gula, the more insulin ni u pakai.

some people ada capacity utk produce insulin utk, say 50-60 thn, some people 90-100 thn etc. suatu hari nnt semua org akan kehabisan insulin juga akhirnya.

storyboard

thanks banyak2 doc.. ur explanation really helps..