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

jazyboy

asalamualaikum....... DOKTOR IPES just nak tanya tadi pergi klinik hajat nak ambik darah utuk full blood test...tapi doktor klinik swasta nie ramai nak jumpa.....pastu dia just buat cucuk dekat jari yang letak darah dekat mesin kecik tue dengan bacan 5.4 mmol/L...tue bacaan diabetes ke atau masih normal...masa nie puasa.....semalam uji darah dengan kaedah sama dah breakfast lempeng dengan bubur nasi selepas dua jam bacaan 6.8 mmol/L...pakai alat yang kecik macam jam tue....jari kena cucuk pakai jarum kecik tue.....just nak tanya doktor...

ipes2

jazyboy posted on 30-10-2014 02:37 PM
asalamualaikum....... DOKTOR IPES just nak tanya tadi pergi klinik hajat nak ambik darah utuk full b ...

jb, 5.4 tu normal capillary fbg.
6.8 2hour postprandial tu maksud nye u ada impaired fasting glucose ie ifg.. ada risk for diabetes in the future

nasuha30

salam doc... jika glucose tidak semestinya rasa manis.. contoh nasi..mee kuning..
maka adakah semua yg manis itu mengandungi glucose... contoh kurma dan madu..

dalam Islam kurma dan madu dianggap makanan sunnah... jika ia mengandungi glucose..adakah ia berbahaya...?  sorry jika soalan ini too naive...

ipes2

nasuha30 posted on 4-11-2014 12:25 PM
salam doc... jika glucose tidak semestinya rasa manis.. contoh nasi..mee kuning..
maka adakah semua ...

wslm nasuha; its not like that.
as an organism, kita memang guna glucose utk metabolism..takleh lari dah.
other organism guna benda lain.. pokok guna benda lain etc etc.

so, almost semua makanan kita ada carbohydrate; akan tukar jadi glucose. apa apa yg ada dalam kurma and madu tu ok je semua.
yg penting jgn overeat je. makan apa pon if byk sgt will be detrimental.
minum air kosong byk pon boleh mati.

Dark_Vampire

ipes2 posted on 29-10-2014 04:53 AM
hmm.. boleh je..malah amat digalakkan.. especially if you buat resistance exercise eg angkat berat ...

heavy book xde...banyak magazine....mybe alternatif lain guna batu bata......kottt....

office mate age 50tahun baru2 ni cek gula dah 18.... tapi makan still non control
i ajak g gym reason penat x larat...letih n bla2....

ipes2

Dark_Vampire posted on 10-11-2014 09:48 AM
heavy book xde...banyak magazine....mybe alternatif lain guna batu bata......kottt....

office m ...

alamak 18 tu tinggi tu. umur baru 50.
nnt kidneys and mata and nerves rosak baru tau.
risk for heart attack and stroke also high tu if not treated or tak jaga makan.

also, if sugar tinggi dalam darah, akan jadi penat lah sebab cells yg perlukan sugar tu, bukan darah.. darah hanya bawak je sugar tu semua

Dark dah tumbuh muscles dah sebb gi gym?

Dark_Vampire

ipes2 posted on 12-11-2014 06:53 AM
alamak 18 tu tinggi tu. umur baru 50.
nnt kidneys and mata and nerves rosak baru tau.
risk for h ...

muscle skit jew kat lengan... klu amik protein mau berketul muscle...ha3

my friend tu i dh ajak die g gym ... die kate letih...n macam2 alasan... badan die mmg besar..
tinggi dlm 160cm berat 95kg-100kg... ...klu die x dapat buat berat2 sekurang2nya boleh jew die buat
benda2 ringan....burn kalori...semalam petang baru jew die ikot lepak ngan dark
order teh o suam n nasi goreng seafood...

ipes2

Dark_Vampire posted on 12-11-2014 09:09 AM
muscle skit jew kat lengan... klu amik protein mau berketul muscle...ha3

my friend tu i dh ajak ...

exactly..buat yg ringan ringan je..sambil tgk tv, guna 2kg dumbbell for 10 minutes each arm every night.

seenicecare

ipes2 posted on 28-10-2014 04:12 AM
SB, normal is 4-6; some says 4-5.9; americans sentiasa nak reduce this range further.
betul, T1DM ...

Salam, boleh terangkan lagi tak psl MOD dan LADA? Tq

nacuwin

nak tanye.

apa punca diabetes?
sbb kite tgk yg kurus pun ramai gak kene.

mohon nasihat?

ipes2

nacuwin posted on 27-11-2014 11:41 AM
nak tanye.

apa punca diabetes?

kencing manis disebabkan oleh badan kita tak begitu efficient utk metabolise carbohydrate.
untuk metabolisekan carbohydrate, ia mesti ditukar jadi glucose dan masuk kedalam cells.
untuk masuk kedalam cells, kena ada insulin utk 'bukak' cells tu.
kalau glucose tak masuk dalam cells, ia akan tinggal dalam darah, dan boleh rosakkan urat darah tadi, especially yg halus halus seperti didalam kidneys, brains, eyes, nerves, kulit, hujung kaki dan jantung.

yang kurus dapat Type 1 Diabetes (treatment: insulin)
yg gemuk dapat Type 2 Diabetes (treatment: kuruskan badan, kurangkan carb, bykkan exercise; if teruk, kena ambik ubat, if teruk lagi, kena guna insulin jugak last last)

ipes2

seenicecare posted on 27-11-2014 03:31 AM
Salam, boleh terangkan lagi tak psl MOD dan LADA? Tq

Wassalam.

For the more common types of DM, please refer to my answer for Nacuwin above.

MODY ni maturity onset DM of the young; ada berapa belas jenis tah MODY ni. tak common; jarang; kat mesia entah ade ke tak registry utk diagnose mody ni...maybe depa lump together with others eg t1dm or t2dm agaknya. if so, malanglah.
yg penting, MODY ni genetically passed on.
so, bleh dapat before umur 25.
byk problems of diabetes ni will surface dgn mody.
treatment taklah byk beza tapi takla pakai insulin.

LADA ni latent autoimmune diabetes of adults; mcm in its name, its autoimmune - your body produces antibodies against your own cells yg produce insulin in yer pancreas tu. cells tu berkumpulan, berterabur; nama cells tu Islets of Langerhans. dalam islets ni, bukan semua cells buat insulin, Beta cells dalam islets ni je yg buat insulin. bila u ada autoantibodies against beta islet cells ni, kurang la insulin production u; diabetic la you jadinye.
my Prof lebih suka panggil LADA ni 'diabetes type 1.5'. byk gak autoantibodies ni eg antiGAD etc. sebab u takde insulin, treatment u ialah inject insulin.

AwgSagi

Doc @ipes2
kalau boleh nak tanya produk komersial ni, MECOMIN, iklan kat TV3.

Saya nak cari ubat yg boleh melegakan rasa kebas kaki. Kalau jalan kat lantai rata tanpa alas kaki, terasa berjalan di atas batu2 kerikil. Tenaga pun dah jauh kurang.

MECOMIN ada yg equivalent dgn ubat hospital tak?

Ubat hospital saya: mixtard 30 (36iu / 22iu), metformin 2x2, daneuron 1, aspirin 1 & januvia 1.

Saya dah pernah minta doktor rujuk kat neuro, dia kata, neuro pun tak boleh tolong hilangkan kebas & needle pain tu. Turun gula jer opsyennya.

ipes2

AwgSagi posted on 13-12-2014 12:40 AM
Doc @ipes2
kalau boleh nak tanya produk komersial ni, MECOMIN, iklan kat TV3.

Askm, Awgsagi; sorry lambat reply, I oncall (dalam oncall semalam pon ada seorang wanita datang emergency sebab GP dia check sugar dia sbb dia penat selalu; sugar dia 26, ie diabetes la dia. I dah bagi lantus and correct her ketones etc. tgk la ape jadi nanti).

so u kene peripheral neuropathy la ni. I am sorry to hear that. di barat ni, we all guna duloxetine (Cymbalta 60mg), kekadang gabapentin (Neurontin), kekadang pregabalin (Lyrica), kekadang amitriptyline, etc etc.. (did u get my point? ie bila byk benda diguna utk sesuatu symptoms, itu makna nya symptoms tu jenis yg susah utk di treat; and neupathic pain is klike this lah ie susah utk di treat)

apa yg u ambik tu ie daneuron is actually vitamin complexes je ie b1, b6 etc; mecomin  ni pulak vit b12 derivatives rasanya, used mainly in Taiwan. byk u ambik vitamins ni, you kurang vitamin ke?

apa apa pun, I just tak nak u tertipu oleh marketing yg cuba jual products. di asia, even doctors jual products, and this is unethical.

yes, neurologist tak boleh treat diabetic neuropathy; a Pain Specialist boleh treat and here kita refer kes yg susah to these pain specialists.
try lah jaga sugar baik baik. buat exercise biceps guna dumbbell 2-3kg tu supaya20minit sehari..improve sikit sugar u.
u bleh jawab these questions on a private basis if u taknak org tahu: umur u, berat u, berapa lama dah kene guna insulin.
diabetics meds u r on ni bagus and your doctor have done well.

AwgSagi

ipes2 posted on 13-12-2014 03:57 PM
Askm, Awgsagi; sorry lambat reply, I oncall (dalam oncall semalam pon ada seorang wanita datan ...

Thanks Doc Ipes2 sebab reply.

MECOMIN tu saya tengok iklan kat TV3 jer, belum ambil lagi.

Setakat ni saya guna ubat hospital yg Doc GOV saya bagi sahaja.

Dulu dia pernah bagi amitriptylene masa 1st time saya komplen susah tidur sebab needle pain tu. Tapi, saya rasa tak berkesan, mungkin saya expect sudden result masa tu.

Vitamin B tu dia bagi utk membantu urat saraf.

First time kena simptom tu, saya search internet. Then, print out dan tunjukkan kat Doktor yg 1st time saya jumpa. Dia baca dan respon dia sangat baik & nasihat jgn risau yg penting kurangkan gula dan maintain level. Saya tanya apa jenis exercise utk saya samada jogging atau jalan cepat. Dia suggest yg sesuai ialah berenang then cycling supaya berat badan tidak membebankan kaki yg sakit.

Thanks advicenya Doc. Insyaallah ada saya PM nanti.

Post ni utk acknowledge reply Doc. :-)

ipes2

AwgSagi posted on 13-12-2014 08:59 PM
Thanks Doc Ipes2 sebab reply.

MECOMIN tu saya tengok iklan kat TV3 jer, belum ambil lagi.

Thank you.
Vit B12 amat perlu utk badan for the nervous system integrity; if you are low in it, then it is wise to take vit b12 supplement. if your level is not low, taking it will not improve your diabetic neuropathy. taking it will only crete an excess, and your body will get rid of it as waste sahaja.

your meds yg doctor you bagi are very good as I said before.

overall, diabetic neuropathy is incurable, cuma the symptoms of it can be reduced, but as I said before, with mixed effectiveness.
you should concentrate on keeping the sugar levels low, keeping creatinine low and keep fit.

berenang as your doctor said is good, but u kene book slot kat kolam renang, hen u have to go there, change and then berenang; then u kenen balik umah. ni semua makan masa dan ramai org boleh buat benda benda cam ni including gym etc, just for 3-5 years je..lepas tu penat dan keinginan utk terusklan pon hilang.

yg u bleh buat setiap hari all your life is what I mentioned in my first reply. I will check u out in the PM

AwgSagi

ipes2 posted on 15-12-2014 04:24 PM
Thank you.
Vit B12 amat perlu utk badan for the nervous system integrity; if you are low in it, t ...

Low nervous system integrity ada simple explanation tak?

Dan, apa simptom2nya?

Adakah daneuron itu penenang supaya fikiran kewl & tak worry tentang rasa needle pain tu?

Ubat yg kena bagi masa tu, daneuron & amitriplene tak beri kesan. Keduanya dimakan malam hari.

Saya banyak berjumpa dgn individu2 yg ada simptom cucuk2 jarum randomly kat badan. Ada yg opt jumpa 'scanner', perawat tradisi, etc except doktor hospital. Saya pity pada yg dah set mind: "penyakit cucuk jarum tu akibat dari perbuatan other party".

ipes2

AwgSagi replied at 15-12-2014 11:42 PM
Low nervous system integrity ada simple explanation tak?

Dan, apa simptom2nya?

eh.. tak dapat notifictions pon pasal message ni.. sorry ye tak jawab sebab mmg tak tahu.. if tau I mmg jawab.
Low integrity? hmmm.. kurang fasih la pulak.
pasal meds tu, u maybe kean increase dosage nyer..
..tetapi yg penting is the HbA1c controls tu kene better, and blood sugar kene improved

Apa perkembangan awak ek?

AwgSagi

Ayat 'low system integrity' to @ipes2 sebab ipes ada bagitau vit b12 tak perlu makan kecuali system integrity  low.
Belum lama ni saya masuk wad sebab ada bengkak kat peha kiri yg didahului dgn fever.
Saya tak pasti ia bisul. Kad wad saya diberi suntikan antibiotik - dlm 5 hari. Ia membengkak tapi tak dibedah sebab doktor cakap nanah ada sikit tapi deep bawah urat besar. So sambung antibiotik. Sekarang ni bengkak dah mengecil dan tak sakit. Kawan saya, juga doktor, agak itu CARBUNCLE? Saya surf info tu, ada kesamaan.
Gula masa kat wad kira OK lah. Saya belum tanya tentang HB tu.
As of now tengah tunggu Q panggilan doktor pakar follow-up kes peha bengkak tu.
Tak balik bercuti ipes?

ipes2

AwgSagi replied at 17-3-2015 01:20 PM
Ayat 'low system integrity' to @ipes2 sebab ipes ada bagitau vit b12 tak perlu makan kecuali system  ...

Vit B12 tu you take only when it is low in your blood system; sebab it controls the integrity of the Nervous System. If your B12 is not low, tak payah la ambik sebab it will just be discarded by the body.

Regarding the 'bisul' in  your peha tu, what did the MRI show? Did it show an abcess? Did it show a tumor? Did it show a blood clot ie DVT?
However, becoz they used antibiotics on you, tu suggests to me that depa thought it was some kind of infection.


Apa meds yu and your HbA1c?