Diabetes is due to a relative lack insulin secretion to its demand by the body. Insulin is a hormone produced by the pancreas that opens the access on the cell surface to allow entry of glucose from the blood stream into the cells. Without sufficient insulin, two problems may arise: In the short term, patients with severe diabetes, the glucose in the blood is not utilized and can lead to extreme high blood glucose leading to acidosis and coma. In the longer term, high blood glucose levels can harm the eyes, kidneys, nerves, heart, brain and extremities.

Regular investigations during follow up are required. These include HbA1c, fasting blood glucose, lipids, liver enzymes (AST and ALT), potassium, creatinine  (kidney test).

Hb A1c is an index reflecting the average amount of glucose molecules that are attached to the red blood cells in the past 3 months. We have a machine to test for HbA1c and result is available in 6 minutes.

Annual assessment include eye screening, foot screening for nerve and vascular damage and urinary protein (albumin/creatinine ratio or 24-hour urinary albumin excretion)

All new oral medications are available for treatment of Type 2 Diabetes Mellitus. It includes medicines which can improve insulin action (metformin XR, Avandia and Actos),  newer sulfonylureas (Diamicron XR and Amaryl) and DPP4 inhibitors (Januvia and Galvus) which may help to protect the insulin producing cells.

New rapid acting insulins such as Novorapid and Apidra and a peakless long acting insulin, Lantus are available for Type 1 and Type 2 Diabetes.