Managing Your METABOLISM
High blood glucose, high blood pressure, high blood lipids and overweight
or obesity are four common conditions that are afflicting most people in
the world today. But did you know that all four conditions are closely
associated? Below are some answers that may help you understand more
about how these conditions are related.
Q: I developed high blood cholesterol when I was 38 years old. When I
was 44, I developed high blood pressure. Recently, after my 50th
birthday, the doctor told me that I have type 2 diabetes. I’ve heard that
these three conditions are related. Can you explain why? Santhi P, Klang
A: Yes, the three conditions that you have are some of the
characteristics of the metabolic syndrome. The metabolic syndrome is
characterised by a group of metabolic risk factors.
The risk factors include insulin resistance (when the body cannot use
insulin efficiently), obesity or overweight (particularly in the
abdominal area), blood lipids disorder (dyslipidaemia), high blood
pressure (hypertension), high blood glucose level (hyperglycaemia) and an
increase of insulin level in the blood (hyperinsulinaemia).
These features of the metabolic syndrome increase the risk of
cardiovascular diseases related to plaque buildups in artery walls
(atherosclerosis) leading to heart attack, stroke and peripheral vascular
disease and development of type 2 diabetes.
Most experts say that if you have either one condition, you are likely
to have or develop the other conditions too. This is why other features
of the metabolic syndrome can be present up to 10-20 years before the
diagnosis of your diabetes.
So if you are overweight or obese or already have high blood lipids or
high blood pressure, you need to get it treated and/or change your
lifestyle as soon as possible, or you may also develop diabetes and have
increased risk of heart attack and stroke.
This also means that if you are already diagnosed with type 2 diabetes,
you should not only focus on managing your high blood glucose, but also
on reducing the other cardiovascular disease risk factors such as
abdominal obesity, high blood pressure and high blood fats levels.
Q: I developed Type 2 diabetes when I was in my 40s. The doctor has
advised me to control the amount of fats that I eat because I’m likely to
develop high blood cholesterol, which will put me at a higher risk of
developing cardiovascular diseases. Is this true? Wong P.K., Kuala Lumpur
A: This is true. Having diabetes opens the pathway to increased risk of
cardiovascular diseases.
This is because when you have type 2 diabetes, you are most likely to
have a condition called insulin resistance. Insulin resistance occurs
when the body cannot use the insulin (a hormone produced by pancreas that
is responsible for glucose uptake by the cells) effectively.
This metabolic dysfunction (insulin resistance) is associated with
abnormal blood lipid levels (dyslipidaemia) such as an elevated levels of
triglycerides (one of the main components of body fat which could
eventually be converted to LDL or ‘bad’ cholesterol) and a decreased
level of high-density lipoprotein (HDL or ‘good’ cholesterol which
removes cholesterol from the arteries).
All these abnormal blood fats levels accelerate the development of
atherosclerosis (where LDL cholesterol and other fats build up inside the
artery walls, causing them to narrow and restrict blood supply).
Atherosclerosis is dangerous as it can cause blockage in your blood
vessels, which increases your risk of heart attacks and stroke. To help
you achieve a healthy balance of lipids, you should limit your total fat
intake by avoiding foods like pastries and biscuits that have hidden fats
and foods that are deep fried.
Also watch out for saturated fats (a type of fat that increases your
LDL level) that are mainly found in animal derived foods, such as dairy
products including full cream milk, butter and full fat cheese as well as
ghee, lard, and the skin of cooked meat.
Foods that are cooked with ‘santan’ (coconut milk) are best avoided as
they also contain high saturated fats.
Opt for monounsaturated oils (canola or olive oil) and/or
polyunsaturated oils (like corn, sunflower or soybean oil) as they are
beneficial in helping to lower LDL cholesterol (‘bad’ cholesterol),
and/or raise HDL cholesterol.
High cholesterol foods found in animal products such as egg yolk and
offal (liver, brain, kidney and intestine) should be avoided as this can
further increase your LDL cholesterol level.
While managing your blood lipid levels, you still need to maintain a
normal blood glucose level at all times. You can achieve this by adopting
healthy eating habits and controlling your carbohydrate intake.
Q: I have type 2 diabetes, high blood cholesterol and high blood
pressure. Will controlling my diabetes bring down my blood pressure and
blood cholesterol levels too? Affandi M, Petaling Jaya
A: Diabetes is one of the main factors that can alter your body’s
metabolism causing high blood pressure and blood cholesterol levels.
This is why controlling your diabetes may bring down your blood
pressure and blood cholesterol levels too.
The most effective way to control your diabetes, high blood pressure
and high blood cholesterol level at the same time is by practising a
healthy lifestyle.
The recommended practice is to eat a healthy and well balanced diet,
increase your level of daily physical activity and maintaining your ideal
body weight.
It is also crucial that you monitor your diet, your weight and your
blood glucose at home and see your doctor regularly for a health check
up.
Your doctor will be able to advise you on whether you need any specific
medication if there is no improvement on your blood glucose, blood
pressure or blood cholesterol levels despite practising a healthy
lifestyle.
If you check your blood lipids profile, you may notice a higher
HDL-cholesterol (‘good’ cholesterol) and a lower LDL-cholesterol (‘bad’
cholesterol) and triglycerides values.
Remember to keep your blood glucose (3.8 – 6.1mmol/L when fasting and
below 7.8 mmol/L after meals), blood pressure (below 130/80 mmHg) and
blood cholesterol (HDL-cholesterol at more than 1.02 mmol/L,
LDL-cholesterol at less than 2.6 mmol/L and triglycerides at less than
1.7 mmol/L) values within the recommended range at all times, so as to
reduce your risk of heart attack and stroke.