Detected to have diabetes - What to do next?
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Detected to have diabetes- What to do next?

Don’t panic, you are one among the nearly 425 million in the world. 50 years ago diabetes was uncommon and was considered to be a ‘rich man’s disease’. Now 1 out of 5 , both rich and poor, suffer from it.

You can live an almost normal life if you take care from the beginning. The problems occur mainly if you delay in taking care of yourself.

Please see the star of diabetes care.

1 Correct awareness and guidance

In this era of social media, one gets messages and forwards which are often incorrect and there are many myths regarding diabetes and its treatment. There are so many such messages regarding diabetes that one can get lost. Believe only authentic scientific information and not quick fixes, commercial dietary and unproven (often masqueraded as medical) advices. Take advice from well qualified doctors and not from friends or quacks. Each person requires an individualized guidance based on the type of diabetes, its precipitating and aggravating factors. More than 90% of the people with diabetes have Type 2 diabetes which is due to causes that make the body resistant to the insulin produced in the pancreas. The triggering factors of the disease include improper food, unhealthy life style, sedentary habits which lead to overweight and obesity. Stress is becoming a very important factor in the current scenario. Advancing age is also a factor. One should be empowered to manage diabetes well based on food, life style, stress management, self-monitoring and periodical assessment by doctor. When needed, medicines should be individualized.

2. The food plan should be wholesome with low calorie, low carb salads and vegetables, adequate in proteins and healthy fats. The carbohydrates should be restricted to 40 -50% of the calories and should consist of mainly of low GI (Glycemic Index) items.

High GI food leads to sharp rise in blood sugar and weight gain. Low GI foods do not raise the blood sugar to high levels; produce less hunger and less weight gain. All family members may eat the same low GI food as it would also prevent/delay diabetes in others at risk. First and foremost you should have proper awareness.

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3. Life style management includes avoiding of smoking and second hand smoking, alcoholism, moderate exercise for at least 30 minutes a day. It is advisable that those with diabetes and starting exercise for the first time consult a doctor and discuss regarding the best suited exercise on an individual basis. Stress is a very important factor for precipitating diabetes and for worsening diabetes and its complications. It has to be managed well.

4. Regular monitoring of the important parameters and proper record keeping are essential. Checking of blood sugar, weight, blood pressure and pulse rate can be done at home. These can be monitored remotely by the doctor/diabetes care team giving feedback including corrective suggestions. HbA1c is a pointer towards the risk of complications due to diabetes. Studies have shown that 1% change in HbA1c changes the risk of overall complications by 21% with 14% for heart disease and 35% for kidney and eye disease. HbA1c is related to the average blood sugar of the past 3 months. Lipid profile, microalbuminuria indicative of early kidney involvement, ECG, eye examination and foot examination have to be done periodically by the doctor.

These and other tests, other health issues , medicines , allergies and other relevant information can be stored electronically in a cloud based Personal Health Record ( PHR) and would be accessible by the patient any time, even during foreign travel. The availability of such records can be time, money and lifesaving in emergencies. It also empowers patients to manage diabetes themselves without the need for frequent doctor visits.

5. Last but not the least, medicines are important. There are 12 groups of medicines including the injectable and more than 75 different molecules. Choice of medicines depends on several factors like the type of diabetes, built of the person, other coexisting medical conditions, interactions and tolerability. Along with blood sugar, weight, blood pressure and cholesterol control are important for the best outcome. A medicine that is working well for one person may not be the best for his friend or relative.

Role of Insulin

Insulin is the hormone that felicitates entry of blood sugar (glucose) from the blood to the cells to give us energy. It is produced in the beta cells of Pancreas which is situated in the abdomen. Many people are under the impression that insulin injections are the best treatment. This is wrong. Insulin is required in people whose pancreas does not produce enough. In vast majority of people there is sufficient insulin production and insulin injection in such people can do harm like weight gain, hypoglycemia (plunging sugars) and increase the risk of heart disease and strokes. Insulin injection can be removed from such people with careful monitoring and continuous care, giving them a better quality of life. It is a myth that insulin injection cannot be removed from people once it is started.

It is possible to get better control in majority of people, thereby reducing the risk of complications which are life threatening and decreasing the quality of life. For this one has to be vigilant and willing to follow the Golden Star approach incorporating good awareness, low GI diet, exercise and healthy life style, proper monitoring with accessible records and appropriate medicines.

With this approach over 80% of the people with diabetes achieve target blood sugar readings and HbA1c without the side effects of weight gain and hypoglycemia.

On Continuous Care monitoring, about 90% of those with Type 2 DM on insulin injections could stop or reduce insulin injections. They achieved better quality of life with better blood sugar control, weight reduction and less hypoglycemia. Let us work together to contain the epidemic of diabetes and to improve the quality of life and longevity in people afflicted by it.