Sugar sense: Diabetes Q&A

~World Diabetes Day Special~

Q. How can one know whether he or she is suffering from diabetes?

A. The classic symptoms of diabetes—increased thirst and increased frequency of urination—are not always present and many patients are unaware that they may have diabetes. Hence, doing periodic blood tests to check blood sugar levels is recommended. HbA1c [Glycosylated haemoglobin] is the blood test, that indicates your glycaemic status accurately. This test does not require fasting but should be carried out in an accredited laboratory. A level of less than 5.7 is normal and 5.7 to 6.5 is considered pre-diabetes or “diabetes at risk” category. A level of 6.5 and above is definitely indicative of diabetes. Other tests like fasting blood sugar and post-meal blood sugar can also be done, but theses parameters can show variable results on different occasions.

Q. What lifestyle modifications can help us to prevent/treat diabetes?

A. Obesity is a social problem and the solution to it begins in the home. The family should adopt a healthier lifestyle and switch to eating a healthier diet. It’s understandable that high calorie foods are difficult to resist, but we should avoid foods that are rich in simple sugars, oil/ghee and processed refined flours. It is also difficult to find the time to exercise in today’s busy life schedule, but it should be made a habit. Sedentary lifestyles contribute to a lot of diseases including diabetes. Lifestyle modification should not be looked at as a punishment because you have diabetes or you are putting on weight—it should become a commitment to living a fuller life.

Q. How should one keep diabetes under check?

A. Follow the ABC approach—

• Quarterly monitoring with HbA1c [Blood test] helps to gauge the blood sugar control. The target level should be <6.5 – 7.
• Blood pressure should also be <140/90 mmHg. If persistently high, medications may be required to bring it under control.
• Cholesterol should be under control. LDL should be <70 – 100 mg/dl and HDL levels should be <40 – 50mg/dl. Triglycerides should be <150mg/dl.

Controlling blood sugar, blood pressure and cholesterol is critical to prevent complications like heart disease and kidney failure.

Q. Why is the number of diabetics increasing these days?

A. Obesity is the mother of diabetes. With the recent transition in our economy, and changing lifestyle, obesity has become rampant. Excess fat in the body leads to insulin resistance and high blood sugars. Heredity also plays an important role. Research has shown that recognising and tackling obesity with lifestyle changes can prevent diabetes.

Q. What medicines are available for diabetes control?

A. There are different classes of medicine available [oral/injectables]. Metformin is the basic and first line drug. It not only decreases blood sugar but also causes some weight loss and does not produce hypoglycemia [excessively low sugar level]. Other drugs like DPP4 inhibitors, sulphonylureas, glitazones, and insulins are to be used judiciously as add on drugs if metformin alone fails. Patients need to understand the dosing, frequency and other specifications attached with different medications prescribed.

This was first published in the November 2015 issue of Complete Wellbeing.