Diabetes: mind your numbers

Living a good life with diabetes boils down to one simple thing—keeping your blood sugar under control

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Initially, every patient diagnosed with diabetes tends to panic. Many diabetics get mired in the sea of information thrust upon them or simply tend to neglect the illness as an unsolvable problem.

Actually, under the care of a specialist doctor's advice, diabetics can use the wealth of information to confidently handle their own diabetes. If you just follow a few things diligently, living with diabetes can become a whole lot easier.

Food

The human body needs continuous supply of glucose for maintaining normal body functions. This supply comes from the food consumed or is mobilised from the body stores—liver, muscle and fat. Hence, the first step for patients is to modify their eating pattern.

As a general rule, all diabetic patients should try and match their food intake to their energy needs, which depend on their levels of physical activity. A simple way out is to determine your caloric need and make a diet plan. The plan should be such that it distributes the daily caloric need in 4 – 5 portions.

Starting the day with breakfast and restricting the quantity of food consumed later in the day is a good way to start working on controlling high sugar levels.

Avoid free sugar and sweets in all forms. Balance your consumption of carbohydrate-rich foods especially rice and potatoes and reduce fat intake. Eat more salads and greens as they are devoid of calories but meet the vitamin and fibre needs. You can eat fruits to replace the sweet tooth craving.

Of course, fruits too need to be consumed in limited quantity and eaten with consideration avoiding those with high glycemic index like mangoes, chikoo, banana and dates.

Body mass index is a good indicator of a person's nutritional status. Achieving ideal body weight should be the long-term goal of all diabetics, as it improves sugar profile and reduces the need of medicines.

Exercise

Exercise helps burn excess calories, keeps the body fit and improves sugar control. Walking for minimum 30 minutes on alternate days is a must. Of course, more the merrier, but only after considering things like prevailing cardiac complications.

Ensure appropriate foot protection while exercising and take care to avoid falls and injuries.

Rest

'A sound mind in a sound body', goes a saying. Yoga and meditation help calm the mind and reduce stress in diabetics.

Disciplined working hours and adequate rest after a hard day's work are essential.

Medicines

Of course, for a majority of patients, the above measures alone are not enough. As the crux of the problem is the uncontrolled high sugar level and the resulting complications of the heart, kidneys, eyes and nerves, use of medicine to control sugar is essential in most cases.

A variety of medicines when used under the supervision of experts, work wonders for most patients. A mix of various medications is often the need of most patients. The medications have to be reviewed by the treating doctor and regular blood tests are to be conducted to determine their effectiveness. It is a must for all patients and goes a long way in preventing long term complications.

Since its discovery in 1921, rapid advances in the development of insulin have made it a safe and effective treatment option. Use of insulin as treatment for diabetes may be intermittent or continuous. Newer devices for insulin delivery such as pen devices have simplified the storage, transport and use of insulin therapy and minimised the pain.

Associated complications

Identifying associated risk factors like high cholesterol, high blood pressure is important. Regular eye, blood and urine testing and appropriate treatment as per the results reduce the risk of long term complications. Most patients on medications experience hypoglycaemia or low blood sugar levels. Giddiness, cold sweats, hunger pangs, and in extreme cases, unconsciousness are some symptoms of low blood sugar. At such times, consume some sugary food for immediate relief. Later, consult a specialist doctor to determine the cause and remedial measures.

Long-term complications are common in diabetics and develop over the years. Good diabetes control retards onset of these complications. Check your blood sugar often. If monthly testing is not possible, get your HbA1c checked every quarter or six months. You can even use self-monitoring devices to take away the guesswork out of sugar control. In diabetes, guess work can be dangerous as symptoms of high and low sugar levels at times can be the same.

Without fail, all diabetics should get a yearly comprehensive check up to assess complications. Particularly important is detecting cardiac complications by using exercise stress test or imaging.

Check your eyes for ailments from time to time.

As the nerves in the feet get damaged, the sensation in the soles reduces. Use appropriate footwear, and examine your feet daily to look for injuries. Get corns and callosities treated in time. These simple precautions go a long way in reducing the loss of limbs due to infections.

Many diabetics experience sexual dysfunction characterised by loss of sex drive, erectile and performance problems. Often, this is a result of nerve damage leading to poor dilatation of blood vessels present in penile muscles. Many treatment options are available; consult your expert for them. Of course, good sugar control improves the condition and is needed in most diabetics. Avoiding medications, which may be affecting your sexual functions also helps.

Maintaining normal weight, following a good diet, exercising regularly, avoiding smoking and alcohol, and stress management go a long way to help diabetics lead a healthy, happy and uncomplicated life.

Difference between low glycemic index [GI] and high glycemic index foods

Low-GI foods release glucose slowly and steadily and hence are a good choice to maintain steady glucose levels. Most fruits and vegetables, legumes/pulses, whole grains, meat, eggs, milk, nuts, fructose and products low in carbohydrates fall in this group.

High-GI foods cause a rapid increase in blood glucose levels and hence are suitable for energy recovery after strenuous exercise or for a person experiencing low blood sugar. Foods such as baked potatoes, watermelon, white bread, white rice, corn flakes and breakfast cereals are classified under this.

—Team CW

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