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.

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As diabetes occurs, there are changes in insulin metabolism in the body. This causes patients to show symptoms like excessive urination, excessive thirst, excessive hunger, and rapid weight loss. These symptoms may be absent in a vast majority of patients on diagnosis [when diabetes is first detected]. Hence, it is critical to regularly screen patients at high risk—those with a family history of diabetes, those who are overweight and lead a sedentary lifestyle.

Once diabetes is diagnosed and you are on medications, it is important for you to know the warning signs of problems related to it like hypoglycaemia and hyperglycaemia. Other associated problems are to do with heart, brain, feet, eyes and kidneys. Read on to understand some of the problems that diabetes brings along.

Hypoglycaemia

Hypoglycaemia [lower-than-normal sugar levels] is a common occurrence in diabetics. Warning signs include giddiness, sweating, cold clammy skin, blackout, palpitations, and loss of consciousness. Any patient on diabetes medications should be warned about such symptoms, especially if s/he skips or delays regular meals.

Consumption of sugar or any sweetened food till the patient feels better is recommended as first aid. Prompt consultation with the treating doctor is required to determine the cause. This also helps rule out the possibility of kidney-related trouble as the contributing factor.

Hyperglycaemia

Hyperglycaemia or high blood sugar can be the result of many factors including stress, illness, infection, excessive carbohydrate intake, and inadequate treatment with medication or insulin. Over time, chronic hyperglycaemia can put you at risk for diabetic complications such as neuropathy [nerve damage], heart disease, and kidney failure.

In the short term, severe, untreated hyperglycaemia can cause diabetic ketoacidosis or DKA [total absence of insulin in the body] and other life-threatening problems. Warning signs include severe thirst, blurred vision, vomiting, and excessive urination. If you experience any of these symptoms, or if your blood glucose levels are running consistently higher than 180 mg/dl, call your healthcare provider immediately.

Cardiac complications

High glucose sugar levels lead to complications of the heart, eyes, brain, kidney, nerves and peripheral arteries. Hence, it is mandatory to follow the plan chalked out by the doctor to maintain normal sugar levels. Also keep a look out for early warning signs of trouble to avoid a crisis. Cardiac complication is a silent killer.

Any chest discomfort or pain while at rest or exertion, breathlessness and giddiness are indicators of heart problems. Yearly electrocardiogram [ECG] and tests like stress test, 2D echo and angiography can help detect heart problems at an early stage.

Stroke or paralysis

This is a result of blocked blood supply or bleeding in the brain. It occurs in uncontrolled diabetes and due to high blood pressure. Patients should maintain normal sugar levels and look for warning signs such as weakness in hands or feet, headache, and giddiness. It is best to approach your doctor immediately in case of any discomfort. Scanning of the brain helps to diagnose such problems and prevent major complications.

Feet trouble

Feet are commonly affected in diabetics with problems like infection, ulceration and gangrene, risk of sepsis or amputation. Changes in sensations like burning, pain, or loss of sense or pain in calves on walking should ring alarm bells. Any wound in the feet should not be ignored and should be treated completely. Further, measures should be taken to prevent recurrence such as specialised testing for nerve damage or loss of blood flow. Proper foot hygiene and use of clean socks, clean footwear and anti-fungal powder helps prevent foot infections.

Infections

High glucose level is an invitation for a variety of infections related to skin, nails, lungs, genital region, feet, and eyes. Boils on face or back are dangerous and can spread to other parts of the body. At the first sign of infection such as redness or pain, seek medical advice. Elderly patients are also at a risk of developing chest and abdominal infections like breathlessness or high fever with whooping cough or severe loose motions.

Kidney and eye problems

As symptoms related to kidney and eye disorder may not appear at an early stage, regular screening is needed for their early detection. Changes in visual acuity such as blurring of vision, double vision, watering in eyes are considered to be warning signs of eye disorders. Decreased urination or altered mental status and vomiting are signs of kidney damage at late stages.

The best approach that diabetics can adopt to avoid complications is to keep their sugar levels under control. Following a proper diet under the supervision of a dietician, regular exercise, intake of medications at appropriate doses and performing tests to assess sugar levels regularly goes a long way in managing diabetes. Controlling your lipid and blood pressure levels and maintaining an ideal weight is also an effective treatment.

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