Living with diabetes

Diabetes,a syndrome of disordered metabolism,is something that most of us are aware of,thanks to its widespread hold on the urban population.

Written by Sharon Fernandes | Published: February 1, 2009 3:39:18 pm

Here are some pointers to survive this lifestyle disorder
Diabetes,a syndrome of disordered metabolism,is something that most of us are aware of,thanks to its widespread hold on the urban population. This syndrome is caused by a combination of hereditary and environmental causes,resulting in abnormally high blood sugar levels (hyperglycemia). Living with diabetes is not easy. And though the best way to keep blood sugar levels close to normal is through exercise and a controlled diet,we look at a few parameters that should also be kept in mind.

BLOOD TESTS
“The only way to find out if you have diabetes is to do a blood test,” says Dr Phulrenu Chauhan,consultant,endocrinology,PD Hinduja Hospital,Mumbai. But what most people do not realise is that a weekly blood test is a must. One can also go for a glycosylated haemoglobin test,which gives a three-month blood sugar average. “This test,along with home monitoring (glucometer),gives good results. For some patients,we also use a glucose monitor—a pager-like device that records the blood glucose levels for three days continuously. This is especially needed for pregnant women,where the blood sugar levels should be monitored closely,” says Dr Ambrish Mithal,senior endocrinologist,Indraprastha Apollo Hospitals,Delhi. Also,never go for a post-meal blood test,having eaten light or too much. “The results for the post-meal blood test are very important. It determines what medicine we put him on. Some patients go for a blood test after a lighter meal or having binged just to see if the medicines prescribed to them work well. These readings then can be faulty and hamper the patient’s progress,” he adds.

DIABETES AND FOOT CARE
For diabetics,kidneys,eyes and feet need special attention. Feet,specially because they are often most ignored. A bruise or a cut on a diabetic’s foot takes longer to heal and is prone to infection. “For a diabetic,the skin on the feet starts drying because of poor blood circulation. Feet crack a lot and creams don’t help too much. Corns are also a common complaint. And when the patient tries to remove it at a parlour,infections are a big risk. This infection and the slow healing of the wound due to diabetes can cause the infection to reach the bones,” says Dr Chauhan.

Nerves around the feet also get affected as high glucose products in the blood impede circulation. This gives rise to numbness. “The patients do not realise that they are hurt since the feet go numb. They may ignore a wound till it is late,” says Dr Mithal. “Diabetics should always keep their feet dry. They should inspect their feet closely for nicks and bruises and if there are corns they should go to a doctor to get them removed. They should not soak their feet in very hot water,” he says. “Moving barefoot even at home is also a strict no-no. Wear cloth slippers or socks to keep the skin safe.”
Dr Chauhan further adds,“Diabetics should try and take care of their feet on their own. If you go for a pedicure,make sure that the person knows you are diabetic. It should be a clean place and it should be supervised. It is best to go to a podiatrist instead.”

INSULIN NEEDS
Patients on insulin shots are sometimes tempted to alter their insulin dosages. “Patients who have diabetes type 2 and dependent on insulin tend to manipulate their doses. But this self-monitoring is not recommended,” says Dr Chauhan. The general logic is that if you consume less carbs,you will need less insulin. “But one cannot have a mithai and say I will take extra insulin. It does not work that way. It is not advised,” says Dr Mithal. When children suffer from diabetes,it is difficult to keep them on a strict diet. There can be an occasional birthday party where they indulge themselves. In such a case,it may be okay to have an extra dose,he adds.

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