Dr Rohan Biswas, MBBS
(Rohan Biswas is a General Practitioner, Ambicapatty, Silchar. He can be reached at [email protected])
One of the myths surrounding Diabetes Mellitus is claiming it as the outcome of overindulgence in sugary substance, thereby raising blood sugar levels. Although blood sugar actually gets raised, yet the way it is raised is a largely ignorant fact among the general mass. In reality, it’s a lifestyle disorder. A cornerstone of diabetes treatment is attention to lifestyle. Unhealthy lifestyles, such as lack of physical activity and excessive eating without adequate calorie burning, initiate and propagate the disease.
Diabetes Mellitus (DM) is a metabolic disorder, characterized by symptoms of increased thirst, increased frequency of urination, unusual weight loss and hallmark signs of increased blood glucose levels.
Basically, it is due to the deficiency of hormone insulin. Complications from diabetes include cardiovascular disease, the risk of stroke and heart attack, kidney damage, nerve damage, ocular complications, skin conditions and Alzheimer’s disease, not to mention non-healing ulcers due to impaired healing mechanisms. Diabetics often observe minor cuts or injuries flaring up into bothersome and painful ulcers – all because there blood sugar levels are uncontrolled or even due to superadded infections owing to callosity towards such ‘minor’ issues such as a ‘scratch’.
Besides glucose control, which is essential for patients who have Diabetes Mellitus, there is a strong need for patients to maintain a healthy and balanced life in order to avoid any complications.
Certain self-preservation behaviours in patients with diabetes predict healthy outcomes viz eating healthy, being physically active, regularly monitoring blood sugar, compliance and adherence to the medications prescribed, and most important of all, not neglecting one’s condition.
Diabetes management can be summed up in a basic ABC trident- A1c (HbA1c or glycosylated hemoglobin), blood pressure and cholesterol. Maintaining an A1c level of below 6.5%, keeping your blood pressure less than 140/90mmHg, and maintaining LDL(low density lipoproteins) at less than 100mg/dL (with no cardiovascular disease) and an LDL of less than 70mg/dL with any type of cardiovascular complications, are key proponents in diabetes management. Achievement of these goals should not be the sole responsibility of the healthcare provider or the medications prescribed to maintain, but the individual themselves.
Paying attention to what should be eaten; diabetic patients should maintain a high fibre diet. Fibre in our diet ensures that the body converts sugar into energy at a gradual pace, thus preventing a sugar spike. Since fibre slows down digestion, the consumption of high-fibre foods means that energy is released gradually into the body helping maintain correct blood sugar levels.
Patients should consider taking high fibre foods like whole grains (brown rice, whole wheat, oats, millets, barley), legumes and whole fresh fruits and green leafy vegetables, keeping plain white rice and potatoes to a minimum.
Diabetic patients should always have restriction of sodium or salt intake. The minimum amount of water a person should consume stands at 8-10 glasses per day. In the case of diabetes patients, adequate water consumption is especially important since it regulates the density of blood. Excessive blood sugar increases blood viscosity which could result in health complications, risks which water negates by diluting blood thickness. A diet chart maintained following the doctor’s advice will work wonders. More simply, if the patient cannot control his love of food on his own, an unyielding family member or spouse may take up the responsibility of supervising the meals.
One of the complications of Diabetes is hypoglycemia or low blood sugar levels, which is a more common cause of nuisance in a diabetic patient than hyperglycemia or high blood glucose.
This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness or a seizure activity. A feeling of hunger, sweating, shakiness, and weakness may also be present. Symptoms typically come on quickly. Monitoring glucose levels is obligatory in such a situation. Patient should act immediately to raise their blood sugar level if it drops below 70mg/dl. They can eat two-three pieces of candy, or a spoonful of sugar, and should eat a normal (non-diabetic) meal.
Incorporating healthy eating habits is just one part of diabetes self-care; a huge focus should be on physical activity, and this is where patients struggle the most. Patients should adhere to physical activity (from something as simple as just walking 30 minutes a day).
A pre-workout meal is a must since it prevents hypoglycemia. Patients can take pre-workout meals like a fruit or bread with butter. But, they must avoid fruits like banana, litchis and mangoes which have high sugar content and settle instead for fruits like apple, guava and papaya that are rich in fibre with moderate sugar.
Medication on its own will help, but without pursuing a balanced lifestyle, complications will continue to arise and the progression of the disease will go on, hence controlling diabetes is more about a complete lifestyle overhaul.