Diabetes is a lifelong disorder and there is no cure for it. It is a deficiency disorder due to the lack or reduced response to insulin, which is a hormone produced in the organ called pancreas. The insulin acts like a key for the glucose to enter cells from the blood and keeps the blood sugar under control. When insulin production is not enough or the available insulin is not effective, the sugar in the blood cannot go into cells and get converted to energy. Therefore the sugar level is raised in the blood. This disorder is called diabetes mellitus.
Although there is no cure, you can keep your diabetes well controlled and live a healthy and active life even if you are a diabetic. But if your sugar level is uncontrolled, it can lead to many complications- problems of infection and weight loss (reversible with good control of diabetes) and also irreversible complications where the organs in your body become severely damaged. These are the eyes, kidneys, heart, nerves and also your teeth and gums.
What is a normal blood sugar level?
For a healthy non-diabetic adult, the normal blood sugar level should be less than 110mg/dl when fasting and less than 140mg/dl post prandial; which means two hours following a meal. Ideal blood sugar values for a diabetic person can be a little higher than a non-diabetic. The fasting value should be less than 120mg/dl and post-prandial value less than 160mg/dl. There is another indicator called HbA1c which is measured to check the long term control of diabetes. It should be less than 7% to say that you have been having your blood sugar well under control over the past three months.
Symptoms of Diabetes?
- Excessive tiredness
- Increased appetite
- Frequent urination – both day time and night
- Excessive thirst
- Loss of weight
- Non healing wounds
- Cramps in the legs
Basically diabetes is divided into two types. Type 1 diabetes is usually diagnosed in children and young adults, where the insulin is not produced adequately. They will need lifelong insulin injections to keep their blood sugar under control.
Type 2 usually occurs in adults. It may run in the family. Patients are usually overweight. Here although the insulin is there, its efficiency is reduced. Treatment is by diet control, exercise and oral medication. But some may need insulin injections.
Certain environmental factors that may contribute to diabetes, are being overweight, lack of exercise, over eating, stress, repeated pregnancies and smoking.
Is it possible to delay or even prevent type 2 diabetes from developing?
Yes it is possible.
Risk factors for diabetes
Family history – affected 1st degree relative (parent/ brother/ sister)
Age – middle age to elderly
Overweight, obesity
Sedentary lifestyle
History of gestational diabetes ( raised blood sugar during pregnancy)
Mothers who delivered big babies (more than 4 kgs)
So if you have one or more of the above risk factors it is better to get your blood sugar checked regularly.
Managing type 2 diabetes
Diet control
Diet is an important factor in controlling your diabetes. You should take a balanced diet with adequate carbohydrates, proteins, fats, vitamins, minerals, fibre and anti oxidants. It is important to meet a dietician and get a suitable meal plan especially if you are overweight.
A diabetic diet need not be a monotonous one or completely different from the normal diet. As it should be adhered to lifelong, it is best to be similar to the normal family diet with a few necessary changes. Fasting or skipping meals is not recommended as it may lead to hypoglycaemia and over-eating in the next meal.
The meal pattern for a diabetic should be;
Breakfast 8 a.m.; snack 10 a.m.; lunch 1 p.m.; snack 4 p.m.; dinner 8 p.m. snack 10 p.m.
Without eating three large meals, it is better to eat smaller portions more frequently, so that the blood sugar doesn’t fluctuate much. Recommended are fibre-rich vegetables like bitter gourd, kohila, cabbage, beans, keselmuva, ash plantain, carrots, ladies fingers etc. Avoid high cholesterol foods like egg yolk, red meats, milk cream, cheese, ice cream, butter or ghee. Restrict fried foods. Baking and boiling is better than deep frying. But a certain amount of fat intake is necessary for all individuals.
1 – 2 servings of fruit can be taken per day. Avoid over ripe fruits and dates. Salads should be taken without dressings like mayonnaise.
Exercise
Aerobic exercises are good for your health, because they have maximum calorie expenditure and oxygen consumption- Brisk walking, jogging, swimming, skipping, dancing, cycling.
Do at least 30 minutes a day for 4 – 5 days a week. With regular exercise it is easy to control diabetes with a lesser dose of medicine. It also helps to maintain ideal body weight, make your heart stronger and relieves stress too. Exercise improves one’s well being.
Avoid sedentary activities like watching TV, playing computer games etc. Walk to shops instead of driving, use stairs rather than the elevator, walk to talk to office colleagues instead of using the telephone. These are simple lifestyle habits which can be done very day.
Medication
Always follow your doctor’s instructions and do not change your medication dosage without consultation. If you’ve overindulged in desserts at a party, don’t think increasing your pills is the answer- there is a risk of blood sugar fluctuating as a result.
Hypoglycaemia
Hypoglycaemia means low blood sugar which is less than 60mg/dl
Symptoms of hypoglycaemia
- Anxiousness
- Blurred vision
- Dizziness
- Fatigue
- Sweating
- Excessive hunger
- Fast heart beats
- Headache
Causes of hypoglycaemia
Increasing the dose of medicines without doctor’s consent
Delaying or skipping meals
Exercising on an empty stomach
Consuming alcohol on an empty stomach
Too much insulin.
What should you do if you get any symptoms
- Check blood sugar immediately
- Take 2 – 3 teaspoons of sugar dissolved in water or a sweet, or cup of fruit juice
- Check sugar again in 15 minutes and repeat till symptoms disappear.
- Do not over treat hypoglycaemia
- Do not drive for at least 30 minutes after a hypoglycaemic episode
- Always carry a diabetic identification card with you
- Consult doctor if symptoms persist or worsen
Check-ups
Annual check-ups for eyes, heart, kidneys, nerves and also dental check-ups are vital.
Tight blood sugar control delays/ prevents complications.
What should you do when sick?
Infection tends to increase your blood sugar level.
When sick;
- Check blood glucose three times a day
- Record in a log book as it will be useful in case you have to see a doctor.
- Stick to regular small meals
- Do not miss your diabetic medicine
- Drink fluids which provide electrolytes and drink at least 10 – 12 glasses of water.
(The writer is attached to the
Health Education Bureau) |
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