SUGAR, STAY SWEET Keeping your blood sugar levels within a specific
range when diagnosed with diabetes can be challenging indeed.
range when diagnosed with diabetes can be challenging indeed.
Here, four doctors share their prescriptions with Saliha Nasline. The bottomline
is discipline in diet, exercise and regular monitoring
is discipline in diet, exercise and regular monitoring
Dr V Mohan, Chairman, Dr Mohan's Diabetes Specialities Centre, Chennai
The late Ravi Baskaran, one of our oldest patients, who was diagnosed to have
diabetes in his teenage. He was started on insulin injections several times
a day which he meticulously took all his life. He maintained good control of
diabetes in the initial years by painstakingly checking his urine sugar by the
good old Benedict solution method. After several years, he had moved to blood
glucose testing using a glucometer. All his life, he maintained very good health
and did not develop any of the diabetes-related complications. He led an active
life in the corporate world as he was a management consultant. He was an ardent
cricketer and had played league cricket at the same level. After over 62 years
of active diabetic life, Ravi finally died at the age of 76 years, not due to diabetes
but due to some other disease. Ravi is actually a role model of how one can have
a long and healthy life despite diabetes.
diabetes in his teenage. He was started on insulin injections several times
a day which he meticulously took all his life. He maintained good control of
diabetes in the initial years by painstakingly checking his urine sugar by the
good old Benedict solution method. After several years, he had moved to blood
glucose testing using a glucometer. All his life, he maintained very good health
and did not develop any of the diabetes-related complications. He led an active
life in the corporate world as he was a management consultant. He was an ardent
cricketer and had played league cricket at the same level. After over 62 years
of active diabetic life, Ravi finally died at the age of 76 years, not due to diabetes
but due to some other disease. Ravi is actually a role model of how one can have
a long and healthy life despite diabetes.
MANAGING DIABETES
We have had many cases of children developing diabetes when they are one or
two years old. But they have grown up to excel in their professions, get married,
have children and are still alive after 60 or 70 years of diabetes. All these patients
have followed a strict discipline by maintaining their exercise schedule, taking
their medicines or their insulin regularly and visiting the diabetes centre for regular
check-up and advice.
two years old. But they have grown up to excel in their professions, get married,
have children and are still alive after 60 or 70 years of diabetes. All these patients
have followed a strict discipline by maintaining their exercise schedule, taking
their medicines or their insulin regularly and visiting the diabetes centre for regular
check-up and advice.
TREATMENT
The treatment style for a patient diagnosed with diabetes for the first time will
depend on the type of diabetes. In the case of type 2 diabetes, which constitutes
90-95% of all patients with diabetes, diabetes can be managed by diet, exercise
and tablets. In the case of insulin dependent, type 1 diabetes, insulin injections
would be needed several times a day and in the case of certain other forms of diabetes,
based on the specific type of diabetes, there could be some variation in the treatment
given. However, in all cases, discipline is very important to maintaining a strict diet
schedule, regular exercise, medication and self-monitoring.
depend on the type of diabetes. In the case of type 2 diabetes, which constitutes
90-95% of all patients with diabetes, diabetes can be managed by diet, exercise
and tablets. In the case of insulin dependent, type 1 diabetes, insulin injections
would be needed several times a day and in the case of certain other forms of diabetes,
based on the specific type of diabetes, there could be some variation in the treatment
given. However, in all cases, discipline is very important to maintaining a strict diet
schedule, regular exercise, medication and self-monitoring.
Dr Srinivasa P Munigoti, Consultant Diabetologist & Endocrinologist, Fortis Hospital,
Bengaluru
37-year-old Sudeep (name changed) is banking professional from Gujarat. He was
unaware of his condition and could not understand the reason for his excessive
thirst and increased urination. After check up, he came to realise that he had type 2
diabetes with high levels of sugar. Even though his family had no history of the
condition, his weight of over 100 kg added to his problem. He was on strict
diet to control his diabetes and he had to maintain a healthy intake of 1,200-1,400
calories on a daily basis coupled with physical exercise. He was able to run close to
35 km per week. With regular exercise and diet routine, Sudeep has fought the
disease and is off medications for diabetes today . As an end result, he has not only
unaware of his condition and could not understand the reason for his excessive
thirst and increased urination. After check up, he came to realise that he had type 2
diabetes with high levels of sugar. Even though his family had no history of the
condition, his weight of over 100 kg added to his problem. He was on strict
diet to control his diabetes and he had to maintain a healthy intake of 1,200-1,400
calories on a daily basis coupled with physical exercise. He was able to run close to
35 km per week. With regular exercise and diet routine, Sudeep has fought the
disease and is off medications for diabetes today . As an end result, he has not only
taken control of his sugar levels but has also lost 20 kg. He has even participated in
marathons. An early diagnosis, a change in his erratic lifestyle and healthy eating
helped this young professional re gain control on his life.
helped this young professional re gain control on his life.
MANAGING DIABETES
Diabetes can be managed well by adopting the right lifestyle changes and following
medical advice that may include various medications, regular tests and follow-up
with doctors.
medical advice that may include various medications, regular tests and follow-up
with doctors.
TREATMENT
A good diabetes treatment always involves diet, lifestyle modifications and right
medication. There are plenty of good guidelines from a number of medical
associations, including some Indian associations which are useful. Individual
treatment for patients is always specifically tailored to their needs after studying
their medical background.
medication. There are plenty of good guidelines from a number of medical
associations, including some Indian associations which are useful. Individual
treatment for patients is always specifically tailored to their needs after studying
their medical background.
Dr Anupama N, Consultant-Preventive Medicine, Dept of Preventive Medicine,
Sakra World Hospital, Bengaluru
Sakra World Hospital, Bengaluru
A 52-year-old patient came for a health checkup; she was a known diabetic for four
years and was on two types of medicines. Her sugar levels were uncontrolled. She was
also on some medicines for high BP and cholesterol; she was very upset with her
results and did not want to take anymore new medicines. On talking to her about the
need to control her sugar levels she admitted that she was not very strict with her
diet and was not compliant with her medications. After counselling, she was happy
and motivated to follow the diet chart suggested to her. After six months, it was good
to see that lady had dropped 7 kg of weight and her sugars were very well
controlled. She acknowledged that good diet and regular exercise helped her achieve
her target.
years and was on two types of medicines. Her sugar levels were uncontrolled. She was
also on some medicines for high BP and cholesterol; she was very upset with her
results and did not want to take anymore new medicines. On talking to her about the
need to control her sugar levels she admitted that she was not very strict with her
diet and was not compliant with her medications. After counselling, she was happy
and motivated to follow the diet chart suggested to her. After six months, it was good
to see that lady had dropped 7 kg of weight and her sugars were very well
controlled. She acknowledged that good diet and regular exercise helped her achieve
her target.
TREATMENT
Treatment of diabetes is a holistic approach, a lot of factors need to be kept in mind.
A patient has to be assessed based on his lifestyle, socioeconomic background, support
system, age, etc. However, on the whole, a patient should be educated about what
diabetes is, its complications and what measures are to be taken for it. It has to be well
explained that it is not a curable disease but only one that can be controlled with diet,
exercise and compliance with medicines. Another key factor is identification and
management of stress.
A patient has to be assessed based on his lifestyle, socioeconomic background, support
system, age, etc. However, on the whole, a patient should be educated about what
diabetes is, its complications and what measures are to be taken for it. It has to be well
explained that it is not a curable disease but only one that can be controlled with diet,
exercise and compliance with medicines. Another key factor is identification and
management of stress.
MANAGEMENT
It is a game of will power for the control of sugars through diet and exercise. A lot of
them go on very strict diet and exercise when they are diagnosed with high sugars, and
after some time, they give up on it. Hence it is necessary to understand that it requires a
great effort, which has to be sustained in the long run. Those who manage to do regular
exercise and healthy diet bring down their sugars well.
them go on very strict diet and exercise when they are diagnosed with high sugars, and
after some time, they give up on it. Hence it is necessary to understand that it requires a
great effort, which has to be sustained in the long run. Those who manage to do regular
exercise and healthy diet bring down their sugars well.
Many a time, when patients come to know about their sugar levels for the first time,
they are in the state of shock or denial. It is very important to know what to tell the
patient and how much of information they can take in such a state of mind. The
treatment, whether it has to be on only lifestyle or medicines depends on the severity
of the diabetes.
they are in the state of shock or denial. It is very important to know what to tell the
patient and how much of information they can take in such a state of mind. The
treatment, whether it has to be on only lifestyle or medicines depends on the severity
of the diabetes.
Dr Ankush Gupta, Consultant General Medicine, Docs App
The son of a 60-year-old patient asked about his father's diabetes for second opinion
on Docs App. One month back he was all normal and suddenly sugar levels were high
in the recent test. We asked all the details about the patient, understood present
medication, types of insulin and quantity of insulin, saw the prescriptions and other
reports, which were uploaded on the website.
on Docs App. One month back he was all normal and suddenly sugar levels were high
in the recent test. We asked all the details about the patient, understood present
medication, types of insulin and quantity of insulin, saw the prescriptions and other
reports, which were uploaded on the website.
A doctor suggested some course of medicine, lifestyle changes and diet changes
and asked the patient to get the test done again after five days. Later, the doctor changed
the levels of insulin, according to the blood sugar values regularly for two months,
monitoring his lifestyle changes as well. After two months, the patient's blood sugar
became normal, he is still continuing the medication without any insulin injection.
and asked the patient to get the test done again after five days. Later, the doctor changed
the levels of insulin, according to the blood sugar values regularly for two months,
monitoring his lifestyle changes as well. After two months, the patient's blood sugar
became normal, he is still continuing the medication without any insulin injection.
He is able to maintain the sugar level, with proper diet and lifestyle changes suggested
by the doctor.
by the doctor.
TREATMENT
There are two types of diabetes mellitus. Type 1 is insulin dependent because
of absolute lack of insulin. Type 2 usually occurs in people who are over 40 and
overweight. There is no lack of insulin but peripheral cells are resistant to insulin.
Dietary restriction, exercise and controlling insulin levels are the cornerstones of the
management of type 1 diabetes. Weight reduction, dietary restrictions, and exercise
are also proven ways to increase insulin sensitivity in type 2 diabetes. If optimal
control of blood glucose levels is not achieved with weight reduction programme,
drug therapy is started.
of absolute lack of insulin. Type 2 usually occurs in people who are over 40 and
overweight. There is no lack of insulin but peripheral cells are resistant to insulin.
Dietary restriction, exercise and controlling insulin levels are the cornerstones of the
management of type 1 diabetes. Weight reduction, dietary restrictions, and exercise
are also proven ways to increase insulin sensitivity in type 2 diabetes. If optimal
control of blood glucose levels is not achieved with weight reduction programme,
drug therapy is started.
Diabetes is a lifestyle disease which occurs due to sedentary lifestyle and bad
dietary habits. So lifestyle changes form an important part of treatment of diabetes.
Avoiding oily, fried foods, food with high glycemic index (sugar, sweets) and taking
small regular meals at regular intervals is important. Daily 30 minutes of brisk walking
five days a week is important to reduce weight.
dietary habits. So lifestyle changes form an important part of treatment of diabetes.
Avoiding oily, fried foods, food with high glycemic index (sugar, sweets) and taking
small regular meals at regular intervals is important. Daily 30 minutes of brisk walking
five days a week is important to reduce weight.
Drug therapy is started mostly after three months of lifestyle management, if optimal
control of blood glucose is not achieved. Regular follow-up with at least one follow-up
for three months is needed to check the blood sugar levels and modify medication
accordingly.
control of blood glucose is not achieved. Regular follow-up with at least one follow-up
for three months is needed to check the blood sugar levels and modify medication
accordingly.
MANAGEMENT
Regular follow-up is very important. Blood sugar level goes up and down depending
on the patient's weight gain or loss, dietary changes and sensitivity to medicines.
Normally, follow up is done after three months to check if medicines are working and
whether the patient is following the suggested lifestyle changes or not.
on the patient's weight gain or loss, dietary changes and sensitivity to medicines.
Normally, follow up is done after three months to check if medicines are working and
whether the patient is following the suggested lifestyle changes or not.
The dose of the medicine can be increased or decreased depending upon the blood sugar
level or the medicine can be changed if it is associated with side effects or optimal sugar
level is not achieved. In essence, maintaining lifestyle changes, weight reduction,
dietary changes, taking medicines at regular intervals as prescribed and keeping a
regular follow-up schedule with the doctor will keep the sugar levels and diabetes in
control.
level or the medicine can be changed if it is associated with side effects or optimal sugar
level is not achieved. In essence, maintaining lifestyle changes, weight reduction,
dietary changes, taking medicines at regular intervals as prescribed and keeping a
regular follow-up schedule with the doctor will keep the sugar levels and diabetes in
control.
Source: The Economic Times
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