Diabetes, a word rarely heard 30 years ago, is now one of the most common word we keep on hearing in any health facility and specialty including pediatrics and obstetrics. If we believe in WHO data published recently, every 16th person is diabetic and in next 15 years every 10th person will be diabetic in this country. We know that we have very poor doctor patient ratio in our country. So we can imagine how health system of this country, which is already, burdened going to crash if this rate of increase in diabetes continues. Can we, as a citizen of this country, help out in this emergency which is in front of us yet we r ignoring both as public and as well as private entity. For this first we need to answer this question why almost more than 50% of diabetic population never have good glucose control. If medicines were the only solutions probably everyone on earth would have had good glucose control hence what is that is lacking in optimal management of glucose control. Probably answer lies in the fact of individual participation in controlling their glucose optimally. In this article I will try to help you out in managing your diabetes effectively and will try to remove some myths, which are quite prevalent.
First of all who should be tested.
Everyone who have symptoms suggestive of diabetes like increase thirst, frequent urination (particularly Nocturia), weight loss and other symptoms should be tested. Any pregnant lady should be tested for diabetes. Obese people , hypertensive and dyslipidemic people and individual with family history of diabetes should be tested beyond 40 yrs of age.
What if I am diagnosed with diabetes.
We must remember Diabetes is lifestyle disease and best medicine for control of this is lifestyle modification which include three things: timing and content of food especially carbohydrates. And other one is exercise. So there are lot of misconception about what should be eaten and what should not be eaten. But it is important to remember that there is nothing like diabetic diet and every person with diabetic can eat everything but important thing is art of eating. You should know how much one should take and where I need to stop my favorite ice-cream. Your half plate should consist of greens including salads and vegetable and one-fourth plate should include protein and one-fourth should be carbohydrates. So it is quantity which is very important when we are deciding our meal.
Second important thing is about exercising. This is something that most of my patient failed to do and simple reason is they don’t have time. Its true that they r time constraint but we need to learn how to include exercise in our daily routine and simplest example is getting down one stop earlier and walking till office or just avoiding lifts.
Can my Diabetes be cured by alternative medicine:
This is one of the question which everyone wants to know and they try too however they are no data to support such misconception. So any treatment can send your blood glucose in normal range and you may not require any treatment other than diet and exercise for prolong period however we must remember that lifestyle modification is first and best treatment and that has to continue life long.
Can my medicine be stopped ever:
Answer is probably no however if someone follow good lifestyle measures he may not require medication for certain period and medicine may be stopped, however this should be done under supervision of your treating endocrinologist and you need to follow up regularly with your blood glucose.
Once on Insulin always on Insulin:
Another myth prevalent is once you are on insulin it has to be lifelong but its depend upon at what stage of diabetes your insulin is started and if diabetes is of prolong duration you may require insulin for long period however in certain conditions like poor control in early stage of diabetes or need of insulin in certain disease condition which once get treated you may be put back on oral medication.
Diabetes and Pregnancy:
I do often see patient who are young and have diabetes and not planning pregnancy in fear of not getting pregnant or pregnancy may go wrong however these are myth and diabetic women can become pregnant as normal women and carry out their pregnancy safely however it is advisable to keep there blood glucose completely normal in pre pregnancy and antenatal period and plan there pregnancy as early as possible as delaying pregnancy lead to increase chances of complications.
So as I have mentioned earlier Diabetes is the one disease where patient participation is of utmost importance and we hope to decrease the impact of diabetes in near future by increasing health literacy of our population.