Dr. Kanwaljeet Miglani, Cluster Head, Amritsar
I distinctly remember the day when my mother called up to inform that she had been diagnosed with Type 2 Diabetes. In fact, I had only advised her to get a preventive health check-up done as she had frequent fluctuations in her blood pressure and recurrent urinary tract infections. She sounded very upset and somewhat scared and surprised as there was no family history of Diabetes.
Being a doctor myself , I explained her that type 2 diabetes may have a strong genetic basis in some patients (something less than a third of them), but the development of diabetes in most patients is dependent upon the effects of environmental and behavioural factors (like obesity and sedentary lifestyle) on an underlying susceptibility that is poorly understood.
Since her reports showed that she is a borderline case (Fasting blood sugar < 120 mg /dl), I calmed her down and informed her that she could very well avoid medicines by following some major life style changes and getting regular health checkups done. She needed to maintain a good quality life with sufficient sleep, regular walks, exercising, maintaining a healthy weight and good diet, in order to achieve the goal of containing sugar levels within permissible limits. I warned her that she needed some positive action in her life right away, as diabetes if uncontrolled, can lead to multiple major heath complications later on in her life.
Since high blood glucose levels over a period of time can lead to damage of small and large sized blood vessels and nerves, she needed a regular health check up from a general physician every 6 months and her eye check up on yearly basis. The general physician would check her nerve reflexes and her feet for calluses, infections, sores, and loss of feeling. The doctor can even advise an electrocardiogram to check her heart health. It was a must that she sees her dentist for a regular cleaning every six months and looks personally into her dental health with self-care like flossing and brushing daily. Though gum disease is a lesser-known complication of diabetes, but when it’s serious, it can make it harder for the patient to control her sugar levels and cause infections and other health problems.
I also explained her about the key blood test in diabetes called Glycosylated Haemoglobin ( HbA1c) which measures the average blood sugar levels over the previous two or three months and gives an idea as to how well your blood sugar is being controlled. One should get this test at least twice a year, if not more often, according to the American Diabetes Association (ADA) and the HbA1c value should be targeted less than 7 percent. One should also go for a good health package especially designed for diabetics, at least once a year, from a reliable laboratory. The package should include Complete Blood counts, Urine complete examination, Heart tests (Lipid Profile), Kidney tests, Microalbuminuria test, Serum electrolytes, fasting blood sugar and Glycosylated haemoglobin.
My mother has had a total lifestyle turnaround in the last few years with her determination to lead a good quality life. Her sugar is well controlled and with positive changes like meditation, yoga and regular walking, she is very much in peace with herself. I just have an advice for all females out there, that to be diagnosed with diabetes can be scary, but it’s very much possible to control sugar with healthy life style and strong belief in oneself.