From the house of Thanevaibhav

Health & Wellness

Self Care in Diabetes

Know Your Town

Dr. Purva Joshi

 Diabetes is a metabolic disorder of multiple etiology characterized by chronic hyperglycemia (increased blood sugar levels) with disturbance of Carbohydrate, Fat and Protein metabolism in the body due to reduced insulin secretion or reduced insulin action or both. Insulin is a chemical hormone which regulates blood sugar levels.

India has been recently declared as Diabetes Capital in the world with approximately 73 million cases wherein 11-14% cases are in urban population and 3-8% cases in rural population as recorded in October 2019.

14th November is considered as World Diabetes Awareness Day and the month of November as Diabetes Awareness Month.

There are 4 main types of Diabetes –

1) Type 1 Diabetes also called as Insulin Dependent Diabetes, occurs more commonly in children and adolescents.

2) Type 2 Diabetes also called as Non Insulin Dependent, occurs more commonly in adults. It is most common in India.

3) Impaired Glucose Tolerance [IGT] – Blood sugar levels are above normal range but below the range to be considered as Diabetes.

4) Gestational Diabetes – Associated with pregnancy.

In any type of Diabetes it is very important to take good care of self. Some critical elements of self care in Diabetes are-

1) Blood Glucose Monitoring – Regular monitoring of sugar levels every 2-3 months.

Following are the tests available –

  1. a) Fasting sugar level – empty stomach blood sugar (upto 110mg/dl)
  2. b) Post Prandial- 2 hours post meal blood sugar (upto 200 mg/dl)
  3. c) Random Blood sugar (80-120 mg/dl)

In IGT, blood sugar is between 140-200 mg/dl

  1. d) Glycosylated Hemoglobin – HbA1C– it is a cumulative hemoglobin estimation of upto last 3 months. A value of upto 6.5-7 % is considered normal blood sugar level.

A value of more than 7% means blood sugar levels are not within normal range and intervention is required.

This test is considered most reliable to estimate sugar levels in body.

2) Medication Compliance – to be compliant and take medication on time (tablets and or insulin shots) as prescribed by the physician.

3) Body Weight Monitoring – Diabetes is a life style related disease and so it is related to Obesity. Therefore, maintaining a healthy weight (Body Mass Index ie BMI below 24.9) with appropriate and healthy diet including regular and adequate physical activity is also equally important.

There are several complications of diabetes which can affect Nervous System, Eyes and  Kidneys.

4) Foot Care- There may occur Diabetic Neuropathy in which nerve damage occurs and sensations are lost which makes the person vulnerable to injuries and infections that  may remain unnoticed and may reach a threatening stage called Diabetic Foot.Hence regular foot care is critical .

5) Eye Care– Diabetes may lead to Diabetic Retinopathy which affects Retina in the eye. Hence annual eye check up after Diabetes is diagnosed is important so that any ailment in the eye can be detected in time and treated.

5) Maintaining personal hygiene to avoid opportunistic infections like – skin infections, bacterial, fungal infections at other sites in the body.

6) Avoiding Smoking, Alcohol, and Tobacco products consumption.

Diabetes is a multi factorial disease with Age, Genetic (Family History), Racial (Ethnicity) , and Lifestyle Related components . Thus having a Healthy diet, controlling Hypertension, Obesity, and maintaining fitness are the most important determinants in developing Diabetes.

Even today, many of the people are not aware about their Diabetes status and so the incidence is likely to increase in future as more modalities of diagnosis and tests are available.

Taking proper self care with early diagnosis and treatment becomes critical in such case.

Note – Prevention is better than cure and therefore preventing the disease from occurring is the best policy.

Also, it is critical to keep a track of any symptoms of Diabetes like- excessive eating (Polyphagia), excessive thirst (Polydipsia) and excessive urination (Polyuria) which are most common; so that early detection and appropriate care can be provided. As the medications in Diabetes are to be taken on a continuous basis, there may be episodes of hypoglycemia (reduced blood sugar levels). So it is advised that people with Diabetes should keep some sweets with them and should carry an I-card with them whenever they are going out, so that appropriate health care can be provided to them if required.

Dr. Purva Joshi is a Public Health Specialist and Drug Safety Physician at IQVIA, Thane.