6 steps to manage Diabetes!

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Previously, I had attended a lecture given by a doctor working at SIUT (Sindh Institute of Science and Technology) about the symptoms, causes and methods of controlling diabetes mellitus. She gave a pretty interactive and interesting lecture so I made notes. I thought it would be useful for my readers if I were to share this knowledge with everyone. By the way, I suggest you don't skip this article even if you are not diabetic (especially if you are, like me, in a family where diabetes has started to become a family tradition). Always remember: "Prevention is better than cure". So here goes:

Diabetes Mellitus a.k.a  "The Silent Killer" (assassin would sound cooler)

It is estimated that about 6.6% adults of the world's entire population has diabetes (Correct me if I'm wrong. But yes, that's a VERY high number)

That means that a lot of us who are reading this article are either already suffering from diabetes or know a friend or relative who is suffering from diabetes. She told us that in Pakistan alone, the number of people suffering from diabetes in 1995 was 4.3Million and that this number was expected to rise to 14.5Million by 2025. That's more than a 3-fold increase of persons suffering from diabetes!

Now its important to understand that diabetes is not a disease that can be fully cured. Diabetes is not like a simple eye infection where you apply some ointment for 3 days and you're perfectly fine again. No. Its not like that. Diabetes is a dangerous disease. Once you're in, you're in it forever. But don't worry, by the grace of God, we do have certain ways of controlling diabetes and make sure it doesn't completely destroy our body.

There are 2 types of diabetes: Type 1 diabetes and Type 2 diabetes. Type 1 diabetes occurs mostly in children and is quite rare as compared to type 2 diabetes. Since Type 2 diabetes is more common, we'll be talking mostly about the methods of controlling type 2 diabetes here. But yes, most of the methods mentioned should technically help control Type 1 Diabetes as well.

So lets move on to the symptoms and causes of Diabetes Mellitus:

Speaking in biological terms, there can be several reasons why a person may get diabetes. Such as insulin resistance in cells, destruction of insulin producing cells by your own immune system, etc. But in  layman terms Diabetes happens to a person mainly as a result of his lifestyle and family history.

The Causes of Diabetes she outlined were as follows:
  • Inactive Lifestyle (Lack of exercise, watching the tube for too long, etc.)
  • Eating excessive amount  of FAT
  • Obesity (being overweight)
  • Old age (yea, this is a major cause for diabetes in my family)
  • Family History (Did your parents or grand parents have diabetes? If so, read even more carefully!)
  • Some drugs which might eventually contribute to diabetes
Symptoms of Diabetes:
  • Fatigue at the end of the day (like serious fatigue)
  • Excessive amount of urination (need to go the bathroom more often)
  • Excessive thirst
  • Excessive automatic weight loss
  • Slow healing of infections or injuries
So now that you suspect you have diabetes, what do you do?
Well, she mentioned 6 'pillars' for managing Diabetes. I have outlined them below.

6 Methods for managing diabetes:

1) Fix your Diet!
The majority of those reading this article probably come from good households where you tend to eat a lot. A LOT. Eating as much as you want, whenever you want, wherever you want. Sounds like fun. But that's not the way it should be at all. Especially if you, or the person eating with you, has diabetes (you don't want to make the victim of diabetes feel jealous of you and eat even more. Seriously).

So, what should you eat? Basically, you need to have a very healthy diet.
  • Eat a variety of food. Don't eat the same stuff everyday. Variation in food will give all the different types of nutrients and vitamins your body critically needs. Eating the same food each day or for most of the week may deprive your body of those essential vitamins.
  • Take low fat foods. This point hardly needs to be emphasized. Excessive fat is never good for your body. Not only is it bad for diabetes, it also brings along a lot of other problems with it, such as coronary heart disease etc.
  • Take 3 small meals each day.
  • Don't over eat. No seriously.  Not only is it bad for your body, but if you're a Muslim like me, its sinful for you to overeat. Its called gluttony. I myself find it very hard to stop my belly from over eating. But there are certain programs developed by doctors which can help you stop overeating. If you want you can search it on Google.
  • Do not skip a meal. She stressed this point a lot. She literally questioned some students whether or not they skipped breakfast. "Don't skip you breakfast!" etc. etc. heard that lots of times right? But unfortunately for some of us, its true. Breakfast provides your body the energy you need to run around like an energizer cell powered bunny all day. Its very important. Also, don't think that skipping meals is going to considerably help you lose your weight. Its only going to tempt you to eat more and more until you overeat so much that you feel like your belly's gonna explode and you wanna vomit and you feel depressed that by eating so much you just crumpled your well preserved diet and threw it out the window. Yea, very long sentence. Anyways, next point.
  • Avoid refined foods and sugars (Icecream's, white flour, etc). She recommended foods like porridge, cereal, bread, milk and egg.
  • Request the family members to take up the diet plan as well as it might help the patient in adjusting to the new diet. (The diet will help the family members too).
  • Try not to eat lots of junk food either. They are know to be very bad for health. Research has shown that if cooking oil is heated several times, it tends to become a dangerous carcinogenic soup. Fried foods like potato chips and french fries which are repeatedly cooked in such oil become carcinogenic themselves and can not only worsen diabetes, but can also give you a high chance of acquiring cancer.
Apart from this, she also mentioned that you should try to refrain from mayonnaise. Its full of fat. She called it poison as far as I remember. Heh. Eating at Fast food restaurants like KFC, Pizza hut, subway, Mc Donalds, etc is also highly discouraged.

Oh, and avoid fizzy drinks (especially alcoholic drinks). Some of us have so many fizzy drinks each week, its not even funny. Some people have more Pepsi and Coke in their fridge than they have water! That must be awesome yaar! No. Its not. Fizzy drinks have tooooooo much sugar in them. And for a patient suffering from diabetes, that is really toxic. Its like drinking carbonated water. Its full of carbon dioxide and contains chemicals which are JUST NOT GOOD for you. These words are coming from the heart. I personally refrain from fizzy drinks. There is nothing good about a glass of Pepsi. You should consider it your enemy. She even disregarded 'DIET' fizzy drinks as they can potentially be even worse. The artificial sweeteners used in them are know to cause cancer, weight gain etc and a range of other problems.

Also, please don't smoke!!! Its not good for you, nor is it good for those around you... AT ALL. Its even worse if you or the person sitting besides you has diabetes. It makes your heart beat faster, resulting in high blood pressure. Consequently you get swellings on your feet, face and other parts of the body and your heart becomes tired. Blood vessels constrict, thus reducing blood flow. More blood clots appear and this can cause a blockage of arteries. Don't even talk about the risk of lung cancer etc. etc. The problems caused by smoking almost never ends. Stop smoking. Seriously.

2) Exercise! Get up and run. Imagine Dino-Diabetes is chasing you! (More like consuming you from the inside)

Don't waste your time on the TV. Don't let your temptations consume you. Get up and walk around. At the least 30 mins a day. Here's some stuff she mentioned about exercise:
  • Lowers your blood-glucose level which might become quite high after a meal or sugary snack.
  • Decreases your weight and is a cure to obesity.
  • Keeps fat at normal levels in the body.
  • Builds Stamina. (Run run run! Dino-Diabetes is right behind you!! (yes its very lame, but you can use it as motivation I suppose)
  • Minimum 30 minutes of brisk  walking or jogging should be done daily. If you walk 1km in 30 mins, it is considered to be a brisk walk.
  • Improves fitness.
  • Burns calories. (Burn em!)
  • Its a saying: If you can sit, don't lie down. If you can stand, don't sit down. If you can walk, then don't stand around. point is, be on the move. for example, take stairs rather than the lift when going up a building. Extra exercise always helps.
  • Yoga and Meditation is extremely helpful. It helps relax the body, mind and keeps one healthy internally as well. But if you're Muslim, all you have to do is pray your daily prayers with concentration (Khushoo) and you'll achieve the afore mentioned objective. Seriously.
  • This one was funny; If you really have to watch TV, DON'T USE A TV REMOTE. Get up and flip through the channels using the buttons on the TV. This way, every time you want to change the channel/volume, you have to get off your couch and walk ALL THE WAY to the TV. Using this technique, you can Exercise even when you're wasting your time watching TV! How awesome is that!
3) Medication:  Insulin tablets or injections prescribed by the doctor which might help you combat diabetes. i suggest you find yourself a good diabetologist who will be able to prescribe the correct medications to you according to your body type and diabetic symptoms.

4) Testing Blood Glucose:

Do this regularly so that you have an idea of how well you are maintaining your blood-glucose level. Make sure these levels are within accepted limits. The following will tell you in detail about the methods of testing, the accepted limits of blood-glucose, and other details. These have been taken from the site (http://www.webindia123.com/health/tests/common/sugar.htm)
Normal level of sugar in blood before your meal is between 70 and 110 mg/dl. After food, level will rise in between 100 to 140. The increased level of blood sugar above 140 mg/dl is considered to be the symptoms of diabetics. Low level of sugar, below 70 is also dangerous. It may cause fainting.
The two main tests used to measure diabetes are (a) Fasting Plasma Glucose Test, the 
direct measurement of glucose levels in the blood after an 8 hour (overnight) fast, and (b) Oral Glucose Tolerance Test, measurement of the body's ability to appropriately handle the excess sugar present after drinking a high glucose drink. 
Fasting Plasma Glucose test is positive when the value of elevated blood sugar level is above 140 mg/dl after an overnight fast. If the value is above 140 mg/dl on at least two occasions, it means that a person has diabetes. Normal people have fasting sugar levels that generally run between 70-110 mg/dl. 
An oral glucose tolerance test (OGTT) measures plasma glucose at timed intervals over a 3-hour period. The person being tested starts the test in a fasting state (having no food or drink except water for at least 10 hours but not greater than 16 hours). An initial blood sugar is drawn and then the person is given a drink with high amount of sugar in it (75 grams of glucose or 100 grams for pregnant women). The person then has their blood tested again 30 minutes, 1 hour, 2 hours and 3 hour intervals after drinking the high glucose drink. If the plasma glucose level is 200 mg/dl or more in the blood sample taken 2 hours after drinking high glucose shows that the test is positive. 
Gestational diabetes is also diagnosed through OGTT. Glucose levels are normally lower during pregnancy, so the basic values for diagnosis of diabetes in pregnancy are lower. If a woman has two plasma glucose values meeting or exceeding any of the following numbers, she has gestational diabetes: a fasting plasma glucose level of 95 mg/dL, a 1-hour level of 180 mg/dL, a 2-hour level of 155 mg/dL, or a 3-hour level of 140 mg/dL. 
Age for testing: Every person who have attained the age 25 and older should undergo this test. Even if the results are normal, the test should be repeated at three year intervals. Chances for diabetes are high in the case of those who are obese, have a family history of diabetes, have delivered a baby weighing more than nine pounds or have high blood pressure or cholesterol. These people can have their blood sugar checked at an earlier age. 
Care for testing: The blood sugar tests are usually done before and after the break fast. Do not do any heavy exercises before the testing. Try to keep a perfect mental and physical health (not have any other illnesses, not even a cold) during the time of testing. You have to limit your meal the day before the testing. Do not take insulin tablets or medicines (most commonly steroids and certain diuretics) that could affect your blood glucose level. The morning of the test, you should not smoke or drink coffee. During the test, you need to lie or sit quietly.
5) Visiting the Doctor Regularly:

This is important as your doctor needs to know how your progressing and whether or not he needs you to increase or decrease your medicine intake. Also, diabetic patients suffer from several other problems aswell (such as fungus on feet) which can be diagnosed can treated by a doctor quickly.
Cholesterol checks must also be done and shown to the doctor so that he may advise you on further courses of action for controlling cholesterol levels.
Funduscopic examination of the eye should also be done twice a year to ensure that the patient is not suffering from any eye disease which is more prone  to affect a person suffering from diabetes.

6) Education:

Its important to educate yourself about your disease (in this case, diabetes) so that you know about its problems and methods of control inside out. As the saying goes, "know your enemy better than you know yourself"... If after reading this article, your appetite for information is still not satisfied, do visit other diabetes related sites to educate yourslef more about your enemy - DinoDiabetes!!. Google should be your friend in the battle.
So these were the methods of controlling diabetes. If DinoDiabetes was not a good enough motivation, I'm sure the following will. These are a Summary of the complications a person suffering from diabetes might face, especially if they don't make attempts to control their diabetes.

Short Term Complications:
  • Hypoglycemia. A condition which may arise if blood glucose levels fall too low (below 50mg/dl). This condition can cause headaches, nausea, vomiting, sweating, anxiety, and more serious issues such as seizures, unconciousness and (rarely) permanent brain damage or death.
  • More frequent Infections.
Long Term Complications: (This could scare you, but do read it)
  • Brain disease. Known as Diabetic Neuropathy. Caused by damage blood vessels and nerves (axonal damage). Causes severe pain all over the body. You can get so much pain in a specific area that eventually that area becomes immune to pain. Literally. You can then have a risk of injuring yourself because your not going to feel pain. Apart from that this disease can cause, diarrhea, loss of bladder control, bloating, drooping of facial muscles and the symptoms just keep progressing overtime. This is treated by a good control of blood glucose levels. Its other symptoms can be handled using medication and other means with the help of a doctor. Yes, this further stresses the importance of regularly visiting a doctor.
  • Eye disease. Known as Diabetic Retinopathy. Considered the commonest long term complication of diabetes. This can cause bleeding in the eye, retinal destruction and in severe cases, complete blindness. This is very serious. You really don't want to live your life without eyesight. There is a high chance you might fall into depression even if you're just partially blind. I hope it encourages you to do Fundoscopic eye examinations atleast twice a year as mentioned earlier.
  • Kidney disease. Known as Diabetic Nephropathy. The kidney can get impaired and as the disease progresses, it eventually stops filtering the blood effectively. Consequently you might have to spend a large part of your lifetime on a dialysis machine to filter your blood from waste products. This can also lead to depression. If not the dialysis machine, you'll have to pay large sums of money to get a kidney transplant which may not necessarily be successful. Maintaining your blood pressure is important if diabetes is to be kept in check. This is why visiting a doctor regularly is important.
  • Heart disease. The chances of heart failure in diabetic patients is 4 times more than a normal human without diabetes. The chance of stroke is also 2-6 times more in diabetic patients. All the 6 methods mentioned earlier should help alleviate this problem.
  • Foot related diseases. Any foot infection or injury should not be kept unchecked, or else, one can develop gangrene discolouration and death of a tissue. If not controlled, this can grow and can cover your entire foot. The treatment for that is... amputation (cutting off that part of the limb).
All these points were not meant to frighten you and get you into depression if you're already suffering from diabetes. They were mentioned so that you become aware of the dangers you might face if you don't control diabetes properly. You are literally fighting a never ending war with your body.

But always be positive and thankful to God that you're still alive and well. Remember to Exercise, have a Healthy Diet, Eat less and Walk more. Oh and most important, never forget to pray to God; after all everything depends upon Him alone.  What you are suffering right now is trivial as compared to what you could suffer after you die. (Much worse than Dino-Diabetes.  I'm serious.)

Feel free to laud, applaud, criticize, comment, question, react, express your views and bring new information to light in the comments section below!
All comments are highly appreciated.

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