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Dealing with Diabetes

On World Diabetes Day, NT BUZZ learns more about the various aspects of the disease, and how it impacts the family and support network of those affected by it

Danuska Da Gama | NT BUZZ

With the number of diabetic patients growing year after year, it could well be said that today, it is quite likely that almost everyone knows someone who is living with the disease. Consultant diabetologist, Healthway Hospital, Preetam Kalangutkar tells us more about this illness.

Excerpts from an interview

Q. Diabetes has a large impact on the family of those affected by it. What are your thoughts on this?

Diabetes is a disease that runs in the family. So, if one family member has it, the offsprings and other relatives are likely to get it too. Secondly, for day-to-day management and good control of diabetes, patients, especially adolescents and elderly people, rely heavily on family and friends. For patients on insulin, there is a thin line between achieving tight blood sugar control and maintaining a good quality of life. Having hypoglycaemic (low blood sugar) attacks can be psychologically devastating and sometimes life threatening.

Although attending regular camps, lectures and educational campaigns help educate the patient in management of diabetes, effective communication between family members about detection of hypoglycaemia goes a long way. Help received from family members in areas such as adherence to diet, exercise, medication, blood glucose monitoring, regular wound dressings and managing doctors’ appointments cannot be underestimated.

Q. Though there is awareness about how life-threatening diabetes can be, are people taking enough precautions to prevent falling prey to the disease?

The diabetic population of India is increasing. With easy access to information on the internet, there is a lot of awareness about diabetes and its complications, be it through print media, radio or television. However, only a small scale of the population takes it seriously by indulging in regular physical exercise and maintaining a proper diet. With people getting busier, lifestyles have changed. Snacking on oily food, use of vehicles even for short distances has become a norm. Secondly, common symptoms of diabetes, like feeling excessively hungry or thirsty, passing too much urine, burning sensation of the feet or blurring of vision are attributed to non-medical issues.

Q. What are the various types of diabetes that are prevalent?

Type 2 is what we see in 95 per cent of the people who are diabetic. This means people are unable to utilise the insulin being secreted from the pancreas and are said to be resistant to it. In Type 1, the immune system destroys insulin producing cells in the pancreas and so there in no insulin production in the body – usually witnessed in children. However, one might get affected during puberty or adulthood. In such cases, patients have to be administered insulin and there are no oral supplements available.

There is also Gestational Diabetes, a third kind, which affects ladies during pregnancy. Another kind is Secondary Diabetes which could occur due to tumours, hormonal imbalance, or long term medications like steroids. This occurs when one uses steroids over a long term which increases the sugar level in the body. Once the usage stops, the sugar levels come back to normal. It can also be caused by consumption of anti-depressants.

Q. What are the life-changing complications associated with diabetes?

Life-threatening complications are those that occur due to involvement of small blood vessels and nerves. If the back of the eye gets affected, it can lead to poor vision and sometimes total blindness. Heart attacks, strokes are more common, particularly in the male population and smokers. Kidneys can get affected and may need dialysis. Involvement of the feet can lead to trivial injuries, ulcers, gangrene and may end up in amputations. These affect your work life balance. Productivity is reduced, expenses increase and frequent trips to hospitals have a financial impact on the patient and drain family resources.

In case of elderly patients, incidence of dementia and depression is quite common. Poor eating habits and poor adherence to medications further increases the risk of having hypoglycaemia (low sugar) and falls. Family members who take the role of care givers lose their productivity as well.

Q. Why does a diabetic lose weight? And how can it be corrected?

In a diabetic patient there is mild insulin deficiency and the insulin that is being secreted is not utilised by the body in an appropriate manner. Hence patient loses a lot of sugar through urine. A diabetic loses therefore a lot of calories and as a result loses weight. Once the blood sugars are controlled, weight lost is regained. This particularly holds true in Type I diabetes where there is absolute insulin deficiency.

Prevent yourself from getting Type 2 Diabetes

  Lifestyle measures like healthy eating habits and making physical exercise a part of your daily routine is of utmost importance.

  Eating less carbohydrates, avoiding oily foods and including protein in every meal is helpful.

  Some physical activity like a brisk walk, cycling, or even taking the stairs instead of the lift, taking regular office breaks, stretching exercises, etc is helpful.

  Annual monitoring of blood sugars after the age of 45 is necessary to detect sugars in the pre- diabetes range (borderline diabetes). Monitoring is particularly important in patients with obesity, polycystic ovarian syndrome and those on long term steroids.

Types of Diabetes

Type 1 – When your own immune system is responsible for destroying your pancreas

Type 2 – When your body is resistant to the insulin being produced

Gestational Diabetes – Occurs during pregnancy

Secondary Diabetes – Diabetes due to effect of long term medications, tumours or hormonal imbalance.

Early signs and symptoms

Common symptoms of diabetes are fatigue, feeling excessively hungry or thirsty, passing too much urine, burning sensation of the feet, blurring of vision, feeling breathless on exertion, and non-healing of wounds.

Prevent diabetic related foot problems:

  Regular inspection of both feet every night. Particularly look out for hardened areas of the skin, infections in between toes, in grown toe nails, ulcers, etc.

  Trim your nails regularly and moisturise your feet.

  Wear comfortable shoes and avoid walking bare feet.

  Toe rings should be avoided.

  Get your feet examined at least once a year and more frequently in case you are diagnosed with ‘at risk feet’

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