Times of Oman
Jun 29, 2017 Last Updated at 03:26 AST
Oman wellness: Dealing with diabetes
May 27, 2017 | 6:43 PM
by Dr Manish Chaudhury
Keeping your blood glucose close to normal prevents or delays diabetic problems.
 
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Diabetes mellitus or diabetes is a group of metabolic diseases with high blood sugar for long periods of time. Some of the commonly observed symptoms of diabetes are frequent urination, waking up in the night to pass urine more often, increased thirst more often, increased hunger, eating more food, eating more sweets, weight loss despite eating more food, slow healing of wounds and injuries, changing of eye glass numbers more often, feeling tired always, very dry skin, getting more infections than usual, and abnormal tingling or sensation in feet and hands.

Cause of diabetes is either insufficient production of insulin (a hormone that regulated blood glucose level) from pancreas or body tissues not responding to insulin hormone activity. More than 400 million people live with diabetes worldwide. Diabetes doubles risk of early death in patients and is a leading cause of blindness, kidney failure, and leg amputation.

Risk Factors

• A family history of diabetes (brothers or sisters, parents, siblings, and others)

• Lack of exercise and proper diet, consumption of beverages containing free sugars

• Overweight and obesity are the strongest risk factors

• Being of African American, American Indian, Alaska Native, Hispanic/Latino, or Asian/Pacific Islander heritage

• Waist circumference: >31.5 inches in women and 37 inches in men increases risk of diabetes multiple folds

Controlling Diabetes

Keeping your blood glucose (blood sugar) close to normal prevents or delays diabetic problems. Through careful control, many problems associated with diabetes such as eye disease, kidney disease, heart disease, nerve damage, and foot problems can be prevented or slowed.

Food

• Eating regular meals every 3-4 hours, as advised can help control blood sugar

• Eat less fat. Avoid fried foods. Choose low-fat dairy products (cheese, milk, yoghurt, and others)

• Eating less sugar, more high-fibre foods is also favoured. Drink lots of water

• Eat less salt. Use less salt when you prepare foods

• Cut down on processed foods

Physical Activity

Physical activity has many benefits. It controls your blood glucose and weight. Do physical activity every day. It’s better to walk 30-40 minutes each day.

Medication

If you take diabetic pills or insulin injections to control your diabetes with prescription from doctor:

• Take medicines on time as prescribed

• Don’t add any herbal or other medicine which are not prescribed, they may have dangerous side effects

• Keep medicine away from sun light, heat, and cold

• Maintain insulin at temperature as advised by the doctor

Blood Glucose

Using a finger prick, you place a drop of blood on a special coated strip, which “reads” your blood glucose on an electronic metre.

• It helps you understand food, physical activity, and effect of medicines on your glucose levels.

• It also tells you when your glucose is too low or too high so you can see the doctor immediately.

Getting a Summary Lab Test (A1C)

An A1C test uses blood to check up your diabetes control for the past three months. An A1C test measures how much glucose has been sticking to your red blood cells. A1C test’s normal value is about < 6%. This test will help you and your doctor keep track of your average blood glucose control with medicines.

Low Blood Glucose

In general, a blood glucose reading < 70 mg/dL is low that can be due to insulin or diabetes pills. Low blood glucose is usually caused by eating less, being more active or taking too much diabetes medicine.

Signs of low blood glucose are feeling nervous, shaky, or sweaty. Sometimes people just feel tired. When your glucose level is very low, you may get confused, pass out, or have seizures.

• Test blood glucose immediately

• Eat 10 to 15 grams of carbohydrate right away = sugar packets (2 - 3); fruit juice (1/2 cup); hard candy (3 - 5 pieces); sugar or honey (1 teaspoon); glucose tablets (2 to 3)

High Blood Glucose

For most people, blood glucose levels that stay >140 mg/dL (before meals) are high. Talk with your doctor about the glucose range that is best for you. Some common signs of high blood glucose are having a dry mouth, being thirsty, and urinating often. Other signs include feeling tired, having blurred vision, and losing weight without trying.

When You’re Sick

• Take your diabetes pills or insulin

• Eat the same amount of breads, eat soft foods or drink enough water

• Test your blood glucose at least once every 4 hours. If your glucose is 240 mg/dL or higher, call the doctor

• Check your temperature every morning and evening. A fever may be a sign of infection

• Having trouble breathing, feeling more sleepy than usual, or not thinking clearly can be danger signs — visit the doctor

During Travel

Try to stay as close to your day-to-day schedule. Test your blood glucose as advised on your trip, as well. Before you travel, plan your timing for medicine, food, and activity:

• Keep snacks with you that could be used to prevent or treat low blood glucose. Carry extra bottled water

• Carry glucometer and all your diabetes medicine

Care for Eye

Diabetic eye disease (also called diabetic retinopathy) is a serious problem that can lead to loss of sight. Signs of diabetic eye disease: If you are having trouble reading, blurred vision, seeing rings around lights, dark spots, or flashing lights, you may have eye problems.

Care for Kidney

Diabetes can cause diabetic kidney disease (also called diabetic nephropathy), which can lead to kidney failure. Kidneys filter out harmful wastes called urea and creatinine.

Testing your kidneys: Testing for microalbumin (a protein) in the urine is an early sign of diabetic kidney disease.

Protecting your kidneys: Keep your blood glucose, blood pressure under control. Avoid food high in proteins (such as meat, milk, and cheese) and high salt diet.

Care for Nerve

Diabetic nerve damage (also called diabetic neuropathy) can cause pain in your feet.

Some signs of diabetic nerve damage include pain, burning, tingling, or loss of feeling in the feet and hands, make it hard to urinate, and sweating abnormally. Keep your blood glucose, blood pressure, and cholesterol in control.

Care for Foot

Nerve damage can cause you to lose feeling in your feet, deform or misshape your feet, blisters, sores, or ulcers. Your feet may tingle, burn, or hurt. You may not be able to feel heat, or cold very well. The shape of your feet can change over time. There may even be changes in the colour and temperature of your feet. The skin on your feet may be dry and cracked. Toenails may turn thick and yellow. Fungus infections can grow between your toes. Blisters, sores, ulcers, infected corns, and ingrown toenails need to be seen by doctor.

Protecting your feet:

• Look at your feet every day to see if you have scratches, cracks, cuts, or blisters. Always check between your toes and on the bottoms of your feet

• Wash your feet daily: Dry them with care, especially between the toes. Don’t soak your feet — it can dry out your skin. Rub lotion or cream on the tops and bottoms of your feet

• Trim your toenails carefully: After you’ve washed and dried your feet — the nails will be softer and safer to cut. If you see redness around the nails, see your doctor

• Treat corns and calluses gently as advised: Don’t cut corns and calluses

• Wear shoes that fit well and protect your feet: Always wear socks made of cotton or wool

• Physical activity can help increase the circulation in your feet

Pregnancy and Women’s Health

Women with diabetes can have healthy babies, but it takes planning ahead and effort. Pregnancy can make both high and low blood glucose levels happen more often. High glucose levels during pregnancy are dangerous for the baby.

Protecting your baby and yourself: Keep your glucose levels near normal during pregnancy as per doctor’s advice. Test your glucose several times a day. Get your eyes and kidneys checked.

Having diabetes during pregnancy: It can be controlled just like other kinds of diabetes for healthy mother and healthy baby.

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(Dr. Manish Chaudhary is medical director at Shifa Al Jazeera Medical Services)


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