Getting diabetes is akin to getting married to the disease unaware. You never knew when this marriage took place. All women like to marry rich and handsome men. (I am using the term women since I am a male, women can read it as men instead). This woman (the diabetes) also love rich people; people rich in body weight (over weight/obese people) & people rich with sedentary life styles etc. You may be poor in both, but your familial richness (parents suffering from diabetes) might have attracted her attention towards you. She loved you so secretly that you were never aware of it, till finally announced by the physician when you went to him for some check up. The new spouse is dangerous, self centered, mean, selfish, erratic in behaviour but dedicated to the relationship. She will not leave you under any circumstance. In marriage there may be an option for divorce but no such law (or treatment) exists here. You don’t have any option, but to keep her in good humour for your own physical and mental peace. She demands your attention 24×7. You have to look after your new spouse properly. She is happy as long as you can keep your blood sugar under control. Failure to do so will invite her wrath (acute complications) which may cost you heavily. She may even inform your in laws (the delayed complications like nephropathy, retinopathy, CAD, neuropathy and atherosclerosis) who would like to stay with you. Your in laws are highly attached to her and won’t mind to kill you even, if she is not happy. If you want to keep them away, better keep her happy. No one else can do it for you. You have to do it yourself (self care tips). Luckily the behaviour of the lady has been extensively studied. In this post I will discuss the mantras (the self care tips) to keep your new spouse happy so that both of you can sail through the ocean of life happily.
Take Your Medicines Regularly
Your new spouse is otherwise very contented. She feels happy when normal level of blood glucose is maintained. High level of blood sugar irritates her. Its common knowledge that one should pamper your spouse by repeatedly telling her that she is beautiful and how much you love her. Taking medicine is akin to telling your new spouse (diabetes) that you really care for her. Take your medicines regularly.
Self Monitoring for Diabetes
You should keep a diary to note down each & every thing which makes your spouse unhappy. Use the diary to monitor the records of urinary and blood sugar results, body weight and alteration in the diet and drugs. During initial phase of the relationship, regular monitoring is required. Glucose strips are available in market. One should measure blood sugar level after 2 hours of food. The same should be noted in the diary and informed to the doctor in the next visit. This will help the doctor to adjust the drug dosage. Once the drug dosages are stabilized, blood sugar estimation can be done once a month. To know the extent of blood glucose control over a period, Hb A1C is done. The value of Hb A1C should be kept below 7. Keep your diabetes happy by monitoring your blood sugar.
Some times, out of enthusiasm you may overdo things, resulting in lowering of blood glucose or hypoglycemia. This makes her unhappy. Its important to recognize her unhappiness (hypoglycemia) and take prompt action. Hypoglycemia may result in coma. It usually results due to excessive insulin or other drug overdose, inadequate amount of carbohydrates in the diet, alcohol intake with anti-diabetic medicines, fasting and strenuous exercises. You may experience increased appetite, weakness, sweating, restlessness, palpitations (feel of own heart beats) and giddiness. Always keep sugar with you and take it when hypoglycemia like symptoms occurs. Timely intake of sugar may avert more serious complications later on.
Have Regular Meals
You must have regular meals. Neither fast nor overeat. Meal should not be skipped. If one meal is skipped, some cereal containing low fat snack be taken. Better to keep banana, roasted Bengal gram etc. 1 or 2 diabetic biscuits can be taken in emergency.
Calorie dense, high carbohydrates foods and simple sugars will irritate your new spouse (diabetes). Take complex carbohydrates. Say no to high-fat foods. It can make blood sugar stay up for longer and in turn irritate your spouse. Sports drinks may have as much sugar as soda. Plain water is probably all you need for a moderate workout of less than an hour. A sports drink may be OK for longer, more intense exercise. But check with your doctor first to see if the calories, carbohydrates, and minerals in them are safe for you. Best drink for diabetics is plain water. Watch out for article on diet modification in diabetes in the next post. To know more about fat intake read post “Are fats really harmful”.
Be Physically Active
Physical exercise is an important aspect of diabetic management. Your new spouse will be happy if you do so regularly. It will also protect you from cardiovascular diseases later on. Exercise enables blood glucose utilization. It also improves insulin resistance. If you have a smartphone, you can download some pedometer Aps and monitor your daily walking. If you can attain a target of 10,000 steps per day you can be classified as physically active.
Maintain Your Weight
No women likes obese & physically unfit spouses and your new spouse (diabetes) is also not an exception. Maintain your weight to attain BMI value of 25 at least to keep her happy. It is desirable to bring it to 22. The waist should also be kept within permissible limits. For weight reduction tips please read the post : lose weight and live healthy. For hazards of obesity you can read the post Obesity Harms be careful
Know Conditions Which Aggravates Blood Sugar Level
During illness blood sugar rises as body works to fight off an illness. Drink water and other fluids to stay hydrated. Doctor must be consulted if you’ve had diarrhea or vomiting for more than 2 hours or if you’ve been sick for 2 days and aren’t getting better. Be aware; some medicines, such as antibiotics and the decongestants can affect your blood sugar.
Medicines like corticosteroids, such as prednisone, are used to treat rashes, arthritis, asthma, and many other conditions. Corticosteroids can increase blood sugar. Diuretics used to treat high blood pressure may have similar effect. Some antidepressants also raise or lower blood sugar. Decongestants that have pseudoephedrine or phenylephrine can raise blood sugar. Cold medicines also sometimes have a little sugar or alcohol in them, so look for products that skip those ingredients. Antihistamines generally don’t cause a problem with blood sugar. Ask your doctor about the possible effects of over-the-counter medicines before you buy them. Birth Control Pills that have estrogen can affect the way your body handles insulin. Still, oral contraceptives are safe for women with diabetes.
Alcohol is a social evil. It has ruined mankind economically, socially & mentally. Like any other spouse, she also gets irritated when you consume alcohol. Best is to say no to alcohol which will protect you from large number of problems pertaining to your new spouse (the disease) as well as other social problems. Alcoholic drinks have plenty of calories. Alcohol will raise your blood sugar. Alcohol may also bring down the glucose level precipitating hypoglycemia. Your levels may drop for as long as 12 hours after drinking. If you can’t resist, better to have booze with food. No more than one drink a day for women and two drinks a day for men are advised. One drink is 5 ounces of wine, 12 ounces of beer, or 1 ½ ounces of liquor like vodka or whiskey.
Dried Fruits Consumption
Fruit is a healthy choice, but you must be aware that dried versions will pack more carbohydrates in a smaller serving size. Limit your consumption to just 2 tablespoons of raisins, dried cranberries, or dried cherries.
Overwhelmed or unhappiness at work takes a toll. When you’re under stress, your body releases hormones that can make your blood sugar rise. It’s more common for people with type 2 diabetes. Learn to relax with deep breathing and exercises. Also, try to change the things that are stressing you out, if that’s possible.
Care of Hands and Feet in Diabetics
Being diabetic you are prone to dry skin, particularly when blood glucose levels run high. This causes the body to lose fluids and skin to become dry. Dry skin can crack and itch, which can lead to infections. Due to neuropathy, the nerves in the legs and feet may not get the message to sweat, which is necessary to keep skin soft and moist. Keeping skin moisturized is one of the easiest ways to prevent skin problems. One should avoid very hot baths and showers, which can dry the skin. “Avoid soaking feet too long,” as prolonged exposure to water softens the feet and makes skin more prone to being pierced. Pain is an important warning system. Diabetes affects nerves and reduces sensation of feet. Diabetics may not notice a small cut or abrasion. This abrasion may come to the notice only when it gets infected or infection is at advanced stage. Diabetics should develop a habit of inspection of hands & feet daily in good light before going to bed or any other fixed time for any swelling, change in colour, abrasion, cuts or wounds. Do not forget to look between the toes. Toe nails should be regularly trimmed. The hands and feet should be washed with soap and water before inspection to have a clear view. In winters the skin should be kept moist with moisturizers, creams etc. Immediate treatment should be taken under such circumstances. Patients with established neuropathies should keep their feet covered properly and protect them from injuries. Use of good quality shoes is mandatory. Slippers and sandals should be used with caution. The shocks worn should not be torn lest they irritate the skin.
Get Eye Tested Once a Year
Diabetes is one of the major cause of preventable blindness. Eye test should be done once year as routine and any time when reduction in vision is felt.
Smoking is a suicidal behavior. Even in normal individuals smoking is not advised. You must quit smoking to keep your spouse happy. Like any other wife, she also does not like your smoking. Your smoking will irritate her. Smoking enhances atherosclerosis and makes one prone for heart diseases. Diabetics who smoke will get complications faster than their non smoking counterparts.
Keep a Reserve of Medicines
Divide medicines into three groups; daily use or running medicines for 15 days, maintenance medicines for 15 days and reserve medicines for 7 days. One should never touch reserve medicine stock. Whenever you go out for travel, keep sufficient quantity of medicines reserve for double the days you are out. It will be great help when someone gets stuck due to calamities en route. In such circumstances getting the desired medicines from market is a big problem. Little precautions can save you from additional miseries.
Keep a Card in pocket
Dispaly your love openly. Show your faithfulness to her by keeping a card in pocket mentioning your name, age, address, telephone/contact number and name & tele number of treating physician. The tele no should have prefix ICE eg if your telephone number is 123456 then it should be ICE123456. ICE is an acronym for ‘In Case Emergency’. If some thing goes wrong it will help people or police to find out a particular telephone number out of contact list.
The self care tips are summarized again for revision as under:-
- Diet precautions
- Maintain weight
- Self monitoring of blood glucose
- Daily foot examination by the patient and 1-2 times in a year by doctor.
- Blood sugar and routine urine examination every month.
- Screening for micro-albuminaria every six months, if routine urine examination found normal to predict diabetic kidney damage.
- Blood pressure measurement every three months
- A1C testing (4 times a year)
- Eye examination yearly
- Lipid profile every six month initially for first year and thereafter every year
Is Future of Diabetics Bad?
After reading the description, it may appear that future of a diabetic is not bright, since he may have to face a life full of misery due to complications. As I said, getting diabetes is akin to getting married to the disease with life long relationship. You have to keep your new spouse happy. Don’t be scared of her. Take it positively. Adversities should be turned into opportunities. Diabetes will give you that opportunity. It will force you to look after your body. You will be under continuous medical supervision. You will modify your diet, exercise and adopt healthy life styles, all because of the disease. It will help you to reduce risk factors for other diseases also. Any complication/abnormality will be detected at the earliest. If you treat diabetes with respect, you may live longer and healthier than non diabetics who may not adopt healthy life styles. Thank your new spouse for it. With life style management and medical supervision you will be able to have a good, productive and healthy life. So better cheer up.
Respect your diabetes and live long and live healthy
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