The number of lives that diabetes has impacted, has been on the constant rise in India. As per the Public Health Foundation of India, nearly twenty eight million people in urban India are suffering from diabetes*. People above the age of 55 can be at a greater risk of contracting the disease. It may be difficult to get rid of diabetes completely, but, with the easy availability of knowledge and lifestyle changes, one can minimize the risks associated with it. Let’s learn to manage and control diabetes well by reading on to know more about it.
What is Diabetes?
Diabetes can be of two types – Diabetes Insipidus and Diabetes Mellitus. Diabetes Insipidus is a rare disorder of salt and water metabolism marked by intense thirst and heavy urination.
Diabetes Mellitus is a common disease that results in high blood glucose. It can be further categorised in to:
Type 1: In this case, the body doesn’t produce Insulin. It is also known as Juvenile Diabetes as people under 40 develop this type of diabetes.
Type 2:This type is prominent in the elderly and as one ages, the risk associated with it increases. In this case, the body doesn’t produce enough insulin. If contracted at a young age and isn’t taken care of, it can get progressively worse.
Pre Diabetes :
Many people today, also have a condition called Pre-diabetes in which blood sugar is high, but not high enough to be Type 2 diabetes. There may not be any clear symptoms in pre-diabetes but it can be diagnosed using the routine blood sugar monitor and lab tests.
Pre-diabetes may not necessarily result in Type 2 diabetes. By making serious lifestyle changes like keeping a check on your health, weight, diet and you can prevent type 2 diabetes
The symptoms you need to watch out for
The most common symptoms of diabetes are the 3Ps: Polyuria, Polydipsia and Polyphagia.
1. Polyuria ( Frequent Urination)
Excessive urination could be a sign of diabetes. This is because, when the insulin is ineffective, or not there at all, kidneys cannot filter the glucose back into the blood. The kidneys will take water from blood in order to dilute the glucose – which in turn fills up the bladder causing frequent urination.
2. Polydypsia (Excessive Thirst) :
Polydipsia is connected to Polyuria. Due to excessive urination, the body craves for more water thus potential diabetic patients may experience excessive thirst.
Frequent Urination is also a symptom for kidney disease. Read here
3. Polyphagia (Excessive Hunger):
Due to the improper functioning or the absence of insulin, the cells are unable to get the required energy. This makes the patient crave for food often.
Other common symptoms are unusual weight changes, increased fatigue, itchy skin, frequent gum bleeding and bruises taking a long time to heal.
If you are above 50, diabetes could impact you in these ways:
1. There is an increased risk of heart stroke due to the high blood sugar level.
2. It can impact the mental faculties making it difficult for some people to carry out daily activities.
3. The wounds may take a longer time to heal. Thus, if you have undergone surgery, your recovery time would be longer.
4. High glucose levels may also interfere with the immune system which increases the risk of infection.
5. The need for medicines increases with age, which may cause minor side effects.
6. Though a high fiber diet is recommended for people with diabetes, but some older people may not be able to adapt to it. Therefore, the fibre diet needs to be introduced slowly.
7. Some patients may develop diabetic retinopathy which affects the vision.
8. People with diabetes can develop nerve damage which may lead to numbness and loss of feeling—in the hands, arms, feet, and legs.
Tests for diagnosing diabetes:
Since the blood sugar levels can vary in a day, Continuous blood sugar monitoring will help you get a true picture of your blood sugar levels. This monitoring can be done at home also.
You need to monitor your readings throughout the day for which the blood sugar levels needs to be checked pre-breakfast,post-breakfast, pre-lunch, post-lunch, pre-dinner, post-dinner and once in midnight. The results of these tests can also be compared with the lab results.
In addition to continuous monitoring, the following clinical tests can give you a fair idea about your blood sugar levels:
1. Urine examination for sugar:
This test measures the level of glucose in urine. A high glucose level often indicates diabetes. If the results in this test is abnormal the Fasting Plasma Glucose test may be done.
2. Fasting Plasma Glucose test
This test is done in the morning on an empty stomach and it checks the fasting plasma glucose levels. Fasting means not having anything to eat or drink (except water) for at least 8-10 hours before the test .The range for various conditions is:
| Condition | Reading range (Venous – Samples taken from a specific vein) |
| Diabetes | 123 mg/dl or higher |
| Glucose Intolerance | 110 mg/dl to 123 mg/dl |
| Non-Diabetic | less than 110 mg/dl |
There may be about an 11% difference from the aforementioned readings if the samples are taken from the tip of a finger.
3. The HBA1C test
The HBA1C is a test that measures the average blood glucose for the past 2 to 3 months. In this test blood can be drawn at any time of the day. The results which correspond to pre-diabetes and diabetes are:
| Condition | Reading Range |
| Non diabetic | Less than 5.2% |
| Controlled diabetic | 5.2%-5.8% |
| Uncontrolled diabetics | Fair: Greater than 5.8% but less than 6.8%Good: Greater than 6.8% but less than 7.8%Poor: Greater than 7.8% |
4. Oral Glucose Tolerance Test:
This test tells how the body processes glucose. It is a two to three-hour long test that checks glucose level before and after one drinks 75 Gm of glucose load. The samples can be drawn in two patterns-
· Five samples are drawn in a time span of two hours. Each sample is drawn in a gap of half an hour
· Four samples are drawn in a time span of three hours. A sample is drawn after every one hour.
On the basis of the readings derived from the samples, the results are determined.
Are the readings of blood glucose monitors reliable?
Various companies offer blood sugar tests to monitor your sugar levels on a regular basis. Though these can also be used to indicate if you have diabetes, however for the initial diagnosis a lab test is recommended. With the rising incidence of diabetes, many people depend on the blood glucose monitor to keep a track of their routine sugar levels or for checking if they have diabetes.
The readings of standard, good brand monitors are generally correct and reliable, but at times may differ from the lab readings. To ensure an accurate reading, you need to ensure the following things:
1. With respect to test strips:
· Throw out damaged strips or those past their expiry date as mentioned on bottle or as advised in product brochure
· Ensure they are stored in a sealed container
· Ensure that the strips are meant for the specific glucose meter
· Keep the meter and strips at room temperature.
· Keep the strips away from Sunlight and high temperature.
· Follow the instructions provided with the blood sugar devices
2. Procedural aspects:
· Wash your hands properly before taking the test
· Don’t put too little or too much blood on the strip
· In case of dehydration or anaemia, the results may differ
Diet tips for diabetics:
1. Fruit Intake: Including fruits in your diet which are low on sugar is strongly recommended. The right choices for you are: Watermelon, Papaya, Guava, Apple (preferably half), Pear, Sweet Lime, Jamun
There are some fruits which are high on sugar. It is best to steer clear from: Grapes, Mango, Melon, Banana
Even though the right fruits are a must for diabetics, it is recommended that they do not consume sugar in direct forms like Juice.
2. Break your meals:
Having two-three light meals in place of one heavy meal is preferable. If you consume four rotis in one meal, dividing the consumption of rotis into separate meals could help you manage your diabetes better.
3. Consume Husk, Gram, Jowar
Incorporating high-fibre foods like Jowar, Gram and Husk helps to keep diabetes under control. You can make Jowar/Gram Roti which are a healthier alternative to the regular flour based Roti.
4. Say no to starvation:
Diabetics need to be careful not to go hungry. They are advised to avoid going hungry for long periods, as the blood sugar can fall and result in hypoglycemia. They are advised to carry a snack preferably a fruit always while out.
While anything sweet is best avoided, one can always make a little allowance on those special occasions. The key is moderation not deprivation. Also, home remedies like amla, karela juice and soaked methi seeds are known to be effective, although their efficacy may not have been proved scientifically.
Managing Diabetes:
| S. No | Managing Diabetes |
| 1 | Take the dilated eye exam |
| 2 | Keep a check on hypertension and depression. Yoga and meditation can help in keeping both under control |
| 3 | Evaluate side effects of drugs |
| 4 | Maintain a balanced weight. |
The world has come a long way in terms of healthcare development and today, diabetes is no more a disease which is synonymous with death. Diabetes can be managed if you give away sedentary lifestyle and move towards a healthy lifestyle.
We hope you stay healthy and enjoy the sweetness of life!!
