Lifestyle diseases like diabetes and hypertension have a tendency to quietly enter the house of our physical bodies, much like unbidden and unwelcome guests. In most of the cases, repeated attempts to entice these to depart and scour around for some greener pastures are unsuccessful. After the first stage of shock and denial has passed, a state of active acceptance comes about. The basic principle of a peaceful coexistence eventually gets followed.
Diabetes is labelled as a silent killer. This unwelcome guest has a tendency to 
enfeeble almost all the organs of the body. Its special affection gets directed towards ones which are already in a state of disrepair. These could be our heart, eyes, kidneys, feet or any other organ or limb which catches its fancy. Nerve endings get compromised. Initially, some tingling sensations may be there, more bothersome at night. Over time, sensations may be lost completely, leading to problems which do not even get felt.
Excessive thirst and frequent urination are the well-known symptoms of diabetes. These could easily get ignored and we could chug along in our lives, blissfully ignorant of the arrival of this unbidden guest amidst us. With urine, the body also ends up ejecting some minerals. The disease leaves one feeling tired and exhausted.
The alpha and beta of diabetes
At the core of this affliction is an organ known as the pancreas. Due to genetic reasons or owing to prolonged abuse, there are times when it refuses to behave like an alpha male. It ceases to run on all its twelve cylinders. It does not produce enough insulin, the hormone which controls blood sugar levels in the body.
The beta cells in our pancreas not only produce insulin but also govern the sugar level fluctuations in the body. So, the higher the level of blood sugar, the higher is the fluctuation of sugar levels in general. The fact that South Asian genes happen to be more susceptible to attracting this disease does not really comfort someone who is actually suffering from diabetes.
There are those in whose case the cells that produce insulin are selectively lost. They would qualify to be suffering from Type 1 diabetes.
The body surely needs sugar to keep active and kicking. But when the sugar intake is more than what it can handle, insulin production lags behind its demand. The pancreas is unable to keep pace. Those whose pancreas has started losing its efficacy over a period of time get categorized as having Type 2 diabetes. Often, obesity rules. The battle of the bulge gets lost. Pear pressure kicks in.
Then there is a portion of humanity which shows signs of an imminent onset of diabetes. These could be called pre-diabetics. Surely, there is some hope for them, provided they adopt an active lifestyle, change their diet pattern, and do not allow diabetes to walk in.
The delicately nurtured amongst our species, when they happen to be in the family way, face the risk of gestational diabetes. Though it is a temporary condition, they end up having a higher predisposition towards Type 2 diabetes.
Sharing some key observations
Yours truly is neither a physician nor a person even remotely connected with the field of medicine. Nevertheless, here is a summary of what one has learnt so far. Some of you might find these of use. These observations pertain to Type 2 diabetes.
Blood sugar levels are a function of the following major factors:
- Stress: The higher the stress levels, the higher the blood sugar levels. A prolonged challenging situation – whether on the home front or on the office front – could reduce the immunity levels of the body and increase the sugar levels.
Laughing things off helps, so does the company of those who exude positivity. Building up inner resilience reduces the impact of external circumstances, and thereby helps in controlling sugar levels better.
- Physical activity is a basic factor. Be a couch potato or a chair tiger and repent at leisure. Regular brisk walks and light exercises help. But these produce results only after about six weeks, by which time the body forms a habit and starts demanding its daily dose of whatever physical regime you decide to follow.
Pottering about in the garden or in the kitchen and doing household chores provides some protection. Climbing up stairs and not using an elevator helps. Living life with lesser dependence on your favourite Ferrari helps.
But nothing to beat the efficacy of either cycling or a brisk walk, which is closer to the way a soldier would typically walk. Sweating it out is a key factor. It also helps with heart-related issues.
Much like a tube light needs an initial surge of additional power to get going, the body also needs an initial impetus of will power to walk the first 500 meters. Thereafter, once it has warmed up, a brisk walk often sounds more like a cake walk.
- Medication cannot be taken lightly. It needs to be taken regularly, on time. This implies that meals required to keep the body and soul together also need to be taken on time, day after day.
Oral medication is convenient. At times, if it is unable to bring blood sugar levels within control (fasting values in the range of 70-100 and other values being in the range of 120-200), the physician may prescribe insulin injections.
Insulin has a singular advantage of the necessary hormone reaching the blood stream directly. But the flip side of using insulin, or any other anti-diabetic agent, is the risk of blood sugar dropping down to such dangerous levels as 60 or below. Symptoms could be tiredness, giddiness, excess sweating, palpitation and even coma and other complications. This could even prove to be fatal.
To avoid such complications, a bar of chocolate, some dry fruits and biscuits should always be kept handy. Sugar cubes could also help. A glucometer needs to be used to immediately check the blood sugar levels and the incident reported to one’s doctor.
- Diet is a crucial factor in managing diabetes. Our scriptures often extol
the virtues of leading the life of an ascetic or a monk. Diabetes propels us towards such lofty goals in life. Controlling our taste buds is a serious challenge and needs nerves of chilled steel. When a piping hot junk food item like a ‘samosa’ comes up in front of us, or when a ‘rasgulla’ gets lovingly offered by an otherwise well-meaning friend, the deep reserves of our tenacity have to be marshalled to refuse these and instead pick on a green salad.
Even fruits like mangoes and bananas are harmless, if taken in moderation and if in the absence of any other item on our plate.
Some tests and parameters
- Regular checks on blood sugar levels (fasting as well as postprandial, PP) are highly recommended.
For fasting level to be correctly ascertained, during the previous night, except for plain water, nothing else should be consumed after 10 PM. Medicines to be taken after the test. Normal breakfast can be had after about 30 minutes.
For PP, a reading would need to be taken two hours after breakfast, with nothing else being consumed in the meanwhile. Any deviation from this procedure can be brought to the notice of one’s physician.
- Once in six months, our physician may recommend a test known as HbA1C. This one tells us the weighted average of our sugar levels over a period of the past three months, thereby indicating the extent of control we have exercised over ourselves during that period. A value below 7 would normally indicate a fair amount of control, though the exact value is best decided between the doctor and the patient.
- Frequent eye and feet check-ups are necessary. Once in a year, functioning of the kidney needs to be reviewed by means of appropriate tests.
When prolonged tension leads to hypertension
Yet another lifestyle disease which creeps up on one is that of high blood pressure. If left unattended, this could result in the hardening of arteries, cardiac problems and an increase in one’s intraocular pressure in the eyes. Keeping this on a strict watch is in some ways even more crucial than regular monitoring of blood sugar levels.
Of doctors and miracle cures
The role of a doctor in managing diabetes is more akin to that of a guide. The hapless physician has no clue as to what our daily meals comprise and the amount of liquors and desserts we gobble up at social events.
Often, we may come across miracle cures made by those who are proficient in alternative streams of medicine, claiming to get us rid of diabetes in a short period of time. If followed, these could achieve good results in the short run, but could do more harm to the body in the long run. The reason is simple – these are not sustainable. In a controlled environment, these cures could really work. But when we are back in the civilization, living our routine lives and facing all the harsh slings and arrows of Fate, the short-term benefits could simply evaporate. However, there is a general belief that some medicines from alternative streams do work as supplements, somewhat nullifying the side effects of allopathic medicines.
A helping hand from the government
One has no statistical evidence, but there is no doubt that those suffering 
from this lifestyle disease do end up suppressing the economic growth of the country they inhabit.
Revenue-hungry governments world over could think of imposing a hefty ‘sin tax’ on all things sweet. Tax breaks can be offered to those who suffer from a lifestyle disease. The delivery of public health services can be strengthened.
The civic authorities would do well to ensure that there are adequate provisions for bicycle tracks and for taking brisk walks in open spaces for its denizens. Public transporters could pitch in by ensuring availability of diabetic diets to those who might be in need of the same.
The trick of managing a lifestyle disease
The real control of diabetes and other lifestyle diseases rests in our own hands. Guided by a competent physician, management of these is no rocket science.
Basically, the trick lies in holding our chin up, looking ahead to a joyful life with clear eyes, and marching on with our lives, wearing this affliction as a badge of honour on our sleeves, aspiring to evolve spiritually, with nary a wrinkle on our forehead.
Bertie Wooster and Jeeves would heartily approve of a sunny disposition of this nature. So would Ashe Marson of the ‘Something Fresh’ fame.
(Inputs from Dr B S Suryanarayana, Additional Professor, Department of Medicine, JIPMER, Pondicherry, are gratefully acknowledged)
(Illustrations courtesy www)
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https://ashokbhatia.wordpress.com/2014/10/06/handling-the-diabetes-tsunami-in-india
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