Diabetes becomes a companion to many of us in the autumn of our lives. The difference between a person who has looked after this companion well and the one who has ignored it becomes obvious with the passing of age. The one who has ignored the disorder is more likely to be blind, have a kidney failure, a heart attack, a stroke or blood vessel and nerve disorders which can lead to sexual problems and even gangrene and amputation of limbs. So it is important that one looks after this notorious companion well. These days one would see and hear many claims of cure for diabetes, but don't be mislead and waste your money and health on such claims. As of now there is no proven and easily available option of a cure. But one realises that many problems including aging have no cure but can be managed well to have a healthy and comfortable life. So how can we make the best of the situation?
Whatever be the type of diabetes, there are some important guidelines. First is the food control which is now known as 'Medical Nutrition Therapy'. It is not the sweetness that matters but the amount of calories and the Glycemic Index( GI) ( the measure of how high the blood sugar rises when compared to Glucose). The calorie requirement depends on the age, sex, weight, height and the activity of the person. There are several online sites which help one calculate this. If one is overweight or obese, one should reduce 500 – 1000 calories from this so that a gradual weight loss to achieve ideal weight is possible. The food should be wholesome and as per the food pyramid shown
The carbohydrates chosen should be mainly from the low GI category. Foods made of rice flour, maida, tubers like potatoes and products like corn flakes have a high or moderate GI and should be consumed in less quantity. Pulses, Chanadal, vegetables with edible part above the ground have lower GI and should form the larger part of the meal. There are several fruits like apple, orange, guava, berries, cherries etc that are low in GI and should form part of the food. However different people respond to the food in different ways. Therefore it is advisable to check the blood sugar 2 hours after the food to ensure that it is under control and to adjust the quantity and quality of the food. Advices like take extra insulin or tablet and eat what you like can be dangerous. If you want to eat food considered taboo on a special occasion, like cake or halwa on a birthday, the principle of food exchange can be applied. You can avoid another carbohydrate rich food like rice and take a lower calorie amount of the food of your choice, but remember to check your blood sugar 2 hours later with your glucometer to ensure that the blood sugar is in a reasonable range.
The next important factor is exercise. All in the middle age or older and starting on an exercise program for the first time, should consult a doctor and have the necessary tests before starting the exercise program. The exercise should be of moderate intensity and should be tailor made for each depending on the complications one might have and carried out regularly. Please consult your physician or a physical medicine specialist. Regular exercise has benefits more than the sugar control achieved. It improves mobility and stamina, improves blood circulation, decreases chances of falls, controls weight, relaxes and relieves stress, improves sleep which is often decreased in the elderly.
Live a healthy life by not smoking and avoiding secondary smoking. In countries where use of alcohol is permitted, its use should be less than 60ml/day.
Infections are more common in the elderly as the immune system becomes weaker and due to the neuropathy and vasculopathy associated with diabetes of long standing. Some of the common areas are the upper and lower respiratory tract, the urine and the web spaces and pressure areas of feet. Regular inspection and washing of feet with soap and mild antiseptics help in preventing feet infections which can have dangerous consequences.
Loneliness and depression are common especially in those whose spouses have passed away or are staying alone. Emotional disorders upset the control of diabetes and also increase the risk of complications. Keeping oneself active, being involved in service activities, relaxation techniques, yoga, interacting with others of the same age or interest etc. would help. If these are not sufficient then safe medicines and psychotherapy are also available.
Regular monitoring of blood sugar, cholesterol and other lipids, blood pressure and weight are important. Self monitoring of blood sugar with a glucometer helps to ensure proper control and avoidance of high or low blood sugars and complications arising out of the same. The treating physician would also do a number of tests periodically and correct any abnormalities to ensure that you are in the best possible health.
Medicines and insulin advised by the physician should be taken in the correct dose and at the correct time regularly. Treatment is tailor made for each person and one should not try to follow a friend's medicines or dose because his/her diabetes is better controlled.
There are many publications which deal in detail regarding this problem. This year’s health guide of Indian Doctors Forum, Kuwait is on Diabetes. It will be available free for all on the web site www.indiandoctorsforum.org after the 5th of February, 2010. The past years’ health guides are available at http://www.indiandoctorsforum.org/HIndex.aspx .
The American Diabetes Association has made the following recommendations for proper care of diabetes
In conclusion, if one takes care of his/her diabetes well, the aging of the person is almost like someone without diabetes. But if the person does not take care, the quality of life can be compromised and life becomes shorter as the complications of diabetes are more difficult to treat than to prevent.
Whatever be the type of diabetes, there are some important guidelines. First is the food control which is now known as 'Medical Nutrition Therapy'. It is not the sweetness that matters but the amount of calories and the Glycemic Index( GI) ( the measure of how high the blood sugar rises when compared to Glucose). The calorie requirement depends on the age, sex, weight, height and the activity of the person. There are several online sites which help one calculate this. If one is overweight or obese, one should reduce 500 – 1000 calories from this so that a gradual weight loss to achieve ideal weight is possible. The food should be wholesome and as per the food pyramid shown
The next important factor is exercise. All in the middle age or older and starting on an exercise program for the first time, should consult a doctor and have the necessary tests before starting the exercise program. The exercise should be of moderate intensity and should be tailor made for each depending on the complications one might have and carried out regularly. Please consult your physician or a physical medicine specialist. Regular exercise has benefits more than the sugar control achieved. It improves mobility and stamina, improves blood circulation, decreases chances of falls, controls weight, relaxes and relieves stress, improves sleep which is often decreased in the elderly.
Live a healthy life by not smoking and avoiding secondary smoking. In countries where use of alcohol is permitted, its use should be less than 60ml/day.
Infections are more common in the elderly as the immune system becomes weaker and due to the neuropathy and vasculopathy associated with diabetes of long standing. Some of the common areas are the upper and lower respiratory tract, the urine and the web spaces and pressure areas of feet. Regular inspection and washing of feet with soap and mild antiseptics help in preventing feet infections which can have dangerous consequences.
Loneliness and depression are common especially in those whose spouses have passed away or are staying alone. Emotional disorders upset the control of diabetes and also increase the risk of complications. Keeping oneself active, being involved in service activities, relaxation techniques, yoga, interacting with others of the same age or interest etc. would help. If these are not sufficient then safe medicines and psychotherapy are also available.
Regular monitoring of blood sugar, cholesterol and other lipids, blood pressure and weight are important. Self monitoring of blood sugar with a glucometer helps to ensure proper control and avoidance of high or low blood sugars and complications arising out of the same. The treating physician would also do a number of tests periodically and correct any abnormalities to ensure that you are in the best possible health.
Medicines and insulin advised by the physician should be taken in the correct dose and at the correct time regularly. Treatment is tailor made for each person and one should not try to follow a friend's medicines or dose because his/her diabetes is better controlled.
There are many publications which deal in detail regarding this problem. This year’s health guide of Indian Doctors Forum, Kuwait is on Diabetes. It will be available free for all on the web site www.indiandoctorsforum.org after the 5th of February, 2010. The past years’ health guides are available at http://www.indiandoctorsforum.org/HIndex.aspx .
The American Diabetes Association has made the following recommendations for proper care of diabetes
In conclusion, if one takes care of his/her diabetes well, the aging of the person is almost like someone without diabetes. But if the person does not take care, the quality of life can be compromised and life becomes shorter as the complications of diabetes are more difficult to treat than to prevent.
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