While most awareness messages campaign heavily for prevention, they inadvertently leave behind those who already have a chronic disease.

But doctors have now veered round to the view that it is indeed eminently possible for those with a chronic disease, or diseases, to live a good, even long life. A study done at Dr. Mohan's Diabetes Specialities Centre (DMDSC) last year showed that in about two lakh patients, about 250 patients were living nearly 40, 50, and 60 years after they were diagnosed.

Chronic diseases are long-term health problems that can last for months or years, and often, a lifetime, according to the Healthwise Handbook. It does not make sense to undervalue a chronic disease, because living with one is certainly not easy. It puts some constraints on life as a person is used to living, with compulsions in the form of dietary restrictions, multiple pills one has to take over a long period of time, and the need for constant medical checks.

“It is estimated that about 75 per cent of people who live with a chronic disease are depressed. It is nearly inevitable, considering the adjustments that a person has to make,” says S.Thanikachalam. This is something that all persons with a chronic condition would have to watch out for and seek professional help if they show signs of depression.

The key to living well if you have lifestyle-related long-lasting conditions such as diabetes, hypertension, cardiovascular disease, cancer, or stroke is to be fully aware of their health condition. A lot of information is now available on the web as well, but it is important to consult the treating physician before incorporating any major changes in life.

Even as the physician plays a key role, so does the patient, says Dr. Thanikachalam. While periodic health check-ups are recommended, he says, tools are now available for the patients to test their own blood pressure and sugar themselves. “The best thing is for the patient himself or herself to monitor BP, sugar and cholesterol. It can be done even without a visit to the doctor,” he explains.

The DMDSC study showed that all patients with diabetes who had lived over 40 years had been careful with diet, had regular exercise, periodic blood sugar tests, and had maintained their three month average (HbA1C) within 7. They have also, it turns out, been regular with their medication and stuck to the regimens prescribed.

These results are indicative of the effect that lifestyle modifications have on people's life, even if they are have already been diagnosed with some chronic disease or the other. They have a beneficial effect on the quality of life and help in avoiding related complications that may involve hospitalisation and increased expenses.

Taking a diet that is appropriate for the condition is important. A diet rich is fibre and low on fat and carbohydrates is said to be ideal, but each condition has a different requirement.

Diabetics must avoid sugar, hypertensives should avoid salt, while conditions like tuberculosis or cancer require a high-calorie diet, A.Panneerselvam, senior diabetologist says. Diet is always a fine balance, especially if age, and co-morbities and financial ability pose additional burden, he adds.

Similarly, some form of exercise must always replace a sedentary life, but be careful what kind of exercise you do, Dr. Panneerselvam explains. Some might have bad knees, diabetic neuropathy, cataracts, or be constrained by breathing difficulties. “We have to individualise the treatment and recommendations for every patient,” he adds.

Keywords: Diabetes

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