Diabetes causes a number of medical complications, so don't take it lightly, warns HEMA VIJAY

If you are a sedentary or an overweight Indian who tucks in much more calories than you spend, with a waist circumference over 85 cm (for women) and 90 cm (for men), it is time to sit up and take notice, especially if you have a family history of diabetes. You could be among the estimated 79.4 million Indians who will be diabetic by 2030, according to WHO estimates! Don't take diabetes lightly. Diabetes can attack your blood vessels, nervous system, eyes, heart, kidney and feet. "Diabetes can cause blindness (diabetic retinopathy), kidney failure (diabetic nephropathy), nerve and vascular disorders and diabetic foot disease leading to gangrene and possible amputations," says Dr. V. Mohan, chairman, Dr. Mohan's Diabetes Specialities Centre. Diabetes can affect nerves and cut off sensation in several parts of the body. In fact, a patient's toe was nibbled off by rats without him feeling any sensation of pain. Diabetes can also induce premature heart attacks. In fact, diabetic patients can have heart attacks even without standard symptoms like chest pain and sweating, because the nerves have already been affected. Diabetes can also affect sexual function leading to impotency in males.

Warding off Diabetes

While type 1diabetes is sporadic and has no warning signs, type 2 diabetes is lifestyle related and triggered by improper diet, obesity, stress and lack of physical activity. "If detected early in the stage of Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGP), you can halt the progress into diabetes by employing a combination of drugs, diet, and exercise," says Dr. V. Balaji, senior consultant diabetologist, Apollo hospitals, Chennai. When to take the testThe most diabolical facet of diabetes is that it is a very silent disease and shows no outward symptoms initially. This makes early screening for your sugar blood levels mandatory. "As diabetes is widely prevalent among Indians, it would be advisable for everyone over 30 years to take the Glucose Tolerance Test (GTT) and repeat the test at least once a year. If you have a family history of diabetes, then this test should be done even when you cross 20. If both the parents are diabetic, the child carries a 99 per cent risk of getting diabetes, if one of the parents is diabetic, the risk for the child is 50 to75 per cent. Even if a close relative is diabetic, the risk for the child is as high as 25 per cent," says Dr. Mohan.

Managing diabetes

Today, there are easy-to-use Insulin pen injectors which can make life easy for a diabetic patient. However, sticking to a strict diet and regular exercise regime remain key to managing diabetes. Regular daily exercise is critically important for diabetics because it not only utilizes blood glucose and brings about weight loss, but also prevents cardiovascular complications and relieves stress. Be it walking or aerobics, a diabetic should exercise intensely for about 45 minutes at least 5 times a week.As for diet, rather than skipping meals to cut calories, people with diabetes need to eat meals/ prescribed snacks at regular times each day and stay off foods with high sugar content (like honey, jellies, candy, syrup and soft drinks). They also need to keep a close count on their calorie intake and also keep note of the ingredients of readymade foods they consume. "Apart from mango, banana, chikku and jackfruits which should be avoided by diabetics, they can eat other fruits if the fruit serving is between 100 to 200 grams," Dr. Balaji says. However, the diet for a diabetic is individualised and has to be arrived at after taking into consideration his or her lifestyle, physical activity and associated complications, Dr. Balaji adds. It also helps to cut down on cereals and increase your vegetable intake.In addition, a diabetic should keep a constant watch on his sugar levels. You can monitor your sugar level by self testing at home using glucometers, but the results should be corroborated with lab tests once in three months.

Watch out for complications

As diabetes causes a number of medical complications, apart from prescribed review visits with the diabetic specialist, a person with diabetes has take regular check-ups of his heart, cholesterol levels, eyes, foot and nerves (at least once a year) and kidneys (once in three to six months), even in the absence of associated symptoms. If the situation warrants, the tests may have to be repeated at even shorter intervals. This might sound laborious and even expensive, but as Dr. Mohan puts it, it would be costlier to loose your vision, kidney function or an arm because of diabetic complications, which often strike silently. These apart, keep track of your blood pressure and body weight, anomalies in which can indicate complications. Take heart: if good control is maintained during the first ten years after the onset of diabetes, most patients can lead near normal lives and escape severe complications later on, say diabetologists.

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