The best way to take control of diabetes is to have a “customized action plan”. No two people are exactly the same and it is important that you work together with your health care professional to devise a plan that works for you. Knowledge of your disease is the starting point.

Imagine preparing for an examination without knowing the syllabus; you would most likely end up underperforming. I daresay you will not approach any examination in this manner, so why would you try to manage your diabetes without understanding the disease and having no clue of your goals? It does not surprise me that many people living with diabetes keep asking when they can stop taking their medication as soon as they see single digits in their fasting blood sugar levels. Single digit fasting blood sugar readings have a lot in common with single digit inflation figures; both of them may not necessarily mean all is well. Both figures only serve as guidelines, there may be much more work to do before you are “safe”. A single digit does not necessarily mean the “organs” are not suffering.

1. Set Your Goals
a. It is important to set targets with your doctor. Work towards this goal daily. You may have bad days but do not give up; it is rare to have a patient who makes a perfect score everyday. This does not mean you should throw caution to the wind; just be realistic and avoid unnecessary stress.
b. Make sure you know what it feels like if your blood sugar is extremely low (hypoglycaemia), since you could quickly find yourself in unknown territory six feet under. Always remember hypoglcaemia is a killer.

2. Know Your Medications
a. Whether you take insulin shots or tablets, it is important to know the names of the medications, their side effects and how they should be taken. Ensure that you do not leave the hospital without this basic information.
b. Do not rely on hearsay; if a friend or relative had a reaction with a particular medication, it does not mean the same will apply to you.
c. It may also take time to arrive at the combination of medication and doses that works best for you. Be patient!
d. Your medication needs may also vary depending on your lifestyle (physical activity, dietary practices etc). If you have Type 2 Diabetes for instance, the amount of insulin your body makes may decrease with time and you may need either new medication or more of your current medication to achieve the same blood sugar control. Do not “play” doctor, work together with your health team that may include doctors with different specialties, nurses, pharmacists and fitness therapists to reach your goals.

3. Get Your Lifestyle on Track
a. Your food is as important as your medication. A diabetic who has not had a formal session with a dietitian is like a person walking through a maze in the dark. A dietitian can assist you with the right meals and portion sizes, as well as help you modify the food if you have any complications with your kidneys or heart. Ensure that you eat three healthy meals a day unless a professional advises you to do otherwise.
b. Always communicate to your dietitian and doctor how much exercise you do. Exercise is key to lowering your blood sugar as well as controlling your blood pressure and weight. Appropriate exercise will also relieve stress and in general improve your wellbeing so that you can keep your goals on track.
4. Monitoring is Crucial
a. If you do all the right things and yet you have no means of monitoring your changes, then the work is only partly done. Tabulate the following and fill them out regularly;
i. HbA1C; ideally should be done every three months. It is a measure of long term blood sugar control.
ii. Fasting or Random Blood Sugar; Do this as often as you can afford.
iii. Urine test; Do this at each hospital visit.
iv. Blood Pressure; you should at least measure this at each hospital visit.
v. Blood Cholesterol; once a year is the barest minimum
vi. Foot Exam; once a year or more often if you have foot problems or are at increased risk. Diabetics are prone to foot ulcers.
vii. Eye examination by an eye specialist once a year.
viii. Kidney test at least once a year
ix. Peripheral Arteries; check now and if normal you may not need to repeat it for another five years.
b. Tabulate all the above, write out the dates you did the tests, your result, date for the next test and your target value.
5. The Psychological Factor
a. Diabetes like all chronic diseases has a high risk of making you depressed. It is thus not strange depression is common among diabetics, and treating depression makes it easier to manage blood sugar. Depression may sometimes be difficult to detect since not all people will feel unhappy etc, quite a number of people may experience unexplained body pains, fatigue not explained by activity and poor sleep pattern. Unfortunately many clinicians may ignore the mental health aspect of diabetes; talk to your doctor
b. You also need to remember that extreme physical and emotional stress may all affect your blood sugar making it difficult to reach your goals.
Spend time to understand your disease, take pains to make your personal check-list or table, make sure you are actually doing all you are required to and I am sure you will realize that you can live a fulfilling life with diabetes – The Control of Diabetes lies in your Hands.

AS ALWAYS LAUGH OFTEN, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)

Dr. Kojo Cobba Essel
Moms’ Health Club
(dressel@healthclubsgh.com)


*Dr Essel is a medical doctor and is ISSA certified in exercise therapy and fitness nutrition.

Thought for the week – Diabetes is NOT a death sentence; you can live well with diabetes once you understand the disease.
Reference:
1. Diabetes – Your Take Control Guide (ADA, 2012)