Chandigarh, May 14, 2019 :
As I was likely to join the International Diabetese Federation Congress, a very young lady of 30 years named Dorthia Web Pucket with Ph.d degree and working as Assistant Professor at Ven State University, Detriot was also present there to express her knowledge and show her better acquaintance. She herself was a patient of diabetese about which she had been aware of it since the age of 11 years. But she had no diabetic complication at the time of her attending the Congress. She used to take ample precautionary measures right from the onset of this disease. She was much happy and none could judge her from the appearance that she was suffering from diabetese. A lot number of people from the world over had assembled in the Congress just to get awareness about the disease.
It was this aspect of the Congress that the diabetic patients had attended it. It was also a part of this Congress to have a medical check-up of diabetic patients. All the participants attending the Congress were wonder-struck to know that the above cited diabetic patient had no diabetic complication. The specialists diagnosed her thorougly related to neurology, heart, kidneys and other organs of the body but she had not developed any diabetic complication. She was awarded ‘Woman of the Year’ title by putting her photo at the front cover in “The Diabetese 2 Forecast”, an important publication of ‘American Diabetese Association.’ This grand world famous Diabetese Congress was organised to acquaint the people with this idea that a diabetic patient, whether man or woman or child can lead a routine life and reach the topmost position.
Symptoms of Diabetese:
1) Much hunger, thirst and profuse urination.
2) A sudden feeling of debility or decrease in weight.
3) Genetic family symptoms.
Diabetese is a latent disease. It is possible that a patient may be inflicted with this disease despite the absence of symptoms. For instance, frequent eyesight disorder, cataract at young age, heart attack or its first stage called angina in which chest pain occurs during walking or mental stress. If the patient under such conditions stands at a place for the time-being, the pain may subside or decrease. Besides these, an injury may take very long time to cure, a crawling sensation occurs in the calves of the legs, paralysis of one arm or one leg, itching in the urinary passage, sex-weakness, diarrhoea, less quantity of perspiration, recurrence of boils, hypertension, urinary infection, weak functioning of kidneys or their failure etc.
All these complications are avoidable if the blood sugar level of our children is monitored at regular intervals. We should not be panicky if we suffer from diabetese. Diabetese can be controlled if the disease is within limits and no complications are noticed a doctor with the help of some clinical tests and diet control and exercise may avoid the onset of disease. We should not be panicky if the diabetic complications arise since it can be cured with the administration of medicines. Nevertheless, we must be careful to avoid, complications like heart or brain stroke or paralysis or failure of kidneys.
Other Important Aspects :
Are pills or tablets suffice to control diabetese? It all depends on the patient. The tablets work very well on some patients. Some patients get relief by injections only. If the patient is using tablets and the blood sugar level remains uncontrolled, a small dose of insulin may be injected.
What should a Patient do During Journey ?
It is a very common disease and the patient should not feel shy to inject the injection individually. Disposable syringes are frequently available. Insulin filled needle fitted pens are available to inject the medicine. However, insulin should be injected just before the meals. Sugar or sugar-cubes should be kept during the journey so that it may be used immediately in the case 4 of hypoglycaemia i.e.low blood sugar level. Moreover, first-aid box for dressing should also be kept to do dressing in case any injury occurs.
Feet of Diabetics
It should be well remembered that diabetics should be extracautious about their feet. The feet should not get injured and the space in between the figures should be kept clean and dry. The elastic of socks should be loose. Also, the underwear elastic should not be tight. In air-journey or cinema hall, the patient should not sit with one leg over the other for a long time. The nails should be pared after taking bath as these become soft and no injury is possibly caused during paring them off. Moreover, some corn should not be cut individually and the doctor must be consulted to do the needful. Blood sugar must be checked before performing even the minutest surgery. If a patient is to undergo major surgery and using tablets, he/she should be put on insulin. It is a medically prescribed principle. It helps fast recovery of wounds caused during surgery.
Care of feet should be observed individually and see if the clolour of the skin of feet is turning to deep red or violet. The skin inbetween the fingers should also be checked. The feet should not grow too cold i.e. if there is a probability of gangrene it may lead to amputation of foot if it becomes incurable. It has been truly said that a diabetic patient should take more care of his feet than face.
Diabetics should never walk bare-footed. The shoes should be broad at the front so that there is no pressure on the fingers. If the feet are aching, shoes should be put off and legs should be raised above the hips. It helps in better blood circulation to feet. It should be practised continuously and regularly. Apart from foot injury, any other injury on any part of the body should be properly cared.
Fasting Blood Sugar :
Test Diabetic person should not consume anything at night for ten to twelve hours. Water may be taken, however, to test the fasting blood sugar. It has been generally seen that people come back home late after dinner party and then call the technician early morning to test the fasting blood sugar. It leads to higher level of blood sugar. A person becomes a diabetic patient without any rhyme and reason. Such a patient becomes tense and above all, cautions the other family members also due to its genetic origin. Some medicines like Corticoids used for other diseases may cause high blood sugar level.
Sometimes, a person may be using Vitamin ‘B’ complex or Vitamin ‘C’ or Aspirin tablet. Urine examination under such conditions may become green in colour due to Vitamin B complex or Vitamin C or Aspirin but the patient may develop the doubt of being diabetic. So it becomes mandatory to seek the advice of the doctor by testing the blood sugar.
What is Postperendial Test ?
Postperendial test is conducted after two hours of consumption of meals. Its normal level should be below 140mg/dl.
What is Glucose Tolerance Test ?
This test is conducted empty stomach where a number of samples of blood and urine are taken. After fasting blood sugar test, 75-100 gram glucose is administered orally by mouth and blood and urine tests are conducted half hourly regularly. Its normal range is 140-200 mg./dl.
Care is advised even if the level is between 140 to 200 mg/dl. This test is conducted on those patients whose fasting blood sugar level is 60-100 mg/dl. but there is a lurking doubt of being diabetic. It means that the family has a diabetic history and the symptoms signal the doubt of being diabetic. Lack of awareness about being diabetic is a gross negligence that can cause sudden serious complications with the passing of time and prove life threatening.
It should be diagnosed at regular intervals if the symptoms exist. Even if there are no symptoms, it should be diagnosed every 2 to 3 years. Extra caution is needed if the disease is genetic. The patient during glucose tolerance test should remain calm. It has been generally observed that the patient during half hourly test of sugar and urine, either starts smoking or goes to nearby place to perform some activity. Such activities may lead to acceleration of blood sugar level. The patient should relax in the laboratory during the test time.
The Author of this article is Dr. Ajit S. Puri, Recipient of Punjab Rattan