DIABETES MELLITUS – Top TEN frequently asked questions!

The incidence of Diabetes is increasing all over the world including India. There are two main types: type 1 or Insulin deficient or juvenile and type 2 or Insulin resistant or adult onset Diabetes. In type 1 Diabetes pancreas does not produce Insulin and you cannot survive without Insulin. In type 2 Diabetes, pancreas does produce Insulin but it is insufficient and/or less effective.

Public education is the key to control the epidemic of Diabetes. Here are the top 10 questions asked by the public and the answers.

How do I know I have Diabetes?

At the beginning there may not be any symptom. When blood sugar is above 180 mg%, sugar starts appearing in the urine. Sugar in the urine drags water and you pass a lot of urine and feel dry and thirsty. You may also feel tired and loose weight. Your appetite increases and peculiarly you may notice that you are loosing weight in spite of eating more. Chance of infection is higher if you have high sugar and also your healing from infection, cut or wound may be unusually delayed. Some people complain of poor eyesight.

Who are at risk of Diabetes?

Family history of Diabetes is the major risk factor. Sedentary life-style, obesity, smoking, excessive alcohol intake, high blood pressure and in case of women previous Diabetes in pregnancy or delivering big baby (birth weight more than 4Kg) are risk factors.

Can I prevent Diabetes when my risk is high?

If you have family history, you cannot do anything about that. Things in your hands are healthy eating (i.e., eating vegetables and fruits, avoiding fast food), healthy life-style (regular exercise, avoidance of smoking, moderation of alcohol, etc) and keeping your weight in accordance to your height. Certain medicines are being used recently for preventing Diabetes in people who have borderline Diabetes.

I have nobody in my whole family with Diabetes, how did I get it then?

Family history certainly is an important factor, but the fact is being Asian, we all have high-risk gene for Diabetes. Remember it is not your fault that you have Diabetes. You are just happened to be the person who got it. In India 4% of villagers and up to 15% of city dwellers have Diabetes. Not only we have more Diabetes we are getting it at an earlier age than people in the west (around 10 yr).

Can I have drink when I have Diabetes?

Yes, you can. Alcohol is not banned in people with Diabetes. As always a little alcohol is pleasant but a lot is not, regardless of Diabetes and can damage the body badly. Remember “Hypo” (low blood sugar) can occur with alcohol and you should not skip meal after a drink with the fear of calorie in the drink.

You need to know the medically allowed limit of alcohol. A small measure of Whisky, Rum, Vodka or Gin, a small glass of Beer or Wine is measured as one unit. The limit for men is 21 units and for women 14 units a week. It is better to space that rather than taking weekly quota on a day! Sweet wine or Sherry should be avoided as they have very high sugar content.

Do I need to stop eating out? Can I have ice cream? Can I take artificial sweetener?

Certainly not, as long as you are not planning to eat out everyday! You need to know what the right food is and correct amount.

Occasionally yes, but do not make a habit of eating ice cream regularly. There are certain ice cream available now with no added sugar, but do not forget they have calories.

Certainly yes, artificial sweeteners are safe. Do not put them in cooking, they break down when heated. So they will not be sweet any more.

Can I control Diabetes with Diet only?

Diet is a very important aspect in the treatment of Diabetes particularly the timing of it. At the beginning you may be successful in controlling Diabetes with diet only, but unfortunately a time will come when only diet won’t be enough, you will require medicine. This time is different for different people, for somebody this can be a few months while for others it may be a few years. It is very important to try with diet first; this will help you to understand the principles of diet and will convince you the need for treatment to control Diabetes.

Once started, do I need to take tablet for life?

This all depends on your Diabetes. If your Diabetes is very well controlled with a small dose of tablet, you may try only with diet. If that is fine, why not to control your Diabetes only with diet and life-style measures. But if you see, your control is not good with diet alone, you must accept that your body needs medicine and you should start again.

Who with Diabetes needs Insulin?

In type 1 Diabetes Insulin is a must for living. In type 2 Diabetes we advice Insulin in certain situations like pregnancy, during and after surgery, severe infection and for some reason or other when you are not able to eat. Obviously, when tablets do not work, you need Insulin for Diabetes control.

Is there any job restriction for people with Diabetes?

Diabetes should not be a selecting or refusing factor in employment arena. We need to make this clear to employers and employees. Driving is a problem if you are getting frequent hypo, as a rule people with Diabetes on Insulin are not given license to drive heavy vehicle and buses. Remember it is not your fault that you have Diabetes and there is no reason to hide it. Make sure that people around you know that you have Diabetes. Tell them about “Hypo” and what they should do in case you have a severe hypo.