Garth Rattray | Take diabetes seriously

Long before symptoms appear or tests reveal abnormally high blood glucose levels, changes are taking place that eventually lead to diabetic problems. A close family history of diabetes, age, excess body weight, inadequate physical activity; a diet with too many refined foods, high in carbohydrates, frequent calorie-dense foods; poor sleep, physical and/or mental stress and some medications increase your risk of becoming diabetic.

Your pancreas controls you blood glucose level, but so does your liver, brain, muscles, kidneys, intestine and adipose tissue. Over 11 per cent of Jamaicans between 20 to 79 years old are diabetic, so you should check your glucose levels intermittently. And, if there are any things that increase your risk, if you are pre-diabetic or actually have diabetes, you need to check far more frequently.

Diabetes is very destructive. I vividly recall many patients who, despite my explaining, begging and warning, never take their diabetes seriously until it makes them very sick. Some even ignore nutritionists and endocrinologists. Diabetes predisposes you to heart and kidney diseases, strokes, blindness, circulation problems, peripheral nerve damage, limb problems or limb loss, digestive problems, dementia, infections, and sexual dysfunction.

It is extremely sad to see patients turn up with scary complications from their poorly controlled diabetes, and we know that if they had adhered to a healthy lifestyle and medication, they would be fine. What I always find amazing is that, after they suffer some sort of end organ failure or other medical catastrophe, it’s at that stage that they start taking their diabetes seriously.

Although some diabetics must be on medication, their lifestyle must also be adjusted to properly control their condition. Some people will eat or drink badly and then either make certain to take their medication or increase their dose of medication, to compensate for their dietary misdeeds. However, this is not the way to handle diabetes. Diet and exercise are essential for proper, long-term blood glucose control.

KNOW YOUR STARCH

Diets are best left up to the nutrition specialists, but the basic rules are that starchy foods must be kept to a minimum. There are two kinds of starches. People are always surprised to learn that vegetables like callaloo belong to the starch family. However, veggies are good sources of starch because they are so complex and difficult to break down and extract the little glucose that they contain that the sugar yield is insignificant, and the vitamin, mineral, fluid and roughage yields are high. Minimise sweet things and take foods with easily accessible starches, like rice, yam, potato and flour products, in moderation. Most patients are surprised to learn that fruits, and especially fruit juice, can elevate your blood glucose levels. Many believe that fruit juices are healthy, but it is better to eat one fruit a day than to purchase or extract fruit juice. Drinking plain water and eating a fruit a day is the way to go.

Exercise for diabetes should be aerobic and best performed for at least half an hour, five days weekly. It should be moderate and sustainable. Eat small meals about four hours apart and make breakfast the heaviest. If you are on tablets for diabetes, take them as indicated. If you need insulin, don’t be afraid, it’s only replacing the insulin that you are no longer manufacturing sufficiently. Make certain to acquire a glucometer; check and record your glucose regularly. Diabetes can be properly controlled.

Look out for the Servier (Central America and the Caribbean) Pharmaceutical Company’s publication in The Gleaner, ‘#Act Now For Diabetes – What Is & How To Manage Type 2 Diabetes’, on Sunday, November 15. It will include some classic symptoms that may indicate your need to visit a doctor and be tested.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.