When someone gets a diagnosis of diabetes, it is often thought of as a condition where your body cannot control it’s sugar levels. This is correct, but patients are often left confused as to why we as doctors start worrying about a variety of issues such as your blood pressure, cholesterol, your feet or your eyes.
Often I hear, “But my cholesterol is not very high, so why are you starting me on cholesterol medication, doc?” or “Why are you saying I need to worry about my blood pressure when there is a problem with my blood sugar?"
A better way to explain diabetes is that yes, your body cannot control your sugar levels very well, but it is the effect of the high blood sugar on your pipes that transport blood around your body, that is the problem. These pipes are in your eyes, feet, heart, kidneys….pretty much everywhere. The high blood sugar can damage those pipes resulting in those parts of the body not working very well. If you don’t control your blood sugar, then your eyes, feet and kidneys become damaged. We worry about your blood pressure and cholesterol because if these are high, they can also damage those pipes causing more damage and more chance that those parts of your body won’t work well.
So, how can we keep things under control?
The most important thing to learn when given a diagnosis of diabetes is what to eat and what to avoid. By changing your diet you can reduce the chances of the condition worsening. Numerous apps are available that can help you log what you are eating so you can better understand what is good for you or not. In addition, many apps come with a health coach who can advise you on any questions that may arise. Should I eat a sweet potato if I have diabetes? Is low fat yoghurt better for diabetics? Advice on diet, changes regularly and it can be hard to keep up to date, however having access to a health coach can make your life easier.
Weight gain is often an indicator that what you are eating is not correct, but this is not always the case. Monitoring your weight is very important in diabetes and very easy to do with a simple bit of technology. However with my patients who are motivated and start exercising regularly when given the diagnosis of diabetes, they often come in despairing because, despite them eating well and exercising they are putting on weight. Why is this happening? With a healthy diet and exercise, you often put on muscle and lose fat, but muscle is denser than fat and causes you to put on weight. Having a set of scales that can tell you your weight and body fat percentage can be useful. If you are aware that you are putting on weight but losing fat, then you know your lifestyle changes are working. If you are putting on weight and gaining fat, then more changes need to be made.
We mentioned above that controlling all things that can damage the pipes that transport blood, is key to preventing the diabetes from progressing. Blood pressure, often known as the silent killer, rarely has any symptoms until it is too late. So checking it often will allow you to do something if it starts to creep up, (change your diet or take some medication). Usually you would see your doctor every six to twelve months, but in the digital age we as doctors should encourage ownership of the problem by the patient. Monitor your blood pressure at home and seek help when needed rather than wait around until you see your doctor every once in a while. By acting sooner you will prevent any problems from causing significant damage.
Many people with diabetes require insulin (the hormone that reduces your blood sugar level). This must be injected into various parts of the body, however the dose of insulin may depend on the level of your blood sugar at the time. This is worked out by piercing your finger and measuring the level of sugar in your blood. For many diabetics, needles and injections have become a part of their life. The digital health revolution has however brought hope to many sufferers. Continuous glucose monitors (CGM) are devices that place a fine needle under the skin that continuously measures the level of glucose in the fluid that bathes the cells under the skin (interstitial fluid). They provide a continuous reading of your blood sugar levels and remove the need for regular finger prick testing. These can be coupled with another device that continuously pumps insulin under the skin according to the readings from the CGM. What you have here is an artificial pancreas (the organ that normally produces insulin in the body). Such devices have significantly improved the quality of life of many diabetics, however they are not freely available and must be commenced under the supervision of your specialist.
Finally, with any long term health condition, it is really important to consider what the worst case scenario could be and prepare just in case. As a diabetic it is important that you know how to identify when a problem is developing and learn what to do. In addition, family members or partners should know how to act if your diabetes is worsening. The Australian First Aid app is a useful information source. With advice on all types of emergencies, downloading it to give you easy access to advice, at a time of need should be considered. (Remember if in doubt call the emergency services).
Our list of favourites are not exhaustive and we would advise you to look at other available products on the website. We at HealthAide aim to empower you to make an informed decision about your health by informing you of available solutions that you may benefit from. Healthcare is changing. By embracing the change you can ensure that any health concerns you may have does not impact on you living a happy, healthy life.
Blog post written by Dr Khurram Akhter.
Khurram is an experienced primary care physician and a thought leader
in the field of digital health.
Disclaimer: This text does not serve as medical advice and if you have any questions, seek advice from your doctor.