While D stands for Diet, I for Information and A for Attitude, the fourth letter 'B' of the word DIABETIC stands for two of the most important things a Diabetic needs to control - Blood Sugar and Blood Pressure.
Blood Sugar Control
The basic problem in Diabetes is that the body cannot manage sugar (which is referred to as glucose). When food is eaten, it is converted by the intestine for the most part into glucose - which then enters the bloodstream in which it is carried to various parts of the body, whose cells then take up this glucose to use as fuel for the various activities of those cells. Excess glucose may also be taken up by the cells and then changed into Fat or Glycogen to be stored.
In Diabetes, this process of uptake by the cells of glucose from the blood is impaired - with the result that glucose accumulates in the blood. This blood containing a high concentration of glucose as it flows through the body can damage the body's various organs.
Althogh simplistic, this is an easy to understand picture of what happens in diabetes - and should explain the importance of keeping one's blood glucose in the normal range..
Knowing what one's blood glucose level is at any time is a vital aspect of managing diabetes - because it allows a diabetic to get an idea of how different foods can alter his or her blood glucose level. For example, if you find your blood glucose when you wake up (having fasted overnight) is 90 mg/dl - and then, having had a huge meal of bacon, eggs, hash browns, tomatoes and mushrooms plus a mug of coffee with two teaspoons of sugar, you test two hours later and find the blood glucose level is 270 mg/dl, you don't need to be a rocket scientist to realise how a High Glycaemic meal like this alters your blood glucose.
Similarly, if you have just spent an hour doing a brisk walk and then test your blood glucose and find that it is at a respectable level, this provides you with feedback on how exercise beneficially alters your blood glucose - since muscles burn up excess glucose when exercised.
Blood Glucose Targets
Ideally, your blood glucose level after an overnight fast should be between 90 and 130 milligrams per decilitre (4 to 6 millimoles per litre) . While blood glucose naturally rises after a meal, it should come down to less than 180 mgm/dl (6 mmol/L) about two hours after the emal.
In addition to knowing what your blood glucose is at a particular time, a very important test is the measurement of Haemoglobin A1C. This substance (commonly referred to as HbA1C0 gives a good indication of what your average blood glucose was over the preceding three months.It is a very good indicator of what your blood glucose control is like,
Blood Pressure
The letter 'B' also stands for Blood pressure. Many folk forget that Diabetes is a significant risk factor for heart disease. All other factors being equal, once a person develops Diabetes, he or she has SIX times the risk of getting heart attack as someone of the same age, sex and genetic makeup. Thus it is imperative that a Diabetic takes care to keep Blood Pressure, Cholesterol and weight under control and to stop smoking - in other words, reduce the risk factors and so minimize the chances of suffering a fatal heart attack.
Today, the target blood pressure for someone who has Diabetes is 130/80. It is important therefore for diabetics to have their blood pressure checked regularly - and if the pressure is repeatedly higher than 130/80, it may be necessary to take medicines to get this high blood pressure under control.
Sanjiva Wijesinha - Dr. Sanjiva Wijesinha, Associate Professor at Monash University medical school, writes on health, travel and medical topics.
