Having gone through the preceding seven letters of the word DIABETIC, I have come now to the final letter C – and for those Suite 101 readers who have been following these articles in sequence, this series will constitute what might be termed the Eightfold Technique of managing Diabetes.
The Mnemonic DIABETIC
D stands for Dietary Discipline, I for Information and Intelligence about the disease, A for one’s Attitude to the condition, B for Blood sugar and Blood pressure measurement and control, E for what is probably the single most important weapon in our armamentarium Exercise, T for Tablets and I for Injections.
The final letter C stands for Consultation – which ties all the others together. I often tell patients after they have been diagnosed as diabetic, have acquired an understanding of the condition, taken steps to get the situation under control and have stabilised their blood glucose readings and blood pressure measurements, with or without medication, that this is just the beginning of a long and lasting relationship with Diabetes.
Unlike conditions such as appendicitis or kidney stones, where once the ailment is diagnosed and appropriately treated that is the end of the story, chronic conditions like diabetes need regular monitoring – and as time progresses, people with diabetes often require modifications to their treatment regime to keep the basic problem under control.
Team of Health Professionals to Manage Diabetes
This is why you need a good team of health professionals that you can consult on a regular basis to help you with managing this disease. Obviously the team must include a doctor – either a committed general practitioner or a specialist, who can check your blood test results, measure things like weight, waist and blood pressure, assess the circulatory and nervous systems as well as organs like the heart, kidneys and eyes that can be affected by diabetes.
My own personal opinion is that a diabetic needs a good GP who can check you twice or three times a year and advise about modifying if necessary the medications you are taking - with this GP working in collaboration with a good diabetes specialist who can see you for a specialised check-up once a year.
Some people make the mistake of thinking that only a specialist consultant physician (a doctor who has specialised and has postgraduate qualifications in medicine, known as an Internist or an Endocrinologist) can manage diabetes.
It is certainly more cost effective for basic diabetes management to find yourself a good GP (Family Physician) who will from time to time refer you to consult an endocrinologist (a specialist who has an interest and training in hormonal diseases like diabetes) to get expert assistance with your management. This is because the specialist will be au fait with new techniques and medications (for example, modern drugs like Sitaglyptin and Exanetide which I mentioned in last week’s article) and can help to fine tune management.
Among other health professionals that you may need to consult are dietitians (who can assess and advise you about your diet), physiotherapists and if available specialised professionals called exercise physiologists (who can advise about exercises, particularly if you have conditions like arthritis or plantar fasciitis that preclude you undertaking the usual forms of exercise) and podiatrists (who can help with care of your feet and nails).
To quote an analogy that I often use, a cricketer can have the best coach, physiotherapist, masseur and manager in the world – but how he performs when he is out in the middle is entirely up to him. Whoever your coach is, this makes not a jot or tittle of difference when the eyes of spectators are on you and you are taking your stance at the wicket to bat. However, trying to perform without a coach and support staff is foolish.
So while managing your diabetes is up to you, select your team – GP, specialist and ancillary health care professionals. Consult them regularly and follow their advice.
The rest, as they say, is up to you.
Sanjiva Wijesinha - Dr. Sanjiva Wijesinha, Associate Professor at Monash University medical school, writes on health, travel and medical topics.
