New advances in treatment helps people with diabetes have a better quality of life

Understanding diabetes and keeping oneself updated with the latest advancements in diabetes care is key to good health for people with diabetes, writes Dr Manoj Chawla

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Diabetes is a lifelong disorder to manage. Once diagnosed, people with diabetes require medication to control their blood glucose levels as well as a change in lifestyle. In addition, they also need to manage multiple aspects of their life including following a certain diet, visiting the doctor regularly and following the treatment regimen as prescribed by the doctor. This can be a little unsettling for many of my patients.

Mala, my 42-year-old patient and a teacher by profession, was prescribed insulin for her uncontrolled diabetes. She was angry and disturbed due to this. Initially, I understood it to be another case of fear of injections. I tried to convince her that her fears were completely unfounded as insulin injection devices are virtually painless today. She then shared the cause of her worry was getting up early on her day off from work. Many of my patients are working individuals and a day off from work is valued. And asking them to follow a stringent treatment plan can in certain instances result in mental stress resulting in high blood sugars.

I realized that in addition to making our patients aware about diabetes, it’s also essential that we provide them with choice of treatment. This will ensure that patients comply with the treatment module and are not pressurized into following something, which is challenging for them to continue for a lifetime. While it is true that only a doctor can decide which medication a person requires; but there are new medicines available now which provide flexibility and also suit the different needs of individuals. People with diabetes need help in controlling blood sugars in two ways: Insulin therapy that controls blood sugar between meals and during sleep is called long-acting or basal insulin. Insulin therapy that controls blood sugar while one is having major meals is called fast-acting or bolus insulin.

For people like Mala, the ultra-long acting basal insulin which provides a uniform glucose lowering action resulting in lower risk of having overall, severe and night-time hypoglycaemia and comparable reductions of blood glucose levels is the answer. We also have insulin which works for around 42 hours, which means that a person gets the flexibility to take insulin at different times, rather than same time every day. That insulin exactly worked for Mala’s requirement, as she need not get up at same time on the days while she is having off from work.

In over fifteen years of practice as a doctor, I have observed several instances where maintaining good blood glucose control with insulin treatment can be challenging for people with diabetes due to concerns over hypoglycaemia. With newer generation long acting basal insulin, patients can be sure of having low variability in blood glucose which is associated with a lower risk of severe hypoglycaemia. Hypoglycaemia refers to an abnormally low level of sugar or glucose, in the blood which if left untreated can lead to severe complications.

When taking insulin is absolutely required, insulin delivery devices like pens can help patients with increased compliance to the treatment module and comfort for people with diabetes. Taking an insulin injection is fairly easy; it has to be injected in the fatty (subcutaneous) layer beneath the skin and above the muscle. People can also do it on their own once they learn the technique from their doctor or diabetes educator.

To ensure accuracy in dosage, most diabetes care companies are now offering insulin injection devices which come with easy-to-set and use dial resulting in accurate delivery in every use. With insulin pens one just needs to dial the dose, insert the needle and push the button. One can carry it in pocket or purse. Also, pen needles tend to hurt less. This is because they are shorter and thinner. Moreover, the devices are cost-effective, lasting up to five years too.

Understanding diabetes and keeping oneself updated with the latest advancements in diabetes care is key to good health for people with diabetes. You can manage it; and live a full and quality life but for this, it’s essential to be an informed patient and I urge all my patients to:

• Learn about diabetes and its management from reliable sources.

• Write down their questions, when they visit the clinic. It’s better to ask questions to your doctor, diabetes educator, dietitian or other diabetes team member too often rather than too rarely.

• Work with your doctor and diabetes educator to create a schedule for yourself and stay as close to your schedule of eating, activity, and medicine as possible.

About Author: Dr Manoj Chawla is a Mumbai-based Consulting Diabetologist. He has been practising at Lina Diabetes Care & Mumbai Diabetes Research Centre for over a decade. He is also attached, as an Honorary Diabetologist, to Asian Heart Institute, Bhartiya Arogya Nidhi Hospital and BSES MG Hospital. Dr. Chawla is a lecturer for postgraduate Diabetology courses conducted through CPS, Mumbai.