Hello and welcome back!
Last week, we looked at Diabetes Mellitus (DM), a condition where the body is unable to make use of sugar derived from the food we eat either due to the total lack of insulin or ineffective insulin action.
This week, we look at what next after diagnosis

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What should I expect?
So, you have been diagnosed with DM. What next? Is that the end of life? NO. Please take a deep breath and tell yourself, there is life after DM. Brace yourself for the future.
Diabetes cannot be cured. It is for life, so please, avoid anybody who claims to have a cure for diabetes. Diabetes can be managed by lifestyle modification which includes diet therapy, physical activities, and weight management. In addition, you may receive some professional counseling on medications such as; how the medications will act, side-effects you should expect, and the need to comply with your treatment.

Diet therapy
It is not easy to change the diet you’re used to eating but sometimes, this change is what can save you.
The modification to your diet usually is a balanced diet that is locally available, accessible to the patient, as well as appropriate.
To a patient or patient relative reading this, seek knowledge so you don’t perish (Hosea 4:6).
Studies confirm that diet therapy should be tailored toward the individual’s needs.
Developing a diet plan for a diabetic is not a one-size-fits-all approach. Several factors need to be considered and these may include; duration of diagnosis of DM, weight goals, blood glucose targets, etc. Thus, it is important to have your own diet therapy session if you are to be holistically taken care of and provided with an appropriate diet plan. (Alison, Boucher, Cypress, Dunbar, & Franz, 2013).

One thing that can’t be over-emphasized however, is portion control🧐. I still see some people sitting behind a mountain of T.Z or banku with a small amount of soup and protein🤣🤣. The days of slavery are over! Say Amen and eat a fist-size of banku or TZ, and fill your tummy up with soup, protein, vegetables, and fruits. Check out http://hectoriaawekeya.com/rainbow/ for more tips on how to incorporate fruits and veggies into meals.

Physical activity
Overall, physical activity is associated with better health (Ong, Crowston, Loprinzi, & Ramulu, 2018). Mild to moderate intensity exercises help to improve the action of insulin thereby helping move circulating blood sugar into the cells to generate energy, thus helping blood sugar control.
It does not need to be “Ghana’s most strongest” kind of exercise 😂 . Simple things like sweeping, packing or unpacking clothes, walking up the stairs or around your house can go a long way to help.
Be mindful to crosscheck with your primary health provider before engaging in exercises that are not routine. I remember the grim story of a newly diagnosed DM woman who “went on road” (dressed up in sneakers and exercise outfit for jogging) after she was told exercise would help, only to return with a blister of the foot that never healed. This one action leads to a bad foot ulcer that almost led to the loss of her leg. Start slowly and be intentional about moving your muscle groups. Check https://hectoriaawekeya.com/keep-moving/  for more information😁.

Weight management
Patients who are overweight or obese are counseled on weight loss as this also helps improve insulin resistance. Those underweight are also put on a diet to help gain healthy weight. Overall, obese patients with DM who lose weight develop complications more slowly as compared to those who do not lose weight(Grams, Garvey, & Garvey, 2015).

Counseling on treatment
Medicinal counseling as well as psychological counseling is very important. Many a time, patients literally break down when they are diagnosed and they attribute their state to ill-luck or even witchcraft🤦🏾‍♀️. In the process, they go finding help away from where the real help is.
I am a woman of faith and one thing I know for sure is that God is the brain behind the science. Not taking the medications and only sticking to faith-based items such as Holy water or blessed handkerchief will only result in you developing complications quickly so be wise👍🏾. At worst, you can safely take your medicines using the holy water from the prophet.

Complications

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Insulin
When I was a child, I used to think and act like a child. In the early years of my practice as a doctor, when I didn’t know any better, I would threaten my patients with insulin by telling them “Maame, if you don’t take your medications well to control your sugar, we will give you injections oo”. 😆😢

The fear of insulin was instilled in all patients in the hopes that it would make them comply better with treatment protocols. Little did I know that a good number of diabetic patients will require insulin at some point in their lives. This is not because they are not complying with the oral treatment, but that, their beta cells which are responsible for producing insulin eventually all die out, and no matter how you beat the dead donkey to run, it can’t move an inch. So my dear, from the very first day of diagnosis, you, as a patient and your caregiver should begin to prime your mind that, you may need it sooner or later. 🤗Like my senior colleague always says, Insulin is not punishment. Insulin is the answer!👌🏾
Treat to target 🎯.

If you are diagnosed and on management, be it lifestyle modification only or together with medications, your risks of progressing to complications will only be reduced if you are being treated to target. What animal is that you ask? 😅. A special test done every 3 months called glycated hemoglobin(Hemoglobin A1c) should be 6.5%-7.5%. The figure decided on by your health provider after taking into consideration factors such as your age, existing complications as well as current guidelines is your “target”. All the adjustments made to your medications is to help you meet this target.

There are a host of people who for some reason have never done this test. Relying on your FBS alone may not give your provider a clear picture. So try and get it done at least once or twice a year to help guide your management. 💪🏾

Until I come your way again next week, keep safe, and let’s treat to target!!
XoXo
Hectoria

7 COMMENTS

  1. On point, thank you for making it simple for everyone to understand. What next after medication and lifestyle changes.
    My worry is how rural folks who are far from nearest facilities are able to cope when the sugar level goes high or to low leading to their sudden collapse in some instances. Any advice for them. Are there any warning signs they should look out for?
    Thanks

    • Thank you Tina for the feedback. You are right, it’s quite a challenge for people living far from hospitals. Good enough high sugars do not tend to kill fast but low sugars do and quick. My advise is they get some quick glucose rich snack on them all the time so that when they have the symptoms they tak it in immediately. Thr symptoms are usually hunger pangs sweating and fainting

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