Diabetes mellitus is a disorder of glucose metabolism, which is usually managed by oral medications and/or insulin and requires food intakes at regular intervals in order to maintain steady blood sugars.
Some of the side effects of these medications are weight gain and hypoglycaemia (low blood sugars). Newer medications are free of this side effect and are now considered as preferential treatment options.
“Awareness and structured education of patient and family members can improve key outcomes of diabetes, reduce complications and cost of care,” says Dr Zia Ul Hasan, Specialist Endocrinologist at Northwest Clinic. “Successful self-management programmes in the UK and US provide evidence in support of the statement. General practitioners, paramedical staff and specialist diabetes nurses particularly can play a significant role in coordinating diabetes care for the patients and their families.
“Support for voluntary initiatives need encouragement from within the communities, particularly from people who are affected by diabetes, either as patients or family members. Encouragement from policymakers, supported by social enterprises and insurance providers, can bring about a palpable change in the management of illnesses such as diabetes.”
On the occasion of World Diabetes Day, Northwest Clinic's message is that the person in-charge of kitchen and buying grocery for the patient’s family can significantly contribute to improving disease control and achieving healthy living.
Here specialists from Northwest Clinic answer frequently asked questions about diabetes and its various complications.
How can diabetes affect a family?
Dr Zain Gulzar, Consultant Endocrinologist: Diabetes is a chronic illness and as with any chronic disease, it can have an impact on the family. There is a cost burden as diabetes can be an expensive condition to manage. Insurance premiums are higher for people with diabetes.
How can family members help someone with diabetes?
ZG: Family members can help support people who have diabetes by promoting a healthy lifestyle and diet. They can make sure that the diabetic attends all the medical appointments and takes medication on time.
Why is it important that families get involved in assisting members in the management of diabetes?
ZG: Most people with diabetes feel isolated when they are the only ones in the family suffering from the disease. Managing one’s diabetes is a constant battle. Having understanding family members who offer encouragement and support day in day out can go a long way in helping patients manage their disease.
Do you think that families need to be more aware of how to deal with a diabetic?
ZG: It is important for family members to be aware of diabetes and be trained in managing low blood sugars. A person with diabetes can get disoriented when blood sugars drop low and even pass out. If family members are trained in managing this condition, it can save a person’s life and help prevent complications from this extremely dangerous but quite common condition.
What are the cardiovascular complications that diabetics should watch out for?
Dr Adnan Raufi, Consultant Interventional Cardiologist: Diabetes mellitus also affects the blood vessels of the body. This process affects the body from head to toe. A few of the serious cardiovascular conditions are stroke, heart attacks, arrhythmias (various types of irregular beatings of the heart), kidney failure (which may lead to dialysis), and poor circulation in the legs (may be complicated by amputation). Any of these conditions can severely hamper the quality of life, which may have grave consequences on the well-being of the patient as well as their family.
A proper diagnosis and an aggressive approach towards treatment may reduce the cardiovascular complications of the disease. A healthy lifestyle, proper diet, smoking cessation and exercise play a pivotal role in improving the quality of life.
Tell us about the main eye problems caused by diabetes.
Dr Faqir Ahmad Qazi — Specialist Ophthalmologist: Diabetes causes significant ocular complications that may result in blindness if not detected and treated. They are:
Diabetic retinopathy — Diabetes can cause the retinal vessels to leak. Abnormal new vessels can also grow over the retina and bleed. It is the leading cause of new blindness in adults.
Diabetic macular edema — Macular edema happens when the fluid builds up on the retina and causes swelling. It can lead to permanent visual loss.
Cataract — Excess blood sugar can cause cataract, which affects vision. Patients need to have their lens surgically removed and replaced with a plastic lens. Maintaining good control of blood sugar helps prevent the permanent clouding of the lens and surgery.
Glaucoma — It is a group of diseases that damages your eye’s optic nerve. This damage leads to irreversible loss of vision. Having diabetes doubles your chances of glaucoma.
What are the psychological problems seen in diabetics?
Dr Ahmed El Shafei – Consultant Psychiatrist: Research has shown that depression is moderately increased in prediabetic patients and undiagnosed diabetic patients and markedly increased in previously diagnosed diabetics compared to people with normal glucose metabolism. Anxiety appears in 40 per cent of the patients with type 1 or 2 diabetes. Depression and anxiety worsen the prognosis of diabetes and decreases the quality of life.