Diabetes 101: It is not a death sentence!

Dr Jacqueline E Campbell

Sunday, December 03, 2017

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YOU may be wondering if diabetes can be prevented. Yes, it can.

Although we have called diabetes a 'killer', it does not mean that if you are diagnosed with the disease that you have been given a death sentence. Far from it! Diabetes can be managed, treated, controlled, and in some cases reversed.


The goals of treatment are to:

• Keep glucose levels within normal range;

• Prevent acute and long-term complications associated with diabetes; and

• Improve quality of life.

Many cases of Type 2 diabetes can be prevented by adapting lifestyle changes. This includes getting regular physical exercise, changing the diet, and controlling weight. This is not so for Type 1 diabetes; currently, insulin is the only treatment available.

By far, the most important measures you can take if you are a diabetic are to monitor and control your blood sugar level. These factors are critical to managing your diabetes and avoiding complications. I cannot stress this enough. It is not difficult and involves keeping the sugar levels as close to normal as possible, and avoiding very high or very low blood sugar levels.

A glucometer can be used to monitor your blood sugar level and help you achieve this. This is a must-have for all diabetics, and is a worthwhile investment in your long-term health.

In controlling diabetes, emphasis is first placed on lifestyle modification, which is, changing some of your habits, especially those related to eating. So, for example, if you are overweight you need to lose pounds until you get to your target weight, that is, the weight which is appropriate for your age, gender and body type.

We have already indicated that 'normal', as in normal blood sugar level, is an important word for diabetics. If blood sugar levels are normal, it means you are avoiding high or low blood sugar levels, both of which are potentially harmful and can send you into a diabetic coma, which can be fatal.


High and low blood sugar levels

Hypoglycemia (low blood sugar) develops when there is not enough glucose in your body. Hyperglycemia (high blood sugar) occurs when the blood sugar levels are too high. Many different factors, including certain medication and diet, can cause both of these conditions to develop. It is important that you know your body, what causes your blood sugar level to spike or fall, and what your treatment plan involves.

This is necessary so that when your blood glucose levels fall outside your target range, you can review your treatment plan to determine what actions you need to take to get these levels back to normal. We will now explain some of the consequences of high and low blood sugar levels and why they should be avoided if a diabetic is to maintain good health.

Hypoglycemia or low blood glucose occurs when your blood sugar level falls below your target range. Some reasons include:

• Not eating enough;

• Skipping a meal or snack;

• Eating later than normal;

• Exercising for a longer period;

• Doing more strenuous exercise

than usual;

• Illness;

• Taking too much insulin, or too

many glucose-lowering medications;

• Drinking alcohol without eating.

Some early symptoms of hypoglycemia include:

• Feeling hungry, weak or shaky;

• Dizziness, light-headedness;

• Rapid heartbeat;

• Sweating;

• Headache;

• Blurred vision;

• Numbness or tingling of the lips.

You will need to be treated for low blood sugar when any of these symptoms are present, or when blood glucose falls below 3.8 mmol/l (70 mg/dl). If you do not get treated, your blood glucose will continue to drop, your symptoms will worsen, and you may faint or go into a coma.

You should to be aware of how your body feels when your blood glucose levels fall, so you can recognise the symptoms and be prepared to act quickly.


Actions to take

When you experience symptoms of hypoglycemia, use your glucometer to check your sugar level. Next, eat or drink something containing 15 grams of carbohydrates.

Examples of one serving (15 grams) of carbohydrates:

• 1/2 cup of fruit juice

• 1/2 cup of regular soda

• 1 cup skim milk

• Glucose tablets (as per instructions on package)

• 1 tablespoon of honey

• 6 saltine crackers

• 4 teaspoons of granulated sugar

• 8 ounces of meal replacement


After you have finished, wait, then test the level again in 15 minutes. If the level is above 70 mg/dl and you feel better, continue with your daily activities. However, if after three tests your blood glucose levels continue to fall, seek help from the nearest doctor.

Hyperglycemia occurs when your blood glucose levels are too high. There are many causes:

• Illness;

• Having too much to eat or drink;

• Having meals too close to each other;

• Not doing your usual exercise routine;

• Stress;

• Forgetting to take medication or


• Not taking correct dose of

medication or insulin.

The following are symptoms of hyperglycemia:

• Tiredness;

• Increased thirst;

• Increased hunger;

• Slow healing sores;

• Headache;

• Frequent urination;

• Blurred vision.


Actions to take

To prevent and treat high sugar levels you need to understand what is happening. Ask yourself these questions:

• Have I stopped taking my medications as recommended?

• Have I changed my daily routine?

• Have I decreased the amount of exercise I usually do?

• Has my eating pattern changed?

If you answered 'yes' to any or all of these questions, then you have solved the problem. Go back to your regular treatment plan, and keep monitoring your blood sugar levels. If your blood sugar level continues to be elevated, call/visit your doctor. If left untreated, hyperglycemia can be dangerous.


1. Diabetics need to maintain normal blood sugar levels.

2. Your fasting blood sugar should be less than 6.1 mmol/l or 110 mg/dl.

3. Your blood sugar level two hours after a meal should be less than 7.8 mmol/l or 140 mg/dl.


Excerpts taken from my book A patient's guide to the treatment of diabetes mellitus.

©Jacqueline Elaine Campbell

Dr Jacqueline E. Campbell is a family physician, university lecturer and pharmacologist. She is the author of the book A patient's guide to the treatment of diabetes mellitus .


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