Good Glucose Control is Essential but Not Enough

          Diabetes management has witnessed a breakthrough in the last decade. With the invention of newer oral drugs, newer insulins, and newer sugar monitoring devices, the management of diabetes in today’s era is much more sophisticated. The primary aim is now shifted from ‘just sugar control’ to “holistic management”.

                      As endocrinologists, our first job is to attain good glucose control. We have 6-7 groups of oral medicines and 2 groups of injectables to achieve this. The choice of therapy depends on a lot of factors and one size does not fit all. We target strict glucose control but at the same time, we tend to prevent sugar fall or weight gain. The newer group of medicines helped us to achieve this goal with ease and at an affordable price. As a result, insulin is no more a first-line choice for glycemic control except in critical situations, however, as insulin has the highest capacity to reduce glucose it's often a boon for the people whose sugars are uncontrolled on oral medication. American Diabetes Association (ADA) has laid a guideline for the same where there is a tremendous change in treatment approach as compared to what we used to do 5 years back.

                      But our job does not end here. Good glucose control is essential but not enough. Any person suffering from diabetes should be periodically screened for comorbidities and complications of diabetes. High blood pressure, high cholesterol, thyroid problem, fatty liver, disordered sleep are often associated with diabetes and need proper evaluation and treatment. Heart attack, stroke, and renal failure are the major complications of diabetes and are the major causes of death in diabetes. On the other hand, retina damage, nerve damage, and foot-related problems are often neglected but must be screened to prevent morbidity. Interestingly, all these complications can be reduced by good glucose control and periodical screening can detect them in the early stage, thus we can prevent further progression.

                   Lastly, let us talk something about diet and foot care. There are lots of myths associated with diet.

                 Today diabetes is an epidemic, it can not be cured but can be controlled. Regular diet and exercise is the key to success. To date, almost half of the diabetic patients are unaware that they are suffering from diabetes, and it is damaging their bodies silently. So test your blood sugar regularly, especially if you are overweight, suffering from hypertension, cholesterol problem, or have a family history of diabetes. Consult the specialist doctor for good glucose control, screen for complications, and enjoy good health.