ABCs of Diabetes: Treatment and Management

Diabetes needs no introduction with more than 62 million people in India affected with this condition. Awareness, precautions, and management are the three vital elements to combat this disease. There are many people at a prediabetic stage or with undiagnosed diabetes. Many others live with chronic diabetes, managing the condition every single day. Let’s get a detailed overview of this condition along with its medication and ways of management. 

What is Diabetes?

Diabetes is of 2 types: Type 1 diabetes is caused because your immune system attacks insulin secreting cells in the pancreas leading to imbalance in blood glucose level. Type 2 diabetes is usually caused by genetic or lifestyle factors. Over time, diabetes can lead to heart disease, nerve damage, eye problems such as glaucoma, and kidney disease. 

Managing Diabetes:

Though diabetes is a chronic condition, it can be managed easily and efficiently for a prolonged and healthy life. Understanding the disease and its contributing factors, collated with a little bit of planning and discipline can reduce the risk of further complication. Read on to get a better idea of diabetes and its management.

Know the ABCs of Diabetes

Knowing the ABCs of diabetes will help you manage your blood glucose levels, blood pressure, and cholesterol. Diligently following ABCs can help lower your chances of having a heart attack, stroke and other diabetes-related problems.

A for the A1C test

The A1C test shows your average blood glucose level over the past 3 months. Take this test regularly to monitor and keep your diabetes in check. 
You can also take a glucose reading at home with glucometers for intermediary checks.

B for Blood pressure

Typically, blood pressure goal for most people with diabetes is below 140/90 mm Hg. Consult with your physician to understand your optimal BP levels. 

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C for Cholesterol

There are 2 kinds of blood cholesterol: LDL (Low-density lipoprotein) and HDL (High-density lipoprotein). LDL or “bad” cholesterol can build up and clog your blood vessels. Too much bad cholesterol can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels.

Ask your physician as to what your cholesterol numbers should be. If you are over 40 years of age, with high cholesterol, you may need to take a statin drug for heart health. Again, it is very important to check with your physician before taking any medication. 

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S for Stop smoking

Smoking is injurious to health under normal circumstances. It is outright dangerous for diabetics since smoking narrows your blood vessels, increasing the pressure on your heart, thereby increasing the risk of heart diseases. 

E-cigarettes, which are slowly gaining popularity as an alternative option for smokers, aren’t a safe option either.

By quitting smoking

  • you lower your risk for heart attack, stroke, nerve disease, kidney disease, diabetic eye disease, and amputation
  • your cholesterol and blood pressure levels will improve
  • your blood circulation will improve
  • you may have an easier time being physically active

Keeping your A1C, blood pressure, and cholesterol levels close to your goals and smoking cessation may help prevent the long-term harmful effects of diabetes You can keep track of your ABCs with a diabetes care record. Take it with you on your health care visits. Talk about your goals, difficulties, and whether you need to make any changes in your diabetes care plan with your doctor.

How to live better with diabetes?

Here are a few ways to improve the quality of your life with diabetes.

1. Follow a diabetes meal plan

Make a diabetes meal plan with the help of your physician. Following a meal plan will help you manage your blood glucose, blood pressure, and cholesterol.

Choose fruits and vegetables, beans, whole grains, chicken or turkey without the skin, fish, lean meats, and non-fat or low-fat milk and cheese. Drink water instead of sugar-sweetened beverages. Choose foods that are low in calories, saturated fat, trans fat, sugar, and salt. Learn more about eating, diet, and nutrition tips for diabetics.

2. Make physical activity part of your daily routine

Set a goal to be more physically active. Try to work-out up to 30 minutes or more every day and be physically activity on most days of the week by getting engaged in sports or other means.

Brisk walking and swimming are good ways to move more.

3. Keep checking your blood glucose levels

Usually for diabetics, checking blood glucose level each day is an easy way to manage their diabetes. Monitoring your blood glucose level is most important if you take insulin. The results of blood glucose monitoring can help you make decisions about food, physical activity, and medicines. You can choose to have Glucometer at home.

4. Take your medicines as advised

Consume medicines for diabetes or any other health problems, as suggested by the doctor, even when you feel good or have reached your blood glucose, blood pressure, and cholesterol goals. You can ask your doctor about any dosage adjustment or change in the treatment regimen. Also discuss about side effects, if any.

Metformin is a very common medication for diabetes prescribed by doctors. Below is a guide to help you understand the drug better.

What is Metformin?
Metformin is an oral diabetes medicine that helps control blood sugar levels. It is usually consumed orally.
Metformin, if used along with diet and exercise, keeps blood sugar levels in control in adults with type 2 diabetes mellitus.
Metformin is sometimes used along with insulin or other medications, but it is not for treating type 1 diabetes.

Important Information:

You should not use Metformin, if you have severe kidney disease, metabolic acidosis, or diabetic ketoacidosis. Doctor’s prescription is a must before initiating any medical treatment with oral drugs.

Before taking this medicine:

You should not use Metformin if you are allergic to it, or if you have:

  • severe kidney disease; or
  • metabolic acidosis or diabetic ketoacidosis

Tell your doctor if you have ever had:

  • kidney disease (your kidney function may need to be checked before you take this medicine);
  • high ketone levels in your blood or urine;
  • heart disease, congestive heart failure;
  • liver disease; 
  • PCOD; or
  • if you also use insulin, or other oral diabetes medications.

People with above-mentioned conditions, if administered with Metformin, may develop lactic acidosis, a dangerous build-up of lactic acid in the blood. This may be more likely to happen if you have other medical conditions, a severe infection, chronic alcoholism, or if you are 65 years of age or older. Discuss these risks with your physician.

Follow the doctor's instructions carefully about using this medicine if you are pregnant. Blood sugar control is very important during pregnancy and your dosage may be different during each trimester of the pregnancy. Tell your doctor if you become pregnant while taking Metformin.

Metformin may stimulate ovulation in a premenopausal woman and may increase the risk of unintended pregnancy. Also, let your doctor know if you are diagnosed with PCOD, as the dosage might need certain alteration for effective outcomes. Talk to your doctor about your risk.

Breast-feeding is not advised while using this medicine. It is recommended to follow your physician’s advice in such situations.

How should I take Metformin?

Take Metformin exactly as prescribed by your doctor. Follow all directions as mentioned on the prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take Metformin with a meal, unless your doctor tells you otherwise. Some forms of Metformin are taken only once daily with the evening meal. Follow your doctor's instructions.

Do not crush, chew, or break an extended-release tablet. Swallow it whole. Some tablets are made with a shell that is not absorbed or melted in the body. Part of this shell may appear in your stool. This is normal and will not make the medicine less effective.

If you are advised to use Metformin in injection format, take care to use proper measuring techniques. It is not advised to eye-ball or use approximate measuring devices like spoons or spatulas. Use a proper measuring device or a syringe.

A sudden decline in blood sugar level (hypoglycaemia) can be noticed in anyone suffering from diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you, such as fruit juice, hard candy, crackers, raisins, glucose powder, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycaemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Metformin is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Your doctor may suggest you to take extra vitamin B12 while you are taking this medicine. Take only the amount of vitamin B12 that your doctor has prescribed.

Store the medicine at room temperature away from moisture, heat, and light.

Metformin side effects:

Normal side effects of Metformin include mild abdominal pain, anorexia, bloating, nausea, metallic taste, mild diarrhoea and tiredness. These are the usual complaints that subside with time. However, get emergency medical help if you have signs of an allergic reaction to Metformin. The symptoms of allergic reaction include hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Some people using this medicine develop lactic acidosis, which can be fatal. Get emergency medical help if you have even mild symptoms such as:

  • unusual muscle pain;
  • feeling cold;
  • trouble breathing;
  • feeling dizzy, light-headed, tired, or very weak;
  • stomach pain, vomiting; or
  • slow or irregular heart rate.

What other drugs will affect metformin?

Many drugs can interact with metformin, making it less effective or increasing your risk of lactic acidosis. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.