After a brief period of intense motivation to exercise and following a set pattern of diet, most patients become satisfied to see the normal blood sugar levels. Once achieved a period of complacency sets in. routine compulsions of life and liabilities makes illness recede to the remote recess of mind .This is generally followed by a prolonged period of persisting with same medications, however, with a much diluted diet and exercise schedule. And also a variable period of delay in checking and monitoring blood sugars.
Generally, however, DIABETES catches up and manifests itself with some symptoms, like infections, or feet numbness and tingling, chest discomfort etc. And upon rechecking, blood sugars are found to be unacceptably high. The sugars have been probably high for a long time. And during this period all the target organs like the heart, kidneys, nerves, eyes are continuously undergoing slow damage. Now even if we control the sugars the target organs have got a little more damaged. But most patients at this point tell me that they will control their sugars on their own. Repeated episodes of control and lack of control of blood sugars occurs throughout the life of the person. And each period of uncontrolled blood sugars leades to a further deterioration of function of key organs like heart, brain , eyes , kidneys etc.
Although some patients may be able to control their sugars with good exercise and diet, most will not be able to sustain their extra efforts. And the sugars invariably will go off control after a few weeks. Hence, in such situations, it is advisable to control blood sugars by lifestyle changes in addition to slight up titration of doses.
Since DIABTETES is a chronic disease, there always comes a phase of poor control wherein the diet and exercise schedule gets disturbed due to various reasons. The effort should be to minimize such period to minimum and maintain a sustained good control of blood sugars. Because, it is now proven beyond doubt that better control in initial years leads to lesser complications like kidney and heart problems in later life.
DR JACOB THOMAS