“Johny Johny, Yes Papa
Are you diabetic, Yes Papa
Did you check your sugar level, yes papa
Tell me how you did it, ha ha ha”
Just another tweaked version of the well-known rhyme of kids, in the context of diabetics.
Well, it’s a plain simple truth that today when we (India) are the diabetic capital of the world, little do we know about the truths about sugar running in our blood.
5 out of 10 people don’t do their fasting glucose test correctly. It is a general finding and personal observation while interacting at various public forums, and exhibitions, where they look at me and ask a simple question- “Do you have medicine for Diabetes in Ayurveda?”. My answer is “Yes, we do, but before we get into prescription, how much is sugar level in your blood?”
The person answers “ It is 250 or maybe 275”. Then I ask “Fasting or PP??”
“Fasting!!” – pat comes the reply.
Then I ask them and understand how they do the Fasting Sugar analysis. To my surprise, many of them don’t observe a minimum of 8-12 hrs hours of the mandatory fasting period. I met some diabetics recently who have been taking anti-diabetic medicines for the past 20 years but they have all been practicing faulty tests. They have late dinners and go early morning to the laboratories to give their blood sample for tests. If this is the condition of somebody taking oral medications and that too for a prolonged period, then think about somebody who is on Insulin shots.
One good thing about high blood sugar is that it will not kill you instantly, but a low glucose level can lead you to the hospital and sometimes people pass it off in sleep as our brain ONLY and ONLY knows one sugar- GLUCOSE.
I often find that the culprit is – a lack of patient education both from the patient side and also from the treating physician’s side who fails to convey this basic information. So what are the various types of blood tests for blood sugar analysis? Let’s take them one by one.
1. Random Blood Glucose (RBS): most common test done in routine is to assess the present blood sugar level irrespective of your last meal time.
2. Fasting Glucose(F): It is the test done after a minimum of 8 hours of fasting and the patient is advised not to eat or drink till the test is done. This is done to rule out prediabetes and diabetic condition in a patient.
3. Post-Prandial Glucose Test (PP): This test is done after 120 minutes or 2 hours after the meals.
4. Glycosylated Hemoglobin ( HBA1c): This test is done to assess the blood glucose level on a 2- 3 month average irrespective of your daily variations. It is one of the best tests to get a hand on a person’s control of blood sugar. The fundamental of this test is that the Red Blood corpuscles (RBC) in the blood contain Hemoglobin and once this hemoglobin bonds with glucose, this is a permanent bond and RBCs have a life cycle of 120 days on average. So it gives an average knowledge of circulating sugar in the blood. Usually, it should be under 6% in healthy individuals. For a diabetic person, any variation in this indicates the change of course of medicines.
5. Glucose Tolerance Test (GTT): Generally this test is done to rule out diabetes in pregnant women (Gestational Diabetes). Orally a fixed amount of Glucose is administered to the patient and the surge in blood glucose response is noted at various intervals.
So now the next question is, how can one person be diagnosed with diabetes. As per the guidelines laid down by American Diabetic Association, if a person meets any one of the following criteria, he can be a diabetic.
1. Diabetic symptoms such as increased thirst ( polydipsia), increased urination (polyurea) and unexplained weightloss + a random blood glucose of equal to higher than 200 milligrams per deciliter
2. Fasting blood glucose level of equal to or more than 126mg/dL.
3. Glycosylated Hemoglobin (HbA1c) level of 6.5% or more.
4. Oral Glucose Tolerance 2-hour Test indicating equal to or more than 200 mg/dL ( especially for gestational diabetes)
It is important that the diagnosis needs to be confirmed by the same blood sugar test or a different test on another day.
A word about Portable glucometer: Here also, if one is using a portable glucometer for blood sugar analysis, the same needs to be used after proper calibrations. There is a variation of 6-8% on a blood sample drawn from the arm. The blood sugar levels tested through a glucometer will be showing a slightly higher reading. The sole reason being the blood drawn from the arm is venous (impure) blood and the blood on the fingertip capillaries (small blood vessel channels) is near arterial (pure) blood composition.
So if you are diabetic, what now? There are some practical tips for Diabetics…
1. Visit a physician and get the correct advice. Do all your tests indicating your health condition at regular intervals as advised by your physician.
2. Understand that there is NO CURE for Diabetes, you can only CONTROL it. The sooner you know about it, the better.
3. Introduce changes in lifestyle and food. Timely food, medicine, and workout can keep your sugar level in check.
4. Control weight and include moderate exercise in your daily routine. Everybody knows it’s difficult to get up early morning. But if you do it for a week, it’s for sure that the next week you would be up and kicking as a routine. Start off with Yoga, Tai Chi, Woo-Shoo, meditation, etc to ward off unnecessary stress and keep mind, body, and soul in Harmony.
5. Keep your attitude positive always. People with strong and positive mindsets have even overcome cancer.
6. Always carry a small card in your pocket indicating your name, complete address, emergency contact numbers, present medications, allergies, and treating doctor’s name, and number.
7. Carry sweet candies in your pocket for emergency conditions. Any Feeling of dizziness, cold sweats, nausea, or thirst, they indicate that your sugar level might be dropping. Calm down, secure yourself, stop if you are driving or doing any work, pop some sugar candy in your mouth and call for help.
8. Remember that low sugar is more dangerous than high circulating sugar levels.
9. Do not stop your allopathic medications if you start off with Ayurvedic / natural herbal supplements and medications. Do discuss with both physicians (allopathic and Alternative medicine) the course of treatments. If there is any change in the dosages of medicines, let the physician do it rather than yourself.
10. Control addictions like- Smoking and alcohol. Remember that your system is in crisis; don’t add to the woes of the body. Help it to heal and recover naturally.
So the next time when you come to know about a friend or a relative or you yourselves are diabetic, do keep the above points in mind. Please remember that if you are educated about the disease, you can tackle it better.
This article was written by Dr.Himanshu Jha(BAMS). Comment if you have any questions related to Diabetes or want to share your experiences/feedback with us.