Health: Monitor your blood glucose

Diabetes mellitus is a condition where the body fails to handle glucose present in the body or taken from outside in form of sugar and sweet substances. Statistics have proven beyond doubt that diabetes is not only a problem of the developed countries, but its prevalence is also rising in under developed countries. It is essential for a diabetic patient to monitor his blood glucose, regularly to see whether it is controlled or not. In general monitoring involves, going to the hospital, once or twice in a month and get glucose tested there. According to the results of blood glucose levels, dose of anti diabetic treatment is adjusted. What is being promoted and is considered essential for any diabetic is self monitoring of blood glucose (SMBG). SMBG is essential part of diabetes management in developed countries. People affected are encouraged to keep glucometers (apparatus used for measuring blood glucose, which the patients or family members can operate at home). They measure blood glucose at home by themselves and adjust dose of anti diabetic drugs or insulin accordingly. This monitoring is done at weekly, fortnightly or fixed intervals routinely. Apart from this, the individual is taught to look at his sugar levels in case of some unaccustomed stressful situation or dietary indiscretion, for example if he has taken some high calorie food like ice cream or cake. In case one develops some clinical features suggestive of high blood glucose levels, they can check blood glucose levels immediately and if high, rectify it. Another method is to monitor sugar levels in the urine for dipsticks are available. When glucose levels rise in blood, excess glucose is removed from the body by the kidneys in the urine. Though not as accurate as blood glucose levels, but still appearance of glucose in the urine is an indicator that diabetes is not very well controlled. Measurement of urinary glucose is comparatively cheap to that of blood glucose. But in poor developing countries, glucometers and dipsticks are a farfetched dream for majority of the population. Even coming to the near by hospital to get the blood glucose test done and collecting the medicines is difficult for some people, because, it involves spending time and money for transport. Due to this, many persons miss their medicines for some days and when they come to the hospital, it is with high or very high blood glucose levels, necessitating hospitalization at times. At times they come with acute complications related to diabetes like coma. Therefore SMBG becomes more relevant for resource poor people. SMBG is also possible through good patient education and motivation. First and foremost, the diabetic patients have to be explained the nature of their illness. They should understand the need for adherence to dietary restrictions, compliance with treatment and avoidance of infections. They should also understand the symptoms of high blood glucose levels in the body. Excess thirst and appetite, increased frequency of urination are the common symptoms of diabetes. Apart from this, itching over genital parts, burning in urination, non healing ulcers and wounds, exacerbations of small infections like boils, e.t.c. all these point to uncontrolled diabetic status of the person. If along with all other information on diabetes, the individual is taught about anti diabetic drugs, he can increase dose by himself till he or she reaches some medical center and seeks professional advice. In addition he should also be knowing about hypoglycemia (i.e. lower than normal blood glucose levels). In that case if he develops hypoglycemia after increasing dose of his medication, he can correct it immediately by eating some sugar or even banana. Poor peasants living in villages, though not much literate are fairly intelligent and understand things very well. If they understand the importance and start monitoring their diabetes, it will definitely ensure that majority of people will have well controlled blood glucose levels. Thus complications of diabetes can be avoided and diabetic patients will have a better quality of life. E-mail –rachna212002