With our hectic, erratic urban lifestyles and genetic predispositions, it is no surprise to know that India is the diabetes capital of the world housing 50.8 million people with diabetes. The International Diabetes Federation (IDF), which tracks the global spread of this scourge, predicts the number to go up to a whopping 87 million — 8.4 per

cent of the country’s adult population — by 2030. Being detected with diabetes is just the tip of the iceberg; dealing with its complications is the actual problem. Every 10 seconds there are two fresh diabetics detected and every 10 seconds a person dies of diabetes-related complications. Diabetic complications are the real killers — they affect every organ in the body most prominently the kidneys, nerves and eyes. Here’s a list of probable side-effects that you should look for...

Diabetic foot
Diabetic Neuropathy (nerve pain) presents itself as tingling and burning pain in your feet and hands, this indicates nerve damage. If left untreated, it will lead to scaly dry skin with repeated foot infections and eventually gangrene which might require amputation. A simple monofilament/vibration test done by your doctor/podiatrist will help check for decreased sensation in your feet and detect neuropathy early. Insist that your doctor examines your feet at every visit. Wearing protective foot care will go a long way in saving a diabetic foot and taking care of it.

Vision distorted
Normal ageing and vision problems are further hastened when blood sugars and blood pressure are uncontrolled. Early signs of eye problems in diabetes are blurring of vision and seeing dots and blots. Uncontrolled diabetes can lead to retinopathy which may even lead to blindness. Diabetes has become the sixth cause of eye problems with 18 per cent of diabetics above the age of 40 having diabetic retinopathy. A regular visit to the ophthalmologist, at least once a year, and undergoing a fundoscopy examination help diagnose the problem at the right stage.

Kidney dysfunction
Diabetes is the most common cause of kidney failure, accounting for more than 40 per cent of new cases. Kidney complications usually present themselves with signs of swelling in the feet associated with high blood pressure and breathlessness. Repeated low blood sugar episodes (hypoglycaemia) and less need for insulin or anti-diabetic pills could also indicate kidney dysfunction. Early detection is very important and can be done by checking the protein/microalbumin in the urine. Rising creatinine levels in the blood is an indicator of progressing kidney damage.

A vascular disease
There is a strong association between high blood glucose and heart disease. Diabetes is said to be a vascular disease wherein eight out of 10 people will end up with heart disease. This is already evident with increasing number of heart attacks seen in younger people around us. Damage to the heart and brain (stroke) are a result of a combination of chronic blood vessel changes because of diabetes and high lipids which end up clogging vessels and damaging the elasticity of blood vessels. People with a high cholesterol, high blood pressure and diabetes find themselves in a dangerous triad. They land up with blocked arteries and damaged hearts more easily than normal persons.

Adapting healthy lifestyle
The only way to ward off these complications is to adapt to healthy lifestyle choices and maintain your blood glucose, blood pressure and cholesterol levels close to normal. Doing so may help prevent or delay diabetes-related problems affecting the heart, foot, eye and kidney. It is advised that you consult your doctor and chalk out a diabetes care plan that fits your lifestyle. Here is a checklist that you should religiously follow:

w Get your diabetes ABCs checked regularly: A1C (an average measure of your blood glucose over a three-month period), blood pressure and cholesterol.
w Know how and when to test your blood glucose and maintain
the records.
w Ensure that you take your medicines as prescribed.
w Follow the healthy eating plan your dietician has suggested.
w Choose an activity best suited for you.
w Do not smoke.
w Follow your foot care and eye care guidelines.
w Have your feet, eyes and kidneys checked at least once a year.
The writer is a well-known Chief Diabetes Educator at
Cheeny Kum-Exemplar Lifecare, which has the first real-time
disease management technology that provides comprehensive
care solutions for chronic diseases like diabetes