Diabetes management in elderly: Everything you need to know
There is a need to need to individualize the treatment targets for diabetic patients. For someone who has had a heart attack, or bypass surgery or has got an underlined kidney problem, the treatment process changes. There is a study called ACCORD that tells that people who have been diabetic for a long time, have an underlined heart disease, kidney problem or a diabetic complication should not be treated aggressively. It actually backfires on them.
Dr. Manoj Chadha who is a Consultant Endocrinologist at P.D Hinduja Hospital and MRC explains, "In the last two-three years there is so much of interesting information that is been researched about the class of drugs that not only does control diabetes very well but it actually protects the heart, and kidney from further damage."
Recommended lifestyle modifications to control blood sugars
In most cases, the amount of physical activity reduces significantly. Depending upon the status of the patient they can do like simple activities like walking for 30-40 minutes, freehand exercises, aerobics, swimming, whatever the patient is capable of doing they should be encouraged to do.
It is also advised to encourage patients to have 6.5-7.5 hours of uninterrupted sleep as it's an important part of diabetes management.
Time management with regard to mealtime also plays a role. One must see that the meal timings should be fairly well regulated. It has been observed that because of the work from home culture the timings seem to have gone haywire.
How frequently should one check blood sugar?
Dr. Chadha tells, "The frequency depends on how is the control. If the patient has a fair control on doing a couple of (3-4) blood test in a week is good enough. But if the control is not good and sugars tend to go from 250-400 I would suggest the individual should monitor glucose almost 2-3 times a day. Although, this has to be individualised. As the control improves the frequency of testing goes down. But till we get some decent control it is required to do tests on a regular basis. Whether it is every day, alternate or twice a week. It gives the patient confidence in how things are improving."
It is important to stay in touch with your doctor to manage diabetes
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How important is it for a patient to regularly stay updated with the doctor?
Dr. Chadha explains that the idea of doing frequent blood testing is to get the feel of what is happening. Trying to identify where you're going wrong? What is the right thing you are doing? What does the body like? And then someone needs to act on it. If an individual knows what to do, it is fantastic, else a doctor will need to intervene.
"As experts, we try to empower our patients so that they do not need to visit the doctor every week. But it depends on how they use that information. Always take the experts advice, if you are in control and you're at minimum medication, you can see a doctor once in six months too. However, this is again individualised between the doctor and patient on how often should the follow up be," he sums up.
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