Aligarh, November 1: “Innovative mindsets are required to bring about a change in the perceived concept of diabetes mellitus” stated Dr Sheelu Shafeeq Siddiqi, Associate Professor, Rajiv Gandhi Centre for Diabetes and Endocrinology, JN Medical College, Aligarh Muslim University. With reference to international guidelines, Dr Siddiqi issued suggestive measures for proper diet, exercise as well as drug for preventing or controlling diabetes mellitus.
Dr Siddiqi advised that, being a major health problem, diabetes mellitus needs proper understanding of diet, exercise, proper compliance of drug, in addition to managing dyslipidemia, hypertension and pro-coagulant state in case of co-existence. With respect to diet, he said that the current epidemic of obesity leading to diabetes could be stabilized by lowering food intake by 100Kcal per day, as the risk of diabetes and its complications increases at lower BMI levels. He recommended that, ensuring consistent carbohydrate intake through monitoring, presence of 0.8 gm of high quality protein per kg in the diet and supplementing low fat diet with olive oil or mixed nuts, could reduce the risk of diabetes or depression in the same.
In relation to exercise, He said that those with diabetes, in the absence of any contraindications, should be advised to engage in 150 min per week of moderate intensity aerobic physical activity spread over at least 3 days per week, with at least two progressive resistance training sessions per week that incorporate five or more different exercises, involving large muscle groups. He informed that to maintain effect on glycemia, there should not be a rest of more than two days between sessions and to avoid vigorous exercise in the setting of proliferative and severe non- proliferative diabetic retinopathy. He also advised waiting for 3 or more months after successful LASER photocoagulation. He called for self monitoring of pre meal/fasting blood sugar when the blood glucose control is poor and when it reaches below 100mg, 1 to 2 hour post meal target of less than 180 should be achieved.
Informing about hypoglycaemic, sick day rules and 15gms of carbohydrate should be considered. He said that with aging, regular checkups is mandatory as it is associated with decrease in glucose tolerance which appears due to decline in both insulin sensitivity and secretion.
He suggested to consume drugs only as advised by physicians as creatinine clearance decline with age and certain drugs is contraindicated with its severe decline. Finally, Dr Siddiqi called for adherence to good communication between patient and physician.