Life Style Modification in Diabetes Management

LIFE STYLE MODICATION IN DIABETES MANAGEMENT.

My practice is located deep into the old city of Hyderabad, where lot of poverty, unemployment and illiteracy exists. Many people there visit to RMP and alternative medicines as they are unaware of prevention and management of diabetes. Addictions of OHAs, life style modification, Insulin paranoia, and regular maintenance of medical expenses are their main worries, which over shadows the prevention and complications of diabetes. Most of the patients diagnosed with type II Diabetes are obese with sedentary life style and has poor Diet control.

In my setup I always try to counsel my patient in view of management of good glycemic control which lies in diet, exercise and weight management and finally with medication.

By motivating patients for life style modification, educating them about advantages and disadvantages of good and poor controlled Diabetes both in type II and GDM.

Advising them about their diet, calculating as per ideal body weight.

Recommending appropriate exercises.

Last but not least of all medications.

Advising orally and in printed. Like charts in local language i.e. Urdu and in English language. Diet charts with three types of breakfast, lunch, dinner, snacks with time and calories mentioning.

The charts are prepared according to calories calculated starting from 1400 cal/day, 1600 cal/day, 1800 cal/day and 2000 cal/day.

With every visit I interview them with questions

A, how is your diet management? Are u following as per the charts? Are there any difficulties in understanding the diet program?

B, are you performing regular exercises? Have you ever had any problems while or during exercise?

C, are you checking weight at home?

D, about glycemic levels.

Category 1 Patient is reviewed on monthly bases whose glycemic levels are within normal levels or nearer to normal levels.

Category 2 patients is reviewed on 15th day for those whose glycemic levels are FBS ≥ 175 mg/dl and PLBS ≥ 300 mg/dl

Category 3 patients are those whose glycemic levels are ≥ 400 mg/dl with ketone bodies + are admitted for intensive management.