Health Wikipedia

Fahim Ahmed was tested as diabetic incidentally after a urine test. That was about ten years ago, and from then on Mr Fahim, like so many other people with diabetes, became fixated on his blood sugar. His doctor warned him to control it or the consequences could be dire — he could end up blind, lose a leg, fail his kidneys and so on.

Mr Fahim, a 45-year-old business executive of a reputed organisation in the city, tried hard. When dieting did not work, he began taking pills to lower his blood sugar and pricking his finger several times a day to measure his sugar levels. They remained high. So he agreed to add insulin to his already complicated regimen.

Blood sugar was always in his mind. But in focusing entirely on blood sugar, he ended up neglecting the most important treatment for saving lives — lowering the cholesterol level. That protects against heart disease, which eventually kills nearly everyone with diabetes. He was also missing a second treatment that protects diabetes patients from heart attacks — controlling blood pressure. He assumed everything would be taken care of if he could just lower his blood sugar level.

Most diabetes patients try hard but are unable to control their diseases in this way and most of the time it progresses as years go by. Like many diabetes patients, he ended up paying the price for his misconceptions about diabetes. Last year, Mr Fahim had a life-threatening heart attack.

Diabetes goes undetected in many heart patients. It is a silent threat for many people who end up with heart disease because these patients do not feel the actual intensity of pain due to nerve damage as a consequence of diabetes. Blood sugar control is important in diabetes, specialists say. It can help prevent dreaded complications like blindness, amputations and kidney failure. So, controlling blood sugar is not enough.

In part it is the fault of proliferating advertisements for diabetes drugs that emphasise blood sugar control, which is difficult and expensive and has not been proven to save lives. And in part it is the fault of public health campaigns that give the impression that diabetes is a matter of an out-of-control diet and sedentary lifestyle and the most important way to deal with it is to lose weight. Again, the fault for the missed opportunities to prevent complications and deaths lies with the medical system. The doctors typically spend just 5 minutes with diabetes patients, far too little for such a complex disease.

Mr Fahim found all that out too late. So, no matter how carefully patients try to control their blood sugar, they can never get it perfect — no drugs can substitute for the body’s normal sugar regulation. So while controlling blood sugar can be important, other measures also are needed to prevent blindness, amputations, kidney failure and stroke.

Dr Md Rajib Hossain