Reader's Corner

• A diabetic avoids other eatables such as nuts, wafers, fried papad, etc. which are consumed along with drinks, as these provide a lot of calories, and
• A diabetic calculates the amount of calories consumed through the drinks and reduces the corresponding amount from other foods (250 ml of beer or 30 ml of Whisky provides 110-120 calories). Equivalent calories are provided by three slices of bread.

Diabetics should note that alcohol potentiates blood glucose lowering action of oral pills and may reduce blood glucose to a dangerously low level. Lactic acidosis, a rare but a dreaded side effect of Phenformin and Metformin (blood glucose lowering pills belonging to Biguanide class), is more likely to occur in those consuming alcohol. Some diabetics on Chiorpropamide (blood glucose lowering pill belonging to Sulphonylurea class), develop severe facial flushing every time they consume alcohol.

Chemically, there is no difference between regular salt and rock salt and hence in all the diabetics, who have been advised salt restriction, even the rock salt should be restricted.

Polyunsaturated fats (safflower oil, sunflower oil, etc.) and saturated fats (animal fats) give equal calories. However, the consumption of former does not lead to significant increase in cholesterol level in blood. However, this does not mean that one can consume polyunsaturated fat in unrestricted amount, because it is a concentrated source of energy and leads to increase in weight and worsening of control of blood glucose if one exceeds the daily quota. Moreover some of the oils rich in polyunsaturated fats have unfavourable fatty acid ratio.

Many ayurvedic medicines have been tried for their ability to reduce blood glucose. Powder of Jamun, Methi seeds, and Karela juice are some of the well known ayurvedic preparations. In addition, there are many expensive branded products. Jamun, Methi and Karela have very mild blood glucose reducing property, which by itself is not sufficient to control blood glucose in most except very mild diabetics, in whom diet control and physical exercise can also control blood glucose. These medicines can not replace insulin or allopathic oral pills in the management of diabetes. In addition to ayurvedic preparations mentioned above, there are many other ayurvedic and homeopathic preparations which may have a very mild antidiabetic action but what is mentioned about above mentioned ayurvedic medicines holds true for other medicines. I know many patients having severe diabetes who have changed over to these medicines and have subsequently come back to me in a worse state. They have regained control after shifting back to insulin or allopathic oral pills.

That insulin once taken will have to be taken life long
No. Non-insulin dependent diabetics may need insulin during acute infections or some acute complications and can revert back to their previous therapy after the acute illness is over.

That insulin dose is increased because diabetes has gone worse
Not always. By splitting the dose better control of diabetes is obtained and this may be the reason for two injections than one injection a day.

That patients with non-insulin dependent diabetes never need insulin
During illness, stress periods or if the oral drugs become ineffective such patients will need insulin, though they continue to belong to non-insulin dependent group.

That if insulin is taken regularly at the same time in the same dose insulin reaction can't occur
Insulin reaction can occur because of other variable factors like change in diet, exercise, variations in metabolic control of diabetes, change in the brand of insulin etc. Hence there is need for repeated blood sugar check ups.

That insulin bottle has to be stored in a refrigetor
No. Not at all. Insulin bottle in use can safely be stored at room temperature but away from direct heat of the sun or cooking range.