Sanjiva Wijesinha -writer and physician

Short stories, Travel and Health Information

Sam’s Story – Part 1

Looking After Diabetes – some lessons from my diabetic friend

A Story in Three Parts

It was good to meet my old classmate Sam, after a lapse of many years, at the birthday party of a mutual friend earlier this year.

While going to serve ourselves dessert, Sam waited while I served myself two generous scoops of ice cream and then, while serving himself a similarly generous sized single scoop, ruefully observed that he didn’t want to take more because he had Diabetes.

Generally I do not discuss medical matters or provide free consultations at dinner parties but I was so intrigued by my diabetic friend serving himself a huge bowl of ice cream that I asked him “How long have you had diabetes, Sam?”

“Oh, I was diagnosed about five years ago” he replied – adding “but I take my tablets every day”

“When did you last have a blood test?” I asked. He replied “I don’t bother about these blood tests. When I was diagnosed the doctor prescribed some tablets, which I have been taking regularly – although some days, I must admit, I forget.”

When I asked him how he got his tablets (being aware that all medications used for control of diabetes are only available on prescription) he told me that when he was initially diagnosed, he had been advised to take Metformin tablets twice a day with his morning and evening meals. He now used to obtain these tablets from his friendly neighbourhood pharmacist (who supplied them without a prescription) and had been taking this same dose for the past five years or so.

He had felt it quite unnecessary to consult his doctor again since that day!

Now I am always reluctant to provide unsolicited medical advice to my friends. Sam however was a time bomb waiting to explode – so I said, over our dessert of ice cream, “Sam, if you have diabetes you need to look after it carefully, with regular blood tests to monitor whether you need to modify the dose or even change the medicines you are taking. Why don’t you come to our clinic next week so I can arrange for some blood tests? We can have a chat about how you can look after yourself better – because uncontrolled diabetes puts you at high risk of heart attacks and kidney failure”.

In my view, Diabetes is a condition which needs careful management, because the primary aim is to ensure that the high concentration of sugar in the blood does not damage vital organs like the heart, kidneys and eyes. This primary aim is achieved by reducing the amount of sugar entering the body from the food we eat – and lowering the amount of sugar that is already in the blood.

The only way we can know that our blood sugar levels are well controlled is by measuring these levels. Fortunately we now have a test that tells us what the AVERAGE blood sugar level in our body was like over the past three months. Measuring the amount of GLYCOSYLATED HAEMOGLOBIN (termed HbA1C) in the blood – a test that can be done without requiring the patient to fast – is easily done, and allows the treating doctor to alter the dose of blood sugar lowering medication.

To be continued next week

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This entry was posted on April 18, 2018 by in Uncategorized.

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