Covid-19 and Sugar Management During Stressful Times
Covid-19 and sugar management information is given under the umbrella of Candela Health initiative of Candela pharmacy. In our previous articles, we shared some details about Covid-19 and Covid-19 precautions.
Dr. Sahib, please tell us something about yourself
Dr. Tariq Nisar: I am a family physician and have been practicing for the last 33 years. In my practice, spanning over almost three decades, I have dealt with and treated all sorts of illnesses. Some illnesses, like diabetes, are chronic and require continuing consultation and medical care and lead to a life-long relationship with the patients.
Please tell us what exactly is diabetes and how it starts.
Dr. Tariq Nisar: As I said earlier, diabetes is a chronic illness, once you get it you need to keep monitoring it throughout your life. There are two types of diabetes.
Type I mostly begins in childhood and it happens when the pancreas stop making insulin. Type 1 patients are treated with insulin. Type 2 diabetes usually starts in middle or old age. In this type, the pancreas is producing insulin but it is inactive. The treatment for type 2 diabetes requires medicines that activate the inactive insulin. Such patients may reach a stage when medicines no longer work and the doctor will have to prescribe insulin.
We hear about low and high sugar levels. What does this mean?
Dr. Tariq Nisar: High sugar level means, your blood glucose levels are above the normal limit. And whatever sugar control the patient is using is ineffective. Elevated sugar levels lead to classical symptoms like body aches, frequent urination, numbness, general lethargy, and weakness.
Low sugar level, on the other hand, means the patient took insulin or medicines but didn’t take a proper diet with it and the sugar level dropped below the normal level. The symptoms of low blood sugar level are dizziness, tremling, or sweating. If this happens, we advise the patients to eat something sweet, this brings back the sugar level to normal within an hour or so.
People who have been managing their sugar for a long time usually know when this happens and take whatever action their doctor has prescribed. However, it is always a good idea to check your sugar with the glucometer to have an exact idea of what you need to do.
Doctor Tariq, as you know, the current situation is quite stressful. The bad news is piling up. It is not just fear because of the pandemic but also the economic situation. As a practicing family physician, how do you think this pandemic is affecting your patients?
Dr. Tariq Nisar: You are right. The situation is challenging and stress and anxiety in such a situation are natural. However, it can go overboard leading to health issues. This is especially true for sugar patients. Diabetes, as you know, is stress-related. It is directly proportional to stress meaning the more anxiety you experience the worse get your sugar levels.
Yes, I have noticed disturbed sugar levels in my regular patients. Not just the diabetic patients but other patients are also showing disturbed sugar levels. The current situation is affecting them negatively.
What do you advise your patients about how they should respond to the uncertainty, fear, and stress because of the current situation?
Dr. Tariq Nisar: To begin with, you don’t need to constantly get the latest updates about covid-19 death tolls and cases. Stick to the once-a-day rule of keeping yourself informed. Your tuning into your news channel 24/7 wouldn’t change anything. It will just make your stress and sugar levels soar.
There are different stress management strategies that work for different people. Experiment and see what works for you. Pray, read, do gardening, cleaning, or any other activities that you love but never had the time to do. Above all, stay in touch with your family and friends via the internet and support each other. Exercise can also make you feel good and it is especially recommended to sugar patients in diabetes management.
However, there may be patients who can’t exercise too much because of some other health issues. For example, I am a diabetic and have unstable angina that makes it difficult for me to follow any exercise regimen. However, I try to follow a routine by visiting my clinic daily, counseling my patients, and taking care of my health in general by relaxation and a good diet.
What I want to convey is that you need to work around whatever situation you find yourself in and make the best of it.
If a diabetic person can’t seem to manage stress and is experiencing high blood sugar levels, should s/he increase the dose of medicine?
Dr. Tariq Nisar: No. Never self-medicate. If you feel you are unable to manage your sugar because of stress, you need to talk to your doctor. The doctor may prescribe some anti-anxiety medicine or may recommend some changes in your medicine dose. Any medicine or dietary changes should be discussed with your doctor.
We keep hearing about boosting your immunity to be able to fight diseases like Covid-19. Sugar patients, however, have to avoid many foods. What diet would you recommend to them for a healthy immune system?
Dr. Tariq Nisar: As for everyone else, for diabetics, a balanced diet is the key. There was a time when diabetics were asked to avoid root vegetables. But the research has shown, diabetes management has more to do with how you eat your food and less to do with what you eat. The calorie intake for a normal healthy person is 2000 plus, but for a diabetic patient, I suggest 1300 to 1500 calories. As a family physician, I don’t give a diet plan to my sugar patients as such and don’t completely forbid any food.
A healthy diet for sugar patients should include all types of fresh vegetables. They should also include fresh fruits in their diet. I suggest adding fruits like apples, guava, or citrus fruits to your diet in moderation. For example, one orange or one apple a day. There are certain fruits like mango, banana, and grapes that sugar patients should avoid or eat them occasionally.
Also, take starch and fats in moderation. One or one and half chapatti a day should be enough. And if you are fond of rice, you can have a quarter plate of rice once or twice a week.
I always advise my patients to change their overall dietary patterns and eat in moderation. And if you are in doubt about anything, consult your doctor and monitor your sugar regularly.
And yes, keep yourself busy and don’t obsess about things you cannot control.
Thank you, Dr. Tariq, for your time and advice.
Dr. Tariq Nisar: You are welcome.