The Puzzle of Wellness: Bilal's Four-Piece Approach to Diabetes

Managing most diseases involves four equally crucial components. In the case of diabetes, these four aspects are not only equally important but also have an interconnected influence on each other. Many patients often focus primarily on one aspect – medicines. However, it's crucial to understand that for effective diabetes management, equal attention must be given to the other three modalities: diet, exercise, and adherence to medicines and the doctor's prescriptions.

Let me share a story that highlights the importance of balancing these four components in managing diabetes:
Once upon a time, in a small town, lived a cheerful man named Bilal who loved sweets and never thought much about his health. One day, during a routine checkup, the doctor shared some news that changed Bilal's life – like his father, he had diabetes.

Faced with this news, Bilal was determined to take charge of his health. The doctor prescribed medications to manage his blood sugar levels, but the doctor also emphasised the importance of a balanced approach.

The first modality was diet. Bilal got the diet plan from his doctor that was not only diabetes-friendly but also tasty and full of nutrition. Bilal learned to make smart food choices, keeping his sugar levels in check while still enjoying his meals. Portion size and meal and snacks distribution, he understood. He also quitted smoking.
The second modality was exercise. Bilal was initially not a fan of exercise, but he soon discovered activities he enjoyed, like brisk walks in the park and gardening. Regular exercise not only helped him maintain a healthy weight but also improved his overall well-being.

The third modality was adherence to medicines. Bilal understood that taking his prescribed medications on time was crucial. He set reminders, organised his pills, and never missed a dose. This helped him keep his blood sugar levels stable.

The fourth modality was following the doctor's advice. Bilal realised that regular checkups were essential and never stopped or changed his medicines of his own. The doctor monitored his progress, adjusted his medications when needed, and provided valuable guidance.

As time passed, Bilal embraced this holistic approach to managing diabetes. He found a balance between his medications, a healthy diet, regular exercise, and following his doctor's recommendations. His blood sugar levels stabilised, and he felt more energetic and in control of his life.

Bilal, in his commitment to managing diabetes comprehensively, took crucial steps to prevent complications that could affect his organs. He paid extra attention to his vital organs. Regular checkups helped monitor his kidney function. He ensured he stayed well-hydrated, a simple yet effective way to support kidney health. By managing his blood sugar levels diligently, he significantly reduced the risk of diabetic nephropathy.

Bilal was aware of the importance of foot care for diabetics. He checked his feet daily for any signs of numbness, ulcers, or infections.
Understanding the potential impact of diabetes on the eyes, Bilal prioritised regular eye checkups. He was mindful of any changes in his vision and promptly addressed them.

Diabetes poses a higher risk of cardiovascular issues. Bilal incorporated heart-healthy habits into his lifestyle. This included a balanced diet low in saturated fats, regular exercise to support cardiovascular fitness, and adherence to medications that not only controlled blood sugar but also contributed to heart health. Regular cardiovascular checkups allowed for early detection and intervention if needed.

Bilal recognized the link between diabetes and mental health. Stress and depression can impact overall well-being and exacerbate diabetes symptoms. He adopted stress management techniques like meditation, engaged in activities he enjoyed, and surrounded himself with a strong support system.

Bilal's story teaches us that managing diabetes is like a puzzle with four essential pieces. Each piece is equally important, and when they come together, they create a complete picture of good health. By taking these preventive measures, Bilal not only managed his diabetes but also safeguarded his organs from potential complications. So, if you or someone you know is dealing with diabetes, remember – it's not just about the medicines; it's about adopting a balanced lifestyle with diet, exercise, and doctor's guidance.

Dr Zubair Saleem is a Senior Geriatric Consultant and Gerontologist