- What is diabetes and how can I be tested for it? …
- What health problems does it cause? …
- What types of diabetes am I at risk for? …
- How can diabetes be treated? …
- What can I do to help prevent diabetes? …
- How can I manage my diabetes better?
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मधुमेह Diabetes : MR Interview question (Medical Representative) in hindi
Beginning
GrainBrain: What type of diabetes do you have? Hanna Boëthius: I have Type 1 Diabetes.
GB: How long have you had diabetes? HB: I was diagnosed with diabetes at the age of 2, 29 years ago now.
GB: How did you manage, growing up? Did you hide your diabetes? HB: I had my moments. Up until the age of about 10, my parents had full control of the diabetes and me. That’s also when I learned how to do my own injections, which gave me a little more freedom. I can’t say I ever took pride in having diabetes before.
Being a teenager with T1D was difficult for me, I wanted nothing else than to be like “everybody else”, and I felt the diabetes hindered me in that. Starting at about age 16 I started hiding the diabetes more and more, at times even ignoring it.
It was a stupid move on my part, as it brought me to the ICU on the night of my high school graduation with a life-threatening DKA (diabetic ketoacidosis), but luckily I survived, thanks to the excellent health care staff around me. This complete roller coaster of taking care of myself vs not doing it continued a few years after that too, purely because I didn’t achieve the results I was promised and that I was working towards.
GB: Was it tough on your sibling, with you being the center of attention? HB: Oh yes, most definitely. What she actually feels about it, you’ll have to ask her, but I think she has found it very tough.
GB: What was hardest for you and your family — emotionally? Or financially? HB: A little bit of both, I think, but mainly emotionally. I’ve always been fortunate enough to have excellent health insurance.
I know my mother was terribly afraid of needles until my diagnosis, and then got over it because, well, she had to. And to get over something you’re afraid of is incredibly difficult. So it has affected my whole family in many, many ways.
Also having to deal with the doctors visits, the low blood sugars, the high ones, the inexplicable ones, the food, the insulin, exercise, hormones as well as other factors that influence the care of diabetes is life changing. And definitely not just for the patient, but also for the ones around them.
Treatment
GB: What treatment do you use to treat your diabetes? HB: Medically, I use insulin and check my blood sugars often.
GB: How often do you have to test your glucose levels? HB: It’s gotten a little easier with my newest acquirement of a CGM (continuous glucose monitor), but I still measure up to 10 times a day. Before that it was 7-12 times a day, depending on how I felt and what I was doing.
GB: Do you use an insulin pump or injections/pens? How often do you need to inject? HB: Since about a year, I use an insulin pump. Her name is Doris, and we’re a great team. But for the other 28 years I’ve used syringes first, and then insulin pens. So I know all about feeling like a human pin cushion!
The benefit with an insulin pump is that it injects small amounts of insulin every 5 minutes, giving the body a smoother supply of insulin, rather than injecting huge lump-dosages and hoping for the best.
The reason I changed was a lifestyle improvement, but also to cut down the margin of error of the big dosages I mentioned.
GB: What kind of insulin do you take? HB: I use NovoRapid in my insulin pump.
GB: What insulins have you had throughout your diabetic career? HB: Oh, I don’t think I can even remember them all! But a selection of them is: Humalog, Lantus, Levimir, Protaphan, Humulin, Actrapid…
GB: How well do you think you manage your diabetes? HB: I think I’m doing better now than ever before!
I take much less insulin and other medications now, my blood sugar is more stable and all my laboratory results and measurements are better than they ever have been.
GB: Can you recognize the symptoms of a low/high blood sugar? HB: Yes, most of the times I can.
GB: What symptoms do you get? HB: When I have a high blood sugar, I get sleepy, my brain feels like toffee, I’m lethargic and I can’t concentrate. Sometimes I’m insatiably thirsty as well.
When it’s low, I feel jittery, I might shake, I can’t see properly, and I can’t concentrate then either. But although that’s exactly what I need to do, I rarely feel hungry, that comes afterwards.
GB: How often? HB: It depends on what I’ve been doing. Stress, too little exercise and water, and too many carbs make it go up. And too much exercise and insulin makes it go down. It’s a careful balancing act.
GB: How do you treat a hypo? HB: I’ve learned to become more patient. Before I used to eat whatever I found, and too much of it, making my low blood glucose race up to be too high.
Now, I reduce my basal rate on my pump to -80% for ½-1 h and eat 4-8 carbohydrates in form of glucose tablets, depending on how low it is. Usually I’m back to my awesome self within 10-15 minutes.
The worst thing for me is waking up with a low blood sugar in the middle of the night and then falling asleep again, once I’m ok. Getting up the following morning is a real struggle. It’s (much) worse than waking up with a hangover!
Reaction to diagnosis (Table
Several people reacted with denial as they were diagnosed at an annual checkup and were not prepared, it was an unexpected diagnosis. Almost all individuals had no symptoms, which led to skepticism, and it took some time to accept the diagnosis. Some participants associated the diagnosis with guilt; a female interviewee talked about a huge amount of shame which led her to keep the diagnosis secret. Some individuals reacted with disappointment and grief.
The majority, however, reacted with acceptance. The information about the diabetes diagnosis was met with a neutral attitude and the interviewees did not think a lot about it.
For some it was a logical consequence of their previous living habits, while others explained the diagnosis as the normal process of aging or heredity.
Being diagnosed with diabetes changed the lives of the participants. Comparison with other people with diabetes was important, especially with those who had suffered from diabetes longer and needed treatment with insulin. It was important for several interviewees to dissociate from those people because they did not feel like them, nor did they want to become like them. They talked spontaneously about problems and complications other people with diabetes suffered from, such as fainting, becoming blind or dying early. Their lives were sad and complicated, for example, when traveling. In contrast, some interviewees talked about other persons who lived a good life and could take advantage of the diabetes diagnosis to receive free pedicure.
The relation to surrounding persons and their comments was very important. A common annoying notion was that the surrounding persons were interfering and had comments on how the interviewees should live their life. One interviewee expressed difficulties telling friends about the diagnosis. At the same time it was important to have someone to talk to, preferably other persons with diabetes, to share experiences and problems.
The therapeutic treatment, both the non-pharmacological and the pharmacological, changed the interviewees’ lives.
The non-pharmacological treatment consisted of dietary changes and physical activity. Concerning dietary changes there were a variety of experiences, for some difficult and a huge commitment, whereas the majority did not mention any great changes or problems. The challenge was changing a long-settled behavior, eating food you never liked and maintaining the changes over time. Personal responsibility was seen clearly by most interviewees. It could be an intense feeling of bad conscious or guilt towards society. Diabetes was caused by the interviewees’ overeating and now they burdened the society’s economy. Changing physical activity was also very difficult, even if personal responsibility was clearly felt. Some succeeded in long-term changes whereas the majority returned to old habits or did not manage to change their behavior at all.
Some succeeded in changing their behavior and kept the changes at least until the time of the interview whereas the majority returned sooner to old habits or did not manage to change their behavior at all.
The pharmacological treatment concerned oral medication and injection of insulin and the difference was huge for all interviewees. Oral medication was no problem for the majority, although some experienced skepticism or fear at the start. Overall, the need for drugs was accepted, especially by those already taking other medications; one more pill was no big deal. In contrast, need for insulin treatment in the future was seen as a huge threat, associated with prejudices and fear. The interviewees were afraid of injections and the possible consequences for daily life, such as hindrance for travel or performing favorite leisure-time activities. In any case, some of the interviewees concluded that if they had to comply they would manage and accept it.
The relationship to health care was one of the central parts in the new life of the patients. The most important expectations on health care were updated knowledge, continuity of care and not being left alone. The majority of interviewees showed trust in their GP or the specialized nurse and felt actively involved in treatment and pointed out the importance of this. The patients do the basic work and health care provides support and planning.
The importance of knowledge was experienced by all interviewees. Some participants were content and received the necessary information from the health care staff even though it was sometimes difficult to come into contact, especially with the GP. The majority, however, needed to obtain supplementary information about diabetes in different ways. Several consulted people in their family. There were different opinions about obtaining information from the internet, which was seen as very positive by some whereas others would never use the internet for information on diseases.
The participants related individually to the information obtained. Some individuals were hardly affected at all by the information. Others related the information very much to themselves, they felt pressure on them and used it to plan for individual changes such as weight reduction.
Things to look for in physical exam of diabetic patient:
FAQ
What are the 3 P’s of symptoms experienced by diabetics?
What is diabetes easy answer?
What are 4 ways to manage diabetes?
- Take your medicines for diabetes and any other health problems even when you feel good. …
- Check your feet every day for cuts, blisters, red spots, and swelling. …
- Brush your teeth and floss every day to keep your mouth, teeth, and gums healthy.
- Stop smoking. …
- Keep track of your blood sugar.
What are the 3 ways diabetes is diagnosed?
