By Dr. (BRIG. RETD)M.L.KATARIA
There was an alarming press report referring to the WHO some time ago that lifestyle ailments were likely to cost India more $2.5 billion in the coming couple of decades. What are these ailments and which age groups are vulnerable to them?
Here are some of the health-related questions often asked by senior citizens:
Question: I am 65 and a diabetic. What is the usual life-span for a diabetic and the recommended lifestyle?
Answer: With controlled blood sugar levels and a regulated lifestyle, I know diabetics at 85, 90 and above.
Q: What are the acceptable blood sugar levels?
A: The fasting blood sugar level should be around 100 mgm% and the post-paradial levels 11/2 to 2 hrs after prescribed meal should not exceed 140 mgs.
Q: How to maintain these blood sugar levels?
A: In a normal person insulin secreted by the pancreas, a massive gland in the abdomen, controls the blood sugar levels. There is an autonomous reciprocity between the quantum of carbohydrate diet ingested and the insulin secretion. A diabetic is an insulinaenic. Therefore, the pancreatic gland has to be flogged by drugs to produce more insulin to cope with the metabolism of carbohydrates to yield energy for the body.
Q: For general knowledge could you please mention some of these drugs?
A: There is a plethora of drugs in the market to control diabetes. Commonly used drugs are Metformis, Glybendamides, Gliclazids and Pyciglitazones prescribed singly or in combination, besides the injectable insulin. As over-dose may lead to fatal hypoglycaemia, these drugs should be used under medical advice.
Q: Can diabetes be controlled without drugs?
A: Yes, mild diabetics can maintain blood sugar levels with in normal limits by diet control and regular exercise. A low carbohydrate diet and exercise can reduce the drug dosage even in an advanced diabetic. Alcohol seems to worsen the blood sugar levels.
Q: In brief, what be a diabetic’s lifestyle?
A: Low carbohydrate diet, preferably vegetarian, with a lot of fibre, regular exercise, with minimum drug dosage and a monthly/quarterly blood sugar monitoring. A diabetic should have his own Glucometer.
Q: I am 70 plus, a case of high blood pressure, on Indral 25 mg. daily for the past 10 years. Many drugs for blood pressure have flooded the market. I am interested in knowing about them. Should I give up Indral and change over to any of the latest drugs?
A: All the drugs for BP belong to the basic groups of beta-blockers, calcium channel blockers, angiotensin, converting enzyme blockers, vasodialators, diuretics, etc. Multinational pharmaceutical companies have given them various names. These are used singly or in combination by doctors to control blood pressure. If Indral has so far kept your BP under control without any side-effect, it should not be changed.
Q: What are the formal limits of BP?
A: Blood Pressure is not the same during 24 hours. There are diurnal variations. As an average, it should be around 120/80 (mm of mercury) preferably 110/70, but not more than 140/90, at any time.
Q: What is the recommended lifestyle for a person with confirmed hypertension?
A: A low salt and fat diet, with regular exercise, normal limits of weight, a bi-annual check on lipidogram, renal function tests, an ECG and above all, a stress-free equanimity of any an easy-going mind.
Q: I am 80 and cannot enjoy dream-free sleep. I often wake up at 2 or 3 a.m. and have to take a half or full tablet of diazopan. What should be my lifestyle to enjoy dream-free sound sleep and no diazopan?
A: Most worldly-wise elderly persons have an anxiety neurosis due to domestic, financial, social and physical problems resulting in insomnia or sleeplessness. Enlarged prostrate, osteoporosis, multi-joint pains, high BP, muscular convulsions and many more must be isolated and treated. A lifestyle of gradual withdrawal and detachment from financial ambitions, social and domestic obligations should ease the mind. Diazopan is too strong a sedative. All sleeping pills, as a rule, should be avoided. They give addiction and have side-effects over the long run. If required, occasionally, Alprazoneles in fractional doses of 0.25 to 0.50 mmm may be taken for insomnia, but not as a regular habit.