IN the past, epidemics like plague and cholera were the greatest threats to the medical world. Today, we are living in the age of lifestyle diseases.
The modern world is faced with the danger of two silent killers. They can creep into anyone and stay unnoticed for a long time, causing slow, irreversible damages to the organs. I am talking about diabetes and hypertension: the two biggest medical challenges staring the modern world in the face.
These diseases hold very consequential problems for the society. If you take the expatriate population, the economic impact of the disease on them is huge. They have to spend on medication for life. Then there is stress. It works like a vicious loop, with stress inducing these diseases, and they in turn causing stress. But then, if one learns to live with it, he or she will be able to cope well, and keep these diseases under check.

Modern science is catching up though. Take for example diabetes. There are many new treatments that have come up in the recent times to tackle this disease, ranging from insulin pumps to pancreatic transplants.
However, none of these is a magic bullet solution for the disease. The patient has to maintain his health with proper diet and exercise. Without that no treatment can be effective. Once you get diabetes or hypertension, it’s more about learning to keep it under control. It’s not like a viral fever where you stay bedridden, take medication for a while, get cured and get back to your old life. In the case of lifestyle diseases, as the name itself hints, it’s all about changing your lifestyle.

Today, there is growing awareness among people on lifestyle diseases, and in the many medical camps I attend, it is very heartening to see youngsters lining up for random blood sugar tests. That’s the key to early treatment. If you can catch the disease at the outset or during the border stages, you can in fact reverse it with nothing more than diet control and exercise.
From thereon, follow up is the name of the game. It’s quite sad that patients don’t realize the importance of follow up.
Once patients find that diabetes is under control, they think they are normal. They just continue with whatever course of medication had been prescribed for them in the initial stage. That’s wrong. The disease condition can vary with time. If there is stress diabetes can shoot up. Or in some cases in can drop down. Accordingly, you may have to change treatment along the course. For this, you have to follow up, visit your doctor regularly, monitor glucose levels, take medical advice on diet and medication, and be prepared to make changes to your lifestyle.

Even mild changes to your lifestyle can make a big impact. Just walking for half an hour every day at least five days a week is good enough. This is good for anyone, irrespective of age. Going to gym and doing strenuous exercise may not be advisable for people with severe hypertension. It’s alright if you are mildly hypertensive. If you have hypertension or diabetes and you want to go to the gym or do strenuous exercise it is better that you take your doctor’s advice. More so, if you have heart problems.
Diet is also very important. However, the ideal diet varies from individual to individual. If you are hypertensive, you have to avoid certain types of food, and if you are diabetic you have to avoid certain other types of food. If you are diabetic, avoid anything sweet. People ask me about fruits. I advise them to avoid fruit juice, because it is in a concentrated form. So we advice diabetic patients to take just one fruit a day, avoiding mangoes, bananas and grapes, which are high in sugar content. Other than that you can eat any fruit, but only one a day. This is for diabetic patients.
For hypertensive patients, there is not much of restriction. They have to cut on salt. It would be advisable to avoid fried things. Cholesterol is another problem that could accompany diabetes or hypertension. So it’s better to avoid fatty food.
Some hypertensive people tend to avoid salt totally. That’s not advisable. Salt is necessary for our body. So, reduce salt by half of what you usually take. It’s good to avoid pickles and Pappads that are high in salt.


Dr Biji Basheer
Medical Director at German Medical Care